Covid-19 vaccine progress has been welcomed around the world. But as scientists inch closer to a viable vaccine, thoughts are turning to the logistical challenges of distributing it as quickly and safely as possible.

There are more than 150 coronavirus vaccines in development around the world. A significant breakthrough came when Pfizer and its development partner BioNTech announced that its mRNA-based vaccine, BNT162b2, is 90% effective after initial tests.

At the same time, promising projects are being developed by teams from AstraZeneca, the University of Oxford, Novovax, Johnson & Johnson, Bharat Biotech, Sinovac, and the Gamaleya National Center of Epidemiology and Microbiology.

It usually takes 10 to 15 years to develop a vaccine but there’s a growing sense that we could have a vaccine (or combination of vaccines) to combat coronavirus around the turn of the year.

Vaccine delivery challenges

Delivering any successful vaccines to the public, at the required scale and speed, will be a huge undertaking – not least because of the specific storage temperatures that most vaccines demand to maintain their stability.

Some of the proposed vaccines need to be stored at temperatures of -80C. Others fit into the more normal vaccine storage range of refrigeration between 2C and 8C.

Variation beyond these temperatures could harm the efficacy of the vaccine, leading to lost stock at a time when nobody can afford wastage or delay. Issues like this could also damage public trust, which will be vital to the acceptance of a national immunisation programme of this importance. Patient safety is an absolute priority.

However, there are big technical hurdles to overcome. Some of the proposed vaccines, for example, will require a series of two doses for each individual.

Temperature sensitivity

Vaccines to be stored at freezing temperatures will mean poor accessibility for two-thirds of the world’s population with insufficient cold chain facilities, according to German logistics company Deutsche Post DHL. Even at the typical vaccine temperature range, current infrastructure would only make the vaccine reachable for around 70% of the global population, according to the research by DHL and consultancy McKinsey.

Air cargo providers are expressing similar concerns about their ability to deliver an estimated 10 billion doses of vaccine around the world within a short timeframe. The global roll-out is expected to generate 65,000 tonnes of air freight – five times the air vaccine volume of 2019.

Immunisation programme planning

Back on the ground, frontline healthcare providers are already being asked to prepare for refrigerated storage of coronavirus vaccines – an addition to a higher volume of regular flu vaccine doses. The NHS Flu and Covid-19 Vaccination Programme was released in October.

At Checkit, we are already receiving requests from hospitals, pharmacies and GP surgeries for additional automated monitoring capacity. The present circumstances make it more important than ever that vital stocks are protected from the potential damage of temperature variation. Scrutiny is high and public confidence is pivotal.

Digital capabilities

Digital adoption will surely be crucial in enabling healthcare providers to deliver this unprecedented immunisation programme with the required scale, speed and efficiency.

Technology will be harnessed to support teams at all point of the supply chain, from tracking stock to logging deliveries and performing quality and safety checks. Digital workflow and automated monitoring tools can reduce the manual burden on teams that will be working at full capacity.

Digital tools can also reduce the risk of human error that can occur under extreme pressure, ensuring the highest standards of safety and efficacy – and an audit trail to demonstrate compliance with regulations and standard operating procedures.

Software-as-a-Service advances have given rise to a new generation of process management technology that prompts, guides and logs best practice via a mobile app. Real-time operational data from multiple locations is collated in centralised dashboards for live analysis and trend mapping.

Automated temperature monitoring can be built into the reporting mechanism. Wireless monitoring is now widely used to protect existing vaccines and will be equally important to the roll-out of coronavirus vaccines. Advanced systems enable temperatures to be constantly monitored 24/7, with live alerts activated upon any deviation from safe parameters. This enables immediate action to protect stock, whether that involves restoring power, closing fridge doors or moving the contents to a safer unit.

Thermostats within most fridges may lack the required accuracy – and are rarely independently verifiable. In contrast, a calibrated temperature monitoring system ensures compliance regulations that are audited by the CQC and GPhC.

A partnership approach that embraces digital capabilities can help public healthcare providers rise to the challenge of delivering coronavirus vaccines in the months ahead.