The Covid-19 vaccination campaigns are under way. The logistics challenge they pose is unprecedented in terms of its scale, the unknowns it involves and its highly sensitive nature.
The Covid-19 pandemic has clearly put the transport and logistics world under the spotlight. After having finally won recognition for their capacity to maintain the supply of essential goods during the peaks of the pandemic despite a much-deteriorated operating environment, transport and logistics professionals have now set about tackling their next challenge: how to transport billions of doses of Covid-19 vaccine all over the world.
Distributing products of this kind is clearly not something new in itself. There are already good practice guides and tried and tested logistics procedures on the vaccines market, which represents $33.1 billion, in annual revenues worldwide, according to a study carried out by S&P Global.
The circumstances in which the Covid-19 vaccines are being brought into use means that classic supply chain methods cannot be used, however. Although the vaccine campaign got under way some weeks ago, voices are being raised in a number of countries to complain that the vaccines are arriving too slowly. The criticism is an easy one to make, since it cannot be disputed that a variety of factors have combined to make the campaign a highly complex operation. So far, however, transport and logistics professionals have shown that they are perfectly able to manage it.
1/ A difficult planning process
How? Where? When? As with any other product, these questions are at the heart of the logistics response. The problem is that, in the current situation, it is very difficult to give precise replies.
The three main vaccines introduced in recent week in the United States, Europe and the United Kingdom, which have been provided by Pfizer/BioNTech, Moderna and Oxford/AstraZeneca, are understood to represent a production potential of 5.3 billion doses in 2021. If all the vaccines currently undergoing third phase tests are approved, that figure could exceed 10 billion doses. Production estimates sometimes vary greatly, however. As things stand, therefore, the number of doses which will need to be transported is difficult to estimate with any kind of precision, as are the dates when they will become available.
We know more about the sites where they are produced, which are clearly determining factors in the organisation of the supply chain, but, here again, there are some uncertainties. According to science magazine Nature, which cites data from specialised biosciences company Airfinity, the United States is likely to be far and away the biggest producer in 2021, with some four billion doses expected, followed by the United Kingdom, India, Norway and France, with one to two billion doses each, and then Switzerland and China. These forecasts need to be treated with caution, however, according to the scientists. Some vaccines involve the use of technologies which have never been used before and their production on an industrial scale can bring surprises. In December 2020, Pfizer had to revise its production targets downwards from 100 million to 50 million doses, because obtaining raw materials had taken longer than expected. There have been more problems since then because the company announced in early 2021 that it had been forced to reduce production levels and revise delivery schedules.
We know that there is great demand for these still virtual supplies. According to Nature magazine, more than 10 billion doses have been pre-ordered, covering virtually all the production of the three manufacturers mentioned above, as well as the vaccines developed by Russia and China. Looking at the firm orders placed so far, we can see that more than half have come from the EU and five other rich countries: Canada, Australia, Britain, the United States and Japan. Taking account of the maturity of the logistics sectors in these countries, this is positive in terms of supply chain organisation. The fight against the pandemic clearly supposes that vaccine cover will need to go much further, however. The WHO wants to secure two billion doses by the end of 2021 to meet the needs of low revenue and intermediate countries, where distribution may be more difficult.
2/ Complex routing
In general terms, the pharmaceutical industry has long neglected the efficiency of its supply chains despite the high value of the products it makes, or perhaps because of their high value. This is the conclusion reached by a Pwc report published in early 2020 which compares the pharmaceutical industry with the textile industry. As regards vaccines specifically, the supply chain was identified by the WHO in its 2011-2020 world vaccine plan, which was published well before the Covid-19 pandemic, as an area which needed improvement. As regards the anti-Covid vaccines, several additional factors add to the complexity involved in transporting them.
Covid-19 is causing considerable damage in both human and economic terms. The vaccine manufacturers are racing against the clock to provide vaccines. The health authorities have also tried to anticipate the difficulties by setting priorities and building the most appropriate logistics systems possible. But the gap between supply and demand necessarily involves just-in-time production which is more difficult to manage.
