“That’s kind of an unprecedented intensity.... that’s tested everyone that’s associated with this,” Walpole said.
Late Friday, the Food and Drug Administration authorized emergency use for Pfizer’s COVID-19 vaccine, which has a spectacular 95% effectiveness rate. In an emergency meeting Saturday, Centers for Disease Control and Prevention advisers agreed with the FDA, and Sunday, the agency’s director, Dr. Robert Redfield, signed off.
The first doses, which will be extremely limited, will go to health care workers and nursing home residents, deemed highest priority by an advisory panel for the Centers for Disease Control and Prevention. Some vaccinations could begin as early as today, once the frozen vials are thawed.
The next vaccine to be considered is Moderna’s, also shown to be 95% effective in clinical trials and which is set to undergo review by the FDA vaccine advisory panel Thursday. If it gets favorable evaluations, as expected, the FDA will likely authorize its use within days.
Moderna’s vaccine also requires cold storage to maintain its integrity, but nothing like Pfizer’s. Moderna’s must be stored at about -20º C (-4º F). Pfizer’s must be stored at about -70° C (-94° F).
Pfizer has built a storage container that, with the help of dry ice, can keep doses cold for up to 10 days in transit without any additional freezer equipment. Periodically replenishing the containers with dry ice can buy another 15 days, but depending on how often the containers are opened, and for how long, that timeline could be considerably shorter. It’s a tricky situation, to say the least.
The vaccine must be used up pretty quickly after it is thawed — within five days, as long as it’s kept in standard refrigeration.
Delta has arranged for special cooler containers that can be used in cargo holds of its planes to ship vaccines, in addition to seeking approvals to handle additional dry ice.
Delta said its 40,000-square-foot cold chain facility at Hartsfield-Jackson International Airport is certified to handle temperature- and time-sensitive pharmaceuticals and was expanded last year. The airline also has electrical infrastructure to power cold containers at the Atlanta airport, where it has its largest hub.
Other airlines have gotten an early start on vaccine transport work, including United Airlines which handled the first mass air shipment of Pfizer’s COVID-19 vaccines in late November.
Walpole said Delta has handled vaccine trial shipments and set up a “vaccine control tower” operation.
The airline grounded hundreds of planes earlier this year due to the sharp decline in travel amid the pandemic, but Walpole said some of those planes can be returned to service for vaccine distribution. The Federal Aviation Administration is working with airlines, airports and manufacturers on special regulatory approvals to safely transport large amounts of dry ice. Dry ice is regulated on aircraft because of the hazards to crews and passengers from the emission of carbon dioxide gas.
UPS freezer farms
While passenger carriers such as Atlanta-based Delta Air Lines as well as United and American can help to transport vaccines internationally, such as from Europe to the United States, FedEx and UPS will distribute them across the country.
Sandy Springs-based UPS also is responsible for shipping all of the kits for the Pfizer vaccine nationally. Last week it began shipping the kits, which include syringes, mixing vials and personal protective equipment, in anticipation of approval of the vaccine.
UPS said the Pfizer vaccine will be transported from storage in Michigan and Wisconsin to the UPS Louisville, Kentucky air hub, and will then be shipped Next Day Air to hospitals, clinics and other medical facilities to inoculate healthcare workers.
“This is the moment of truth we’ve been waiting for at UPS,” said UPS Healthcare president Wes Wheeler in a written statement Saturday.
In preparation for vaccine shipments, UPS freezer farms in Louisville and at facilities in the Netherlands, and it has boosted its dry ice production capabilities to prepare for vaccine transport.
The shipping giant said it can now produce as much as 1,200 pounds of dry ice per hour at its U.S. facilities, and will have enough to pack shipments from facilities in Louisville; Dallas, Texas; and Ontario, Canada. UPS is also turning to dry ice freezer manufacturer Stirling Ultracold for portable ultra-low temperature freezers to store vaccines.
UPS plans to send an additional package of dry ice a day after each Pfizer vaccine shipment, regardless of who shipped the vaccines, for pharmacies or other dosing sites that don’t have freezers capable of the ultra-cold temperatures required.
Other Georgia players will play critical roles in maintaining cold chain logistics.
Pharmacy giants CVS and Walgreens, which have contracted with the federal government to distribute and administer vaccines to most nursing home residents and staff, have also been making cold chain storage preparations. A CVS spokesperson said the pharmacy giant will use a “hub and spoke” model where roughly 1,100 CVS Pharmacy locations across the country will store vaccines, and teams will go to these locations to pick up the necessary doses on their way to long-term care facilities. CVS also said special shippers that utilize dry ice will be used to transport vaccines to different locations.
If a provider cannot store the vaccine, Georgia says it will provide vaccines through an approved redistribution provider location. As an additional backup, the vaccine may be sent to Georgia’s Receipt Stage and Store warehouse.
With initial supplies widely expected to fall short of the amount needed to vaccinate all high-priority workers, others are working to make sure they are ready to put their vaccination plans into action so that no doses spoil.
Katie Logan, chief consumer officer and vice president of strategic planning for Piedmont Healthcare, said the plan is for staff who are administering the shot to go directly to various floors and departments. The task ahead is not easy, but Logan said she felt confident and hopeful about the days and weeks ahead.
“First and foremost, the vaccine is a positive ray of light for all of us and our best opportunity to get to any state of normalcy,” she said.