Attention to the first Covid-19 vaccines – Pfizer, Moderna and AstraZeneca – has focused on the numbers, in turn 90% effective, 95% and 70%. But when it comes to impact and returning society to something more like ‘normality’, the level of effectiveness isn’t the key issue.
There’s no doubt that the pandemic continues to be a war, and as Eisenhower famously said, “wars have been won or lost primarily because of logistics.”
Delivering mass vaccination at the scale needed will be one of the biggest logistical challenges we have faced this century. So the real ‘competition’ between vaccines, how useful and effective they are, will all be founded on the the operation of supply chains. At 70%, the AstraZeneca/University of Oxford vaccine is still more effective than the traditional flu vaccine the UK has depended on for many years (at 40-60%).
The Pfizer vaccine may appear to have won the race to be ‘first to market’, with stocks expected to be available in large quantities from next month. The critical factor is not the time needed to reach the market, but the time involved in supplying the volumes required to meet the needs of a society – and a comparison of the basic realities of the supply chains involved tells a different story. The Pfizer vaccine demands more equipment and materials, the freezers and boxes capable of keeping vaccine supplies at -70°C as they travel into and around the UK. The traditional infrastructure for transporting frozen goods is based around temperatures of -20°C to -50°C: meaning specialist freezer transport. The Moderna vaccine will rely on conventional frozen goods transportation. By contrast the AstraZeneca vaccine can be stored in a standard fridge, critically making mass scale supplies and the vaccination process itself far more straightforward.
We must not forget that the overall impact of any vaccine on the UK population depends on supply chain strategy and how it’s rolled out in practice: from the overall process design; and infrastructure (what warehouses are available, what other equipment is needed to be manufactured, like the freezer boxes, the syringes, the PPE for healthcare workers); to the information systems to monitor and manage flows and geographical distribution of stocks; as well as having the organisations, people and skills available to handle administering the vaccine.
UK supply chains are more than up to the challenge – particularly in the light of the new AstraZeneca news. As the pandemic has demonstrated so vividly, we’re in an age of highly flexible logistics and systems can innovate and adapt at lightning speeds. What happened when an entire population was asked to stay at home? A supermarket like Tesco was able to recruit 45,000 new staff to deliver on the new model in two weeks. In the wake of early chaos, a body like the Chartered Institute of Logistics and Transport stepped in to organise a database matching transport resources and needs.
With this bigger picture in mind, governments and health professionals need to seek out and listen to not just pharmaceutical supply chain experts but also those used to releasing products at great speed in FMCG and technology. An efficient, effective programme of defence against Covid-19 is well within reach – but it’s critical that debate and decision-making around vaccines is carried out in the context of logistics.
Announcement on 2nd December 2020: after U.K. approval of Pfizer vaccine, manufacturers provided further details of the supply chain and logistical constraints during a press conference, these are summarised as:
- Doses destined for U.K. manufactured in Belgium.
- Bespoke Vaccine freezer box can store between 1000 and 5000 doses.
- Pre-packed boxes are transported to vaccine centres.
- GPS trackers and thermo-sensors relay temperature data ensuring safe delivery.
- At vaccinations centres, the vaccines can be stored in delivery boxes and regular fridges.
- There are 1500 immunisation centres in England now prepared to receive the vaccine vials.7)
- Each vial of vaccine contains 5 doses after dilution
- Diluted vials need to be used within 6 hours. (dilution with saline)
- Administration to vaccineers at room temperature.
- Storage in delivery box and regular fridge at vaccination centres for 20 days. (Up to 15 days with re-icing every 5 days (pack can be opened twice per day) then up to 5 days in regular fridge 2-8C.)
- Transport of defrosted vials at 2-8C possible for up to 6 hours.
- Storage of -70C only necessary for long term storage i.e. months.
In addition, at the U.K. Government briefing on the 2nd December, Sir Simon Stevens Chief Executive of the NHS stated that currently batches of 975 vaccines have been authorised by MHRA (Medicines and Healthcare Products Regulatory Agency) to be moved. Approval for „a safe way of splitting packs of 975 doses” is being sought enabling the vaccine to be distributed to smaller locations such as care homes.
Update 6th December 2020 – Dr June Reine, MHRA has announced on BBC Andrew Marr Show (6th December 2020):
„We have approved how the vaccine can be put into the smaller packs, but obviously what we’re doing is giving advice on how well, carefully, that is done”
This important approval means that there is now an approved method, although challenging, of splitting batches. Therefore smaller locations i.e. those without the requirement for 975 doses can receive and administer the vaccine under MHRA approved conditions.
Discussion Points:
1. Which of these knowledge insights are challenging and inspiring to you?
2. Which learnings from the past discussed in this action insight have future implications?
3. What action could be taken from utilising this knowledge by you personally or by an organisation to create value.
Article originally hosted on richardwilding.info
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