The joy that greeted the information of a vaccine candidate that could be extremely efficient in opposition to COVID-19 was certainly one thing to behold. If the ultimate outcomes present something just like the numbers quoted within the press launch, then the world can certainly be happy and the scientists behind the scenes very pleased with themselves.
One complicating issue would be the upkeep of the chilly chain. Vaccines are fragile merchandise: they should be saved at particular temperatures, and a few are delicate to gentle and should be transported in darkish glass vials. These exact circumstances have to be maintained all through the vaccine journey, proper till the purpose once you’re within the GP surgical procedure along with your sleeve rolled up and the nurse opens the fridge door to extract the required immunisation.
For example, let’s say you reside in rural Ghana, in West Africa, and the vaccine itself is coming from the UK. The chilly chain should cowl that vaccine leaving the UK manufacturing web site, being loaded onto a automobile and pushed to a storage web site close to the airport, shifting on the aeroplane to Ghana, storage in or close to Accra (the capital metropolis), transport to a rural district well being centre, after which doubtlessly additional transport in a automobile, and even on foot, throughout tough terrain to bodily get to a distant inhabitants.
That ultimate stage is one thing healthcare employees in Ghana and all low and middle-income international locations do many occasions a 12 months – for instance, with polio vaccination campaigns – and it may be heroic and typically harmful work. Wherever we dwell on the planet, these individuals deserve our thanks.
Healthcare employees in these settings are well-practised at delivering vaccines in all places, however you may see the variety of separate steps the place the chilly chain needs to be maintained. Important package might embrace a transportable fridge behind a 4×4, or a cool bag that’s carried by hand. These cool baggage might comprise “freezer packs” that preserve the merchandise sufficiently cool for a minimum of a couple of hours in order that the vaccines don’t spoil.
The Pfizer/BioNTech vaccine must be saved at -80⁰C, which is hard. This isn’t an insurmountable downside, but it surely poses further logistical challenges. It requires specialist tools referred to as “extremely low temperature freezers”. These are sometimes present in specialist analysis services or biobanks.
Since most routine vaccinations require refrigeration or freezing at a lot lesser temperatures, a GP apply within the UK is unlikely to have already got that facility, not to mention a well being centre in rural Ghana.
Governments the world over will now be questioning what number of of those freezers they’ll want to purchase. And at a value of some thousand kilos per unit, plus working prices of possibly £500-£750 per 12 months, the invoice might get giant in a short time. This sort of monetary outlay might also be past rural Ghana and different resource-poor settings. It’s not simply the price of shopping for the vaccine itself that we’d like to consider.
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Over the subsequent six to 12 months, we hope that we’ll find yourself with a number of completely different vaccines. They’ll all have barely completely different benefits and drawbacks, together with issues of effectiveness, security, variