Cold chain challenges dampen India’s hopes of paving the way for the Pfizer vaccine

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Amidst the frenzied race towards ending the pandemic, the Pfizer vaccine that is in talks of completion has injected more doubts than relief into the minds of leading experts who believe that the “milestone” vaccine candidate with 90 per cent effectiveness against COVID-19 will be anything but plausible for logistics to cope with. We look at why the much-hailed Pfizer vaccine has mounting obstacles on the path to fruition in Indian soil, and also for other countries.

In the run-up to the race for an effective vaccine against the novel coronavirus at break-neck speed, the much-talked about Pfizer vaccine has made headlines for being the first company to release preliminary data that confirms how their shot worked in late-stage clinical trials.

Pfizer and its German partner BioNTech announced how their experimental vaccine was more than 90% effective in preventing COVID-19 based on initial data from Phase III Trials. The analysis was based on the evaluation of 94 Covid-19 infections among the trial’s 43,538 participants.

However, the vaccine has presented more doubts than hopes in terms of the logistical challenges that it demands, for sure shot efficacy.

After reaching vaccination centers, the vaccine shots must be thawed from -70 degrees celsius and injected within five days, or else they go bad.

The tedious process will have to be undertaken again to deliver the second booster shot a month later.

The vaccine now reveals a picture of daunting logistical challenges faced by those looking to deploy it after it exhibited convincing early results from final stage trials, increasing hopes of a potential end to the pandemic.

The hype and speculation surrounding the vaccine is now being watered down by the realisation that no currently used vaccine has ever been made from the mRNA technology used in Pfizer’s shot, which directs the human body to produce proteins that further leads to the production of antibodies.

The only plausible solution is that countries will start rebuilding deep-freeze production, storage and transportation networks from scratch that will maintain the potency of the vaccine.

The massive investment and coordination that will follow in a bid to pull it off has given rise to fears that only rich nations will be able to access it, despite a WHO-backed effort called Covax that aims to raise $18 billion to purchase vaccines for poorer countries.

Japan, the U.S. and the U.K. figure amidst the countries that have pre-ordered doses.

Vickram Srivastava, Head of Planning- Supply Chain Management, Ipca Laboratories believes that the Pfizer vaccine poses challenges to not just the cold chain setup of India, but of Western countries as well.

“It is still in speculation right now. We do not know the real requirement of the vaccine. -70°C will not be commercially viable anywhere in the world (not just India). As per my understanding of the infrastructure and cold chain setup, even the West cannot handle this.

~Vickram Srivastava, Head of Planning- Supply Chain Management, Ipca Laboratories

Subzero temperature may lead to spoilage

Health officials believe that the requirement for extremely cold temperatures is likely to cause spoilage of a lot of vaccine.

In addition to that, the price tag will also prove to be unrealistic for many developing nations, including India that has struggled to contain the world’s second-largest coronavirus outbreak and currently has no agreement to purchase the Pfizer vaccine.

Not suitable for India

Officials in the country’s public health and the pharmaceutical industry have already voiced concerns on how India is not prepared in terms of capacity as well as ability to deliver a vaccine across to its vast population of over 1.3 billion people at the expected speed.

Dr Randeep Guleria, Director, AIIMS said that the data released by the company is very encouraging but it should be looked very carefully.“The challenge with the Pfizer vaccine is that the vaccine should be kept at a very low temperature which is not practical for rural parts of the country and tough to maintain the cold chain”, he said.

Last mile constraints

Ensuring distribution of any vaccine within a short span of time will anyway pose a lot of problems for the country, especially in far-flung areas and rural regions.

Public health experts while alluding to past vaccination campaigns also shared how some people do not show up for the second shot.

However, Mr Srivastava feels that the challenge for achieving unhindered last-mile delivery should be looked at as an opportunity, as the troubled times mandate that the necessity will be here for a couple of years.

“It will be a challenge, especially last-mile delivery, but a definite opportunity as this requirement is expected to be there for a few years (a minimum of 3-5 years or even more)”, he says.

“So, any investment from service providers will have enough demand to make the ROI look promising and that will encourage players to innovate and invest”, he adds.

When asked if the government would look to buy any of the Pfizer vaccine, Rajesh Bhushan, the Secretary at the Health Ministry, declined to release any purchase details immediately but said that that India was in a position to “augment and strengthen” its existing cold-chain capacity and that New Delhi was in talks with all vaccine manufacturers.

After the release of the positive preliminary data, some governments have rushed to finalise orders and start negotiations with Pfizer and BioNTech.

The entire situation has boiled down to a dilemma in the form of a choice between two pertinent decisions: to pay for the expensive construction of subzero cold-chain infrastructure for a vaccine that promises efficacy, or to wait for a protein-based vaccine that promises similar results and can be delivered through existing health-care networks.

The rising obstacles would only signify that despite early signs of the Pfizer vaccine’s exceptional efficacy, developing countries are likely to give it a pass.

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