MIAMI – Air cargo has been pivotal in the global battle against COVID-19, delivering essential equipment and medicine to those who have needed them most. As firms, Pfizer and BioNTech announced its experimental COVID-19 vaccine is 90% effective, how soon a COVID-19 Vaccine is delivered and administered directly correlates to how many lives are saved.

On November 9, Dr. Albert Bourla, Pfizer Chairman and CEO said, “Today is a great day for science and humanity. The first set of results from our Phase 3 COVID-19 vaccine trial provides the initial evidence of our vaccine’s ability to prevent COVID-19.”

“We are reaching this critical milestone in our vaccine development program at a time when the world needs it most with infection rates setting new records, hospitals nearing over-capacity, and economies struggling to reopen. With today’s news, we are a significant step closer to providing people around the world with a much-needed breakthrough to help bring an end to this global health crisis.” 

Pfizer is now gearing up to quickly distribute the coronavirus vaccine once the Food and Drug Administration grants emergency approval. However, according to Supply Chain Dive, the vaccine distribution will be limited at first. Bourla makes this clear when he says that if the company were able to produce 30 million doses in 2020, that would only be enough for 15 million people. Still, the news from Pfizer and BioNTech is a turning point for the pandemic. The challenge is now to deliver the vaccine in a timely manner.

Photo: Daniel Sander/Airways

Getting the Vaccine Ready for Delivery

Pfizer and BioNTech expect the delivery of their COVID-19 vaccine to require about 12 trucks a day leaving Pfizer’s formulation and filling facility in Kalamazoo, Michigan, and 20 planes flying around the world every day, Pfizer told Supply Chain Dive in an email. First, however, the vaccine must be approved, if not authorized first, for distribution.

The company reported that there were “no other big logistics supply chain partners outside,” but DHL, FedEx, and UPS are collaborating on delivery plans in the US. “We will be using road and air modes of transport via our main carrier partners in the U.S. where we hope to be able to deliver the product to point of use (POU) within a day or two,” a Pfizer spokesperson told supply chain news outlet.

In the meantime, around 200 drug companies are currently working around the clock to produce, test, and have ready a COVID-19 vaccine. But developing them is just half the problem. Last month, more than 40 vaccine candidates were already undergoing clinical trials, according to the World Health Organization (WHO).

In a staff note, Delta Air Lines’s (DL) CEO Ed Bastian wrote that “while developing a vaccine is an important step, widespread distribution will take many months. We continue to expect 2021 will be a year with continued challenges.” In other words, when the necessary research protocols have been passed for the vaccines, it will be a logistical challenge on an unprecedented scale to deliver them internationally.

Photo: Brandon Farris/Airways

Vaccine Approval vs Authorization

A medical emergency such as the pandemic allows for multiple vaccine manufacturers to show any promising results for their vaccine candidates and to aggressively prepare for large-scale production before even mapping their full effectiveness. The rush is but a preparation to get manufacturing units in place and process large volumes of the winning COVID-19 candidate vaccine.

An unprecedented crisis calls for unprecedented measures. While a vaccine takes years before its approval, by the end of November, Pfizer and BioNTech could have the data needed to apply for emergency authorization to put the vaccine to use. The US and the UK have both said that vaccinations could start in December, and EU countries have been told it will be distributed quickly.

And that is the key issue: distribution. “If 50 million doses were available today, could we distribute them?” asks Glyn Hughes in a Wall Street Journal report. He is head of cargo at the International Air Transport Association (IATA). “The answer is almost certainly ‘No’, for every jurisdiction.” How then, is the air cargo industry preparing for the daunting task ahead?

The Logistics of Transporting the Vaccine

Air cargo logistics experts say it will take anywhere from 8,000 to 15,000 fully loaded jumbo flights to carry 20 billion doses around the world. Additionally, Accenture’s Seabury Consulting estimates the global roll-out of a vaccine will generate 65,000 tons of air freight, which is five times the air vaccine trade from 2019. Although air transport is often the preferred method for shipping pharmaceuticals because of time sensitivity, it is likely that large ocean transport companies will take on some of the load.