- Exceptional temperature requirements
Respect for the cold chain is an essential feature of vaccine transport and one which is already well-known to vaccine manufacturers. Market authorisations show zero tolerance for any failure to observe temperature specifications. In general, the manufacturer needs to be able to guarantee that the vaccine is transported at 2-8°C and the logistics chain is used to dealing with this kind of requirement, even though this does not mean that it is easy to do so. In the case of Covid-19, however, the ARN vaccines currently in use involve much more stringent requirements. "The ARN molecule is fragile, which is why Pfizer recommends keeping its vaccine at a temperature of -70°C.," said Marie-Paul Kieny, director of research at French health and medical research institute INSERM, in an article published on the The Conversation website. "This poses major logistical problems." The manufacturer has developed special packaging, moreover, to enable the vaccine to be stored at -80°C for 10 days, thanks to the use of dry ice. It is also carrying out tests to evaluate the stability of the vaccine at -4°C, as well as in traditional conditions of 2-8°C. Pfizer is even looking at new methods which would enable the vaccine to be transported at room temperature. The Moderna vaccine, which is also ARN-based, requires slightly less stringent conditions but still needs to be transported at -20°C.
- Particular safety and security requirements
The Covid-19 vaccines are high added value goods irrespective of their market price. "As we saw at the start of the year when there was a high number of thefts of personal protection equipment, freight thefts are particularly targeting products related to the Covid-19 pandemic," said Thorsten Neumann, chairman and CEO of the Transported Asset Protection Association's Europe, Middle East and Africa region last December. "Organised crime groups, which work according to the laws of supply and demand, are very much aware of the value of the (vaccine) doses and it is very likely that they are already looking for ways to disrupt the supply chain, particularly with such high volumes being distributed in such a short time."
Transport is one of the most sensitive stages in the supply chain. In 2018, thefts from heavy good vehicles accounted for 75% of thefts recorded. If thefts from trailers and thefts of entire trucks and trailers are included, the percentage rises to 94%. In short, while logistics buildings are sensitive areas, heavy goods vehicles are particularly vulnerable and require particular attention.
Transport companies involved in vaccine distribution need to be particularly vigilant with regard to cyber security. Last December, IBM security experts uncovered large-scale cyber attacks on companies and organisations involved in the transportation and distribution of anti-Covid-19 vaccines.
3/ Transport disruption
- Air transport the favoured mode
Vaccine manufacturers have traditionally relied heavily on air transport for their international deliveries. The epidemic has considerably perturbed the organisation of the sector, however. Passenger aircraft transport about 60% of world freight traffic in tonne-kilometres but, in the first lockdown in spring 2020, virtually the entire passenger fleet was grounded. Demand fell but in lower proportions. Access to capacity was difficult, therefore, and this was reflected by higher prices.
In this situation, manufacturers and logistics operators quickly understood that they needed a dedicated supply chain suited to the exceptional nature of the operations involved. The particular conditions required by the Covid-19 vaccines also meant that a high level of coordination was needed along the entire chain. The air freight sector, including airlines, forwarders, airport authorities and handling agents, prepared themselves to meet these requirements in the autumn.
- Shipping not involved for the time being
At this stage, sea transport is not an option even if ships are sometimes used for vaccine transport, as Sophie Marchand, a distribution support executive at Sanofi Pasteur, explained at the TIPS conference organisation by the Pharma Logistics Club in 2019. Sanofi has been using sea transport since 2011. Because of the numerous breaks in the transport chain in shipping, however, procedures need to be carefully adapted and certified on a route-by-route basis and test shipments need to be carried out. The specific nature of the Covid vaccines means that this cannot be envisaged in the short term and, in any case, the shipping companies' current difficulties in meeting normal demand do not plead in favour of this alternative. In the longer term, sea transport could be brought into the supply chain for vaccines which need to be kept at -20°C. "A reefer container can provide contractual temperatures of between -26°C and -28°C both aboard ship and ashore once it is plugged in," said Upply shipping expert Jérôme de Ricqlès. "Compared to a specific logistics deep cold chain, which is costly and creates constraints, transportation at -20°C could be managed easily and could even bring additional storage flexibility if one imagines that containers could be plugged in close to vaccination centres."
- The efficiency of road transport
Road transport is indispensable for short and medium distances, as well as for final delivery. The concern here is less about access to capacity as about the security measures which need to be taken to ensure safe delivery. Discretion and surveillance are needed both during the transport operation itself and during storage periods.
At the moment, however, the major problem encountered during the vaccination campaign is the limited production capacity of the pharmaceutical companies. For its part, the transport and logistics sector is well prepared to work with the health authorities as required.