The country’s COVID fatigue is beginning to show as we enter the ninth month of media-fueled fear, lockdowns, curfews and serious attempts to shut down Thanksgiving. Although there might be a few turkeys out there happy for a reprieve this season, the attempt to disrupt the beloved family holiday to “keep people safe” has not been well received. Like the Toms dropped out of a helicopter in that famous scene from WKRP in Cincinnati this turkey may be flying, but not for long. Oh! The humanity!
Good news from an unprecedented effort
While the country awaits the certifiable returns of the election, riveting results have started coming in from the President’s $10 billion vaccine creation initiative, Operation Warp Speed. The two top vaccine candidates Moderna and Pfizer, both reported superior efficacy rates ~95% in late stage clinical trials. Approval will likely follow very soon.
Both Pfizer and Moderna use the same genetically engineered vaccine approach, which involves RNA molecules. Assuming FDA authorizes the vaccines for “emergency use,” the companies will ramp up production and distribution of hundreds of millions of doses as fast as they can. These vaccines will not deliver themselves; enter America’s truckers.
On November 18, A panel of Operation Warp Speed (OWS) officials met in Washington, D.C. to update reporters on the vaccine and the government’s intended distribution plan. Army Gen. Gustave F. Perna, chief operations officer for OWS; Health and Human Services Secretary Alex M. Azar II and Dr. Moncef Slaoui, chief advisor for OWS, delivered remarks covering how government agencies and private companies intend to distribute vaccines efficiently and fairly, but first to the most vulnerable.
"We've worked closely with these manufacturers to ensure that they have what they need in the way of raw materials with Operation Warp Speed, applying the same skills and that keep the U.S. military supply to ensure that there are no delays in vaccine production," Secretary Azar said.
Kalamazoo Michigan center of the vaccine universe
Pfizer expects to produce up to 50 million doses in 2020 and projects as much 1.3 billion doses in 2021. Moderna, intends to manufacture about 20 million doses in 2020 and another 500 million to 1 billion in 2021.
Wall Street Journal report Pfizer’s effort to deliver vaccines globally will revolve around two central refrigerated final assembly storage and staging sites at two of the company’s centers—Kalamazoo and the other in Belgium. Pfizer says it’s going to be relying hundreds of air and ground shipments to key distribution centers in Pleasant Prairie, Wisconsin and in Germany now outfitted to handle extra capacity.
According to Moderna it will manufacture its vaccine in New Hampshire, Pennsylvania and Indiana. The company intends to ship vials to McKesson Corporation’s distribution center in Irving, Texas, the location of most of the OWS vaccination initiative. Moderna intends to distribute via the government funded OWS program, while Pfizer, supported by OWS in other ways, will rely more on its own operational resources to get the job done.
Cold chain in a box
To get its vaccines safely and reliably to patients and maintain potency, vaccines need to arrive at hospitals and clinics frozen. To accomplish this Pfizer created its own high-tech, low tech solution: A temperature-controlled container that can store between 1,000 and 5,000 doses for 10 days at minus 70 degrees Celsius before requiring re-icing.
To keep the vaccines safe in transit and to move them fast, the Wall Street Journal says the suitcase-sized boxes, are packed with dry ice and tracked by GPS, which will enable Pfizer to avoid the temperature-controlled containers generally used now, giving the company more flexibility to ship the vaccines faster because trucks and other modes won’t have to wait for standard refrigerated metal boxes. Pfizer expects to load those boxes on 24 trucks a day from Kalamazoo to move roughly 7.6 million doses daily to airports from both sites.
Working the cold-chain gang
Multiple steps are needed to deliver vaccines reliably. Moderna’s vaccine has to be shipped at -20o C (-4o F), after that it can be stored at that temperature for six months. Once thawed and kept in a refrigerator between 2 and 8o degrees C (36 – 46o F) for as long as 30 days. Pfizer’s vaccine must be kept at -70o C (-94o F)—a much greater challenge. Once transferred to a refrigerator, it has to be administered within five days.
Known as the “cold chain,” Scientific American asked Julie Swann, a professor of industrial systems engineering at North Carolina State University, about what cold chain in the context of vaccine distribution means. Swann, who specializes in healthcare supply chains, has experience that predates main-stream media fear mongering and politically-driven social health policies, as one of the government officials guiding the country’s emergency response to the swine flu pandemic in 2009.
CDC has a playbook that offers guidance for what you can and can’t do with e type A or Type B vaccines. According to the CDC, once a facility receives a shipment -- like one from Pfizer, it has to replace the ice within 24 hours, and every five days after that. Dispensers can only open these boxes once or twice a day. Within 15 days from product manufacture, they must be transferred to refrigerated storage at specified temperatures and then used within five days.
Trucking and intermodal poised to get the job done
Although there are few fears circulating out there that because domestic travel has been curtailed, there might not be enough air freight capacity and cause a pinch. With reports from all major carriers, as well as the major financial and social implications, most analysts are dismissing those fears because air shippers have plenty of capacity. FedEx, USPS, DHL all are positioning their capacity and organizations as ready to rock.
Trucking ready too
Although there was some tut-tutting about air freight capacity and capabilities nobody seemed to share any similar sentiment on the ground side. The whole world is waiting for this supply chain to kick into gear and trucking has got this. Ground shippers are going to be busy, but this is a job trucks were built for. Ever since ever since the first vaccine was approved for flu around 1947, truckers have been an essential link in the logistics chain for vaccine distribution. With advent of an effective Covid-19 vaccine coming online very soon, hopefully the world will start to breathe again.