Regardless, significant quantities of pharmaceutical and life science items are transported vía air freight. According to IATA, these total 1.9% of the amount of air cargo and contribute 2.6% to the overall revenue for the sector, around US$2.5bn annually. but for 20 million doses, James Jordan, a senior associate at law firm HFW’s Asia aerospace and insurance practices, says that “the scale of the operation is such that [air cargo] will need to utilize the aircraft from not just your primary airlines but the second and third-tier airlines as well.”

Furthermore, Julian Sutch, head of Emirates SkyCargo’s pharmaceutical division, estimated recently that a single Boeing 777 freighter can carry 1 million individual doses of a vaccine. On his part, Neel Jones Shah said last month via a Bloomberg report that the rollout is “an iPhone 12 launch on steroids.” Shah is the global head of air carrier relationships at San Francisco-based freight forwarder Flexport and a Tiaca director. “I would still say that the confidence in our state of readiness is maybe a 6.5 out of 10.”

Another issue is whether the temperature-controlled supply chain will store, treat, and transport the dramatic increase in volume involved in the rollout of the COVID-19 vaccine. Air cargo companies must follow EU Good Distribution Practices, the standards of the US Federal Drug Administration, and those from IATA’s Temperature Control Regulations (TCR) for the handling of temperature-controlled sensitive products.

Photo: Luca Flores/Airways

The Temperature-controlled Supply Chain

Due to the scale of such a massive undertaking, logistics stakeholders need to configure deliveries with details on vaccine stability in mind when transporting them. According to Logistics Update Africa, there are currently various types of vaccines being studied and their variations are mostly due to their stability. Gene-based vaccines, including DNA, RNA, and mRNA, require different storage conditions compared to spike protein vaccines.

Between genetically engineered DNA and mRNA vaccines, the temperature criteria for storage are deferred. A DNA vaccine is relatively stable, so it can be kept at room temperature compared to an mRNA vaccine, which needs to be refrigerated – Pfizer and BioNTech’s candidate is an mRNA-based vaccine.

One company, Delta Cargo, approved the use of the DoKaSch Opticooler RAP container last month as part of its cold chain pharma service. The approval is an example of what the air cargo industry needs to do to prepare for the widespread transportation and distribution of COVID-19 vaccines. Key features of the DoKaSch Opticooler RAP container include temperature ranges of 2-8°C and 15-25°C, which enables it to be used for the transportation of Pharma 1 goods without dry ice.

This is an important factor. Dry ice is technically a hazardous good, so there are restrictions on how much can be carried on an aircraft currently. Liquid nitrogen can also be extremely hazardous. Other companies are also manufacturing temperature-controlled containers for air freight. Envirotainer, SkyCell, Va-Q-tec, are some that are preparing for this logistics activity, from manufacturing and pre-conditioning to final delivery, or what the industry calls an end-to-end supply chain—a cold corridor.

According to a major September 2020 survey of air cargo stakeholders by the International Air Cargo Association and Pharma.Aero, only 28% of the sector feels well prepared for a COVID-19 vaccine. Out of this third, more than 80% said they could offer 2-8 degrees Celsius temperature-controlled services. 75% said they could offer 15-25, around 60% said they could do -20, around 15% said -80 while just under 10% said they could not cater to temperature-controlled shipments.

Photo: Brando Farris/Airways

Proper Labeling of Vaccine Packages

According to WHO guidelines, a label must be affixed to the front surface of each package indicating type of vaccine, name of the manufacturer, presentation, batch number, date of manufacture, date of expiry, quantity, and storage conditions. The manufacture date and expiry date on all labels should be written in full, not in a coded form.

Required temperature conditions for transportation must also be clearly visible on the outer carton, indicating where recommended transportation temperatures differ from recommended storage temperatures.

A “Vaccine Rush” Label A label must be affixed to each face of the vaccine package in a language appropriate to
the country of destination (e.g., in English: “Vaccine Urgent”; in French: “Vaccin Urgent”; in Spanish: “Vacuna Urgente”; in Portuguese “Vacinas – Urgente”etc.).

Finally, the IATA Time and Temperature Sensitive Label is a shipment label specific to the healthcare industry that must be affixed to all shipping units booked as time and temperature-sensitive cargo. It is the responsibility of the manufacturer to ensure the label is applied properly to each shipping unit indicating approved transportation temperatures and in accordance with IATA Guidelines.

