cbsnews.com 
<https://www.cbsnews.com/news/covid-vaccine-pfizer-distribution-logistical-nightmare/>
  


Pfizer's COVID-19 vaccine distribution will be a "logistical nightmare"


Stephen Gandel

8-10 minutes

  _____  

November 17, 2020 / 7:49 AM / MoneyWatch 

Moderna says COVID-19 vaccine nearly 95% effective 

Moderna says COVID-19 vaccine nearly 95% effe... 03:57  
<https://www.cbsnews.com/video/moderna-early-data-shows-coronavirus-vaccine-is-nearly-95-effective/>
 

The long wait for a vaccine that could eventually spell the end of the 
coronavirus pandemic <https://www.cbsnews.com/feature/coronavirus/>  appears to 
be on the horizon. Last week, Pfizer said its vaccine in a trial has been 90% 
effective in preventing COVID-19 
<https://www.cbsnews.com/news/pfizer-covid-vaccine-effective-data/> , while 
Moderna on Monday announced similarly encouraging results 
<https://www.cbsnews.com/news/covid-vaccine-moderna-effective-trial/> . The 
companies could get emergency federal approval within weeks. Yet it will only 
be after the drugmakers ship millions of doses around the world that the real 
time crunch on the vaccination effort begins.

Pfizer's vaccine must be kept at nearly minus 100 degrees Fahrenheit to remain 
effective. That's about 20 degrees colder than extreme winter temperatures at 
the South Pole. Early on, experts warned that the U.S. lacked the necessary 
ultra-cold storage trucks and cargo planes needed to ship hundreds of millions 
of doses at sub-sub-zero temperatures.

In order to get around that, Pfizer has developed specially built deep-freeze 
"suitcases" that can be tightly sealed and shipped even in non-refrigerated 
trucks. But while Pfizer may have solved the problem of how to ship the frozen 
vaccine, these highly engineered shipping containers create other problems, 
particularly for the hospitals, pharmacies and outpatient clinics that will 
have to administer the vaccinations to hundreds of millions of Americans.

"The reality is there has never been been a drug that required storage at this 
temperature," said Soumi Saha, a pharmacist and director of advocacy at 
Premier, which acts as a purchasing agent for hospitals across the country. 
"The administration and distribution effort will require an all hands on deck."

Military faces challenges with distribution o... 01:41  
<https://www.cbsnews.com/video/military-faces-challenges-with-mass-distribution-of-covid-19-vaccine/>
 

Among the many logistical and medical challenges that experts say will have to 
be overcome when vaccines are ready to roll:

*       Pfizer's shipping boxes, packed with specially formulated dry ice and 
containing between 1,000 and 5,000 vaccine doses each, can only be opened twice 
a day for less than three minutes at a time while maintaining temperature 
standards.
*       Even so, the deep-freeze suitcases only hold their cool for 10 days. 
And the clock starts ticking when they are sealed, which for U.S. shipments 
will be at one of two Pfizer facilities, in either Kalamazoo, Michigan, or 
Pleasant Prairie, Wisconsin. 
*       Dry ice is considered a hazardous material and restricted on airplanes. 
Pfizer said its packages contain well under the acceptable limit. But given the 
logistical challenges, Premier's Saha told CBS MoneyWatch that it could take up 
to four days for the vaccines to reach their destination. That gives many 
hospitals and pharmacies as few as just six days to administer up to 5,000 
doses before they go bad, or as many as 833 a day. The vaccinations can be 
moved to a typical refrigerator, but for only five days.

*       Pfizer's shipping container can be refilled with dry ice. But it likely 
will have to be in pellets not blocks, and a refill, which could cost a few 
hundred dollars, will only extend the life of deep-freeze suitcase by five days.
*       Hospitals can buy ultra-cold freezers, which will keep the vaccinations 
up to six months. But few hospitals or pharmacies have the specialty freezers, 
which can cost as much as $20,000 each, and are in short-supply. Manufacturer 
K2 told CBS MoneyWatch the wait for its ultra-cold freezers is now six weeks.
*       Pfizer's vaccination requires two doses 21 days apart, making it more 
complicated to deliver the required number of treatments with doses going to 
waste. 

