Pfizer’s COVID-19 vaccine distribution will be a “logistical nightmare”

The long wait for a vaccine that could eventually spell the end of the coronavirus pandemic appears to be on the horizon. Last week, Pfizer said its vaccine in a trial has been 90% effective in preventing COVID-19, while Moderna on Monday announced similarly encouraging results. The companies could get emergency federal approval within weeks. Yet it will only be after the drugmakers ship millions of doses around the world that the real time crunch on the vaccination effort begins.

Pfizer’s vaccine must be kept at nearly minus 100 degrees Fahrenheit to remain effective. That’s about 20 degrees colder than extreme winter temperatures at the South Pole. Early on, experts warned that the U.S. lacked the necessary ultra-cold storage trucks and cargo planes needed to ship hundreds of millions of doses at sub-sub-zero temperatures.

In order to get around that, Pfizer has developed specially built deep-freeze “suitcases” that can be tightly sealed and shipped even in non-refrigerated trucks. But while Pfizer may have solved the problem of how to ship the frozen vaccine, these highly engineered shipping containers create other problems, particularly for the hospitals, pharmacies and outpatient clinics that will have to administer the vaccinations to hundreds of millions of Americans.

“The reality is there has never been been a drug that required storage at this temperature,” said Soumi Saha, a pharmacist and director of advocacy at Premier, which acts as a purchasing agent for hospitals across the country. “The administration and distribution effort will require an all hands on deck.”

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Among the many logistical and medical challenges that experts say will have to be overcome when vaccines are ready to roll:

  • Pfizer’s shipping boxes, packed with specially formulated dry ice and containing between 1,000 and 5,000 vaccine doses each, can only be opened twice a day for less than three minutes at a time while maintaining temperature standards.
  • Even so, the deep-freeze suitcases only hold their cool for 10 days. And the clock starts ticking when they are sealed, which for U.S. shipments will be at one of two Pfizer facilities, in either Kalamazoo, Michigan, or Pleasant Prairie, Wisconsin. 
  • Dry ice is considered a hazardous material and restricted on airplanes. Pfizer said its packages contain well under the acceptable limit. But given the logistical challenges, Premier’s Saha told CBS MoneyWatch that it could take up to four days for the vaccines to reach their destination. That gives many hospitals and pharmacies as few as just six days to administer up to 5,000 doses before they go bad, or as many as 833 a day. The vaccinations can be moved to a typical refrigerator, but for only five days.
  • Pfizer’s shipping container can be refilled with dry ice. But it likely will have to be in pellets not blocks, and a refill, which could cost a few hundred dollars, will only extend the life of deep-freeze suitcase by five days.
  • Hospitals can buy ultra-cold freezers, which will keep the vaccinations up to six months. But few hospitals or pharmacies have the specialty freezers, which can cost as much as $20,000 each, and are in short-supply. Manufacturer K2 told CBS MoneyWatch the wait for its ultra-cold freezers is now six weeks.
  • Pfizer’s vaccination requires two doses 21 days apart, making it more complicated to deliver the required number of treatments with doses going to waste. 

Moderna’s vaccine also must be shipped frozen, although at comparatively less frigid -4 degrees Fahrenheit. Still, that will require the company to secure hundreds of refrigerated trucks, while the vaccine can only be kept in a standard refrigerator for up to seven days.

Pfizer has designed a specialty box that can hold 1,000 doses of its…

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