The Efficient Transportation of Vaccines: In the Hands of the New Cold Chain

The logistics in the supply chain of medical supplies has always had unique demands that make it quite a challenge.

In other words, it was complex before and, thanks to the pandemic, domestic supply chains all over the world are hard pressed to efficiently manage the distribution of the newest COVID-19 vaccines.

The rise in supplies means that the parties involved in the chain must adapt to the new distribution needs and strategies, which implies taking advantage of the newest advances in the cold chain equipment’s technology to increase efficiency.

Why? Because any variation in temperature or humidity throughout the cold chain may render vaccines ineffectual.

In fact, according to IQVIA’s Human Data Science, the biopharmaceutical industry loses approximately US$35 billion a year from failures in temperature-controlled logistics.

It is estimated that 20% of temperature sensitive products are damaged because the cold chain is interrupted during transport.

According to research carried out by the World Economic Forum, over 50% of vaccines are wasted every year throughout the world due to issues related to temperature control, logistics, and shipping.

Currently, no one wants to hear that a thousand of vaccines in a lot cannot be used because a freezer went down, for example. We cannot waste a single shot! So, we must plan in depth how we are going to store, transport, and administer vaccines; and those doing the planning must be fully aware of the challenges. Things go wrong, compressors break down, so we need to have spare parts available as well as know how to repair the units and how long can we take to fix things.

Usually, we can solve this issue by overstocking but, with the high demand for COVID vaccines, every lost or damaged dose hurts deeply. Protecting the usefulness rate of the vaccines depends on monitoring and on the transition to the last mile.

Clearly, this pressure to perform better is pushing the limits of what we can and cannot do. Meanwhile, it is currently a priority and a key element of WHO’s Global Vaccine Action Plan (GVAP).

Together with PATH, WHO has developed the Project Optimize to find new ways to optimize the immunization supply chains to serve an increasingly larger and costly portfolio of vaccines aiming to give the immunization industry stronger, more flexible, and more efficient logistics systems.

According to Who itself, “successful immunization programs are built on functional, end-to-end supply chain and logistics systems. The role of the supply chain is to ensure effective vaccine storage, handling, and stock management; rigorous temperature control in the cold chain; and maintenance of adequate logistics management information systems.”[1]

CTC, the new Cold Chain

Therefore, we are currently evolving beyond the traditional cold chain, which helps keep products like temperature-controlled vaccines in the proper conditions throughout the supply chain, from purchasing to transportation and distribution.

The innovative approach for handling vaccines of the “controlled temperature chain, (CTC)” allows us to keep vaccines at temperatures outside the traditional cold chain that goes from 2 ° C to 8 ° C during a limited time and under controlled and monitored conditions.

We are talking about chains that usually imply a single excursion of the vaccine to room temperature not exceeding 40 ° C for a specific number of days before being administered.

The WHO set criteria for vaccines to be labeled and used in a CTC:

It must be used in a special strategy or campaign (not recommended for routine immunization).

It must tolerate room temperatures of at least 40 ° C for at least three days and it must be accompanied by:
- A Vaccine Vial Monitor (VVM) for every vial
- An Indicator of Maximum Threshold for every vaccine carrier.
- Its use in a CTC must be authorized by the corresponding regulatory agencies and bear a label specifying the conditions.
To ensure an uninterrupted availability of quality vaccines, from the manufacturer to the last stages of service, and to avoid missing any opportunity for vaccination, a supply chain management system is required so we can procure the right product in the right amount and conditions and at the right time and cost. This is the size of the new challenge players in this industry are now facing.