Photo: Luca FLores/Airways

A Precious Perishable Cargo

Once a COVID-19 vaccine is approved and developed (or in this case, given emergency authorization), it will be imperative for cargo insurance to ensure speedy and secure delivery.

Insurance coverage for pharmaceutical goods covering vaccines is widely available. However, the role of experienced professionals in the field of loss prevention is important in providing guidance on proper packaging, proper handling, and storage, setting standards and procedures for suppliers of transport, and recommending safety measures to ensure safe distribution.

According to the Insurance Information Institute, this may be one of the greatest logistical problems in modern history if we consider the infrastructure needed to transport billions of doses from manufacturing facilities to hospitals and clinics worldwide. Pharmaceutical shipments, such as vaccines, raise a range of specific obstacles for underwriting, including:

  • High valuations: According to one industry analyst, the market for COVID vaccines is estimated at US$100bn, with US$40bn in profits. Shipping companies will handle a lot of valuable inventory and pharmaceutical companies have a lot at stake. A single shipment could be valued into the millions of dollars.
  • Time and temperature sensitivities: Vaccines currently under development require precise handling. Some need to be stored at temperatures as low as -80C (-112F), which, as mentioned above, will require special refrigerated containers, along with rigorous temperature monitoring and quality control.
  • Careful packaging and handling requirements: The vaccine will require special packaging such as cold-resistant vials and boxes to hold multiple vials. Dry ice may be required, along with syringes and protective equipment for healthcare workers administering the vaccine. Besides pharma, the vendors who supply these products will also have skin in the game.
  • High theft exposure: Pharma companies plan to use everything from GPS to track their product to fake shipments to confuse criminals. One glassmaker plans to use black-light verification to prevent counterfeiting. Since the start of the pandemic, tests, masks, and other gear have gone missing, so it’s not a stretch to think professional thieves and cargo theft gangs will want to get their hands on a precious and valuable vaccine.

Key Players in the Rollout

The cancelation of 4.5 million passenger flights across all regions dramatically decreased international belly-cargo capacity. About 100 carriers carried out cargo operations by turning passenger aircraft into cargo-only operations to fulfill the connectivity needs of the shipper.

This has enabled millions of tons worth of face masks, respirators, ventilators, and other PPE as well as medical equipment and much-needed medicines to be shipped around the world. But the storage and transport of vaccines add another layer to the logistics of the supply chain.

As new lockdowns result from the COVID-19 resurgence worldwide, government authorities continue to enact restrictive measures that impact trade movements. It is for this reason that IATA is lobbying regulators and working with national and international entities to reduce any negative impact.

Additionally, IATA is already working with airlines, airports, global health bodies, and drug companies on a global airlift plan. The distribution program assumes only one dose per person is needed. “Safely delivering COVID-19 vaccines will be the mission of the century for the global air cargo industry. But it won’t happen without careful advance planning. And the time for that is now,” said IATA’s chief executive Alexandre de Juniac.

The Association will hold a WEBINAR 2 on Tuesday, November 24, 2020, to tackle the topic of global distribution and the flow of vaccines throughout the supply chain.

Pohot: John Leivaditis/Airways

A Globally Coordinated Undertaking

Our Airways emergency correspondent Taylor Beall concedes that any cargo arm of a national airline will be working on the rollout, as the -80 degree vaccine transportation is going to be a challenge unlike any other. Lufthansa Cargo and DHL have already spoken about their cold storage facilities for the undertaking.

Vaccines should travel by the fastest and most direct route wherever possible. Where trans-shipment is unavoidable, the journey should be planned through airports that have adequate cold storage facilities. This coordinated global undertaking entails having in place the right infrastructure, especially for the large quantities as those needed to be shipped.

UPS, FedEx, Cargolux, ABC, Volga-Dnepr, Aerotranscargo, TK Cargo, QR Cargo, EK Cargo, among many others are prepping for what will be the biggest rollout of a vaccine in history. We bid them a safe and speedy operation, for the sake of the commercial aviation industry, and more importantly, for the sake of humanity.

Featured image: Luca Flores/Airways. Article sources: IATA, Bloomberg, The Economist, WHO, IATA, Pfizer, BioNTech, Air Cargo News.