‘Logistical nightmare’: Fears dysfunctional Covid vaccine distribution delays in US could destroy doses

The subzero shipping of Covid-19 vaccines could lead to widespread failure of doses if “dysfunctional" distribution leads to delays and expiration.

Experts are warning the extreme, deep-freeze conditions needed to maintain the vaccines pose a serious risk to their effectiveness as states, the military, airlines, cargo trucks and health services scramble to transport and administer tens of millions of doses to all corners of the country.

Pfizer's vaccine needs to stay at -94 degrees Fahrenheit while Moderna's vaccine needs to stay at -4 degrees Fahrenheit. With hazardous materials like dry ice needed to maintain the extreme cold, the storage and temperature requirements could lead to a four-day delivery window.  

For Pfizer's vaccine, that would give a six-day window to deliver up to 5,000 doses - or 833 per day - before the company's storage solution becomes too warm and doses lose effectiveness, according to Premier, a purchasing agent for hospitals.

"It's a logistical nightmare for rural communities," Soumi Saha, Premier's director of advocacy, told CBS MoneyWatch. "But no one is immune to the challenges distributing the vaccine poses for the medical industry."

Pfizer developed GPS-enabled boxes that use dry ice to keep between 1,000 to 5,000 doses of vaccine at around - 94 degrees for 10 days, and is working with DHL, FedEx, UPS to distribute across the US.  

Replacing the dry ice or transferring to a regular fridge could extend the vaccine lifespan by a few days, while ultra-cold freezers could extend up to six months.

That has led to a run on dry ice, with the CEO of Stirling Ultracold telling USA Today that sales were up 250 per cent over the first quarter. Medical-grade ultracold freezers, however, cost between $7,000 to $25,000 based on size. 

For doses that need to be distributed by air, cargo regulations on dry ice, or frozen carbon dioxide, limit the number of vaccines that can be carried per flight. And flight delays or cancellations would also impact the time available for their effective use.  

A recent survey found only 15 per cent of the industry felt ready to transport cargo near the -94 degrees Fahrenheit of the Pfizer vaccine and 60 per cent were ready to transport at the Moderna vaccine's -4 degrees Fahrenheit requirement, according to Reuters.

Bill Gates said the lack of federal guidance on distribution left no clear articulation of responsibilities between the military and states in managing logistics to ensure vaccines don't expire, that they're delivered to priority patients, the two doses required 21 days apart are tracked, and that cases are follow-up.

He said that the mistakes made on testing and diagnostics were being repeated in the distribution infrastructure of the vaccine.

“I’m worried about vaccine distribution not going to the right people and not going full speed. You can even have vaccine expirations because of the way the cold chain works on these things," Mr Gates said during the 2020 STAT Summit.  

"I can't predict the numbers but wow it is a dysfunctional set of people right at the moment.”

That set of people include Donald Trump and Operation Warp Speed. Mr Trump has said 20 million doses of the Pfizer vaccine will be delivered across the country by December, with another 20 million doses of the Moderna vaccine ready pending FDA approval.

His administration has promised people would be getting their first shots of the vaccine within 48-hours.

But Lori Freeman, CEO of the National Association of County and City Health Officials, said the states need at least $8.4 billion in funding to hire, train, administer and track the vaccine.

"We don’t have the investment in getting the vaccine from the lab to the people ... We’re running out of time for pulling those things together," Ms Freeman told Politico.

The outlet reviewed the vaccine distribution plans submitted by states to the Centers for Disease Control and Prevention and found they lacked basic information on when the vaccines will arrive or how many doses they would receive.

New York Governor Andrew Cuomo said on MSNBC there are still a lot of details that have to be worked out on the federal government's position.

"Like on testing, like on PPE, like on masks, they point to the states, and while it's up to the states, they don't provide the resources for the states to do what they need to do,” Mr Cuomo said.