Moderna's vaccine also must be shipped frozen, although at comparatively less 
frigid -4 degrees Fahrenheit. Still, that will require the company to secure 
hundreds of refrigerated trucks, while the vaccine can only be kept in a 
standard refrigerator for up to seven days.

Pfizer has designed a specialty box that can hold 1,000 doses of its COVID-19 
vaccine at nearly 100 degrees below zero for up to 10 days. Pfizer 

Pfizer declined to offer specifics about the plan to distribute its vaccine. 
While the government is technically in charge of the overall vaccination 
effort, the company has opted to distribute its own vaccine. Pfizer has 
received $1.95 billion from the Operation Warp Speed to manufacture and 
distribute the first 100 million doses. The government will remain responsible 
for distributing syringes and other medical supplies needed for the vaccination 
effort.

In a statement to CBS MoneyWatch, a spokesperson for Pfizer said the 
pharmaceutical giant has "developed detailed logistical plans and tools to 
support effective vaccine transport, storage and continuous temperature 
monitoring."

Emily Gerbers, director of business development at MDLogistics, which 
specializes in cold-storage supply chains, said that it's not just vaccines 
that have to be shipped, but also COVID-19 treatments and antibodies. The 
pandemic supply chain has been growing and adapting, but it's been hard for 
companies like hers to keep up with demand, she said.

"We are talking to people every day looking for solutions," Gerbers said. 
"There is so much need for COVID services. You can't build it fast enough."

Another possibility is for vaccines to be stored in centralized deep-freeze 
warehouses before being moved to hospitals. But real estate brokerage firm JLL 
said cold-storage facilities make up less than 2% of the overall logistics 
warehouse market, and that until recently there has been very little investment 
in the market, making available space a problem. The vacancy rate for existing 
cold storage facilities is less than 5%. 

"The pandemic threw demand way out of supply for the cold supply network," said 
Mehtab Randhawa, a researcher at JLL. "Pfizer's vaccine requires a very 
specific cold storage requirement that might not align with what is out there."

COVID-19 cases surge: The latest perspective 03:31  
<https://www.cbsnews.com/video/covid-19-cases-surge-a-look-at-the-rise-of-cases-upcoming-holidays-and-vaccines/>
 

Premier's Saha said that hospitals still lack some basic information from 
Pfizer about the shipping container, such as its exact dimensions. Hospitals 
have also not yet been notified if they will serve as distribution points. Many 
are waiting for such notice before deciding on whether to invest in ultra-cold 
freezers or staff up for mass vaccinations.

Saha said many university hospitals do have ultra-cold freezers, but they 
typically are in their laboratories and would require permission from local 
health inspectors to be repurposed for vaccine storage. And while the 
government has said it will cover the costs of the vaccine, it's not clear if 
hospitals and other providers will be reimbursed for the extra costs needed to 
store and quickly distribute the vaccines. 

Already struggling rural hospitals might not have the funds to afford the extra 
costs 
<https://www.statnews.com/2020/11/11/rural-hospitals-cant-afford-freezers-to-store-pfizer-covid19-vaccine/>
 , or serve large enough populations to make distributing 1,000 doses in a week 
to 10 days feasible, especially in the first phase of the vaccination effort 
when not everyone will be eligible.

"It's a logistical nightmare for rural communities," Saha said. "But no one is 
immune to the challenges distributing the vaccine poses for the medical 
industry."

Vaccine trials  
<https://www.cbsnews.com/video/pfizer-moderna-coronavirus-vaccine-trials-give-us-hope-as-covid-19-cases-rise-doctor-says/>
 "give us hope," doctor says 03:07 

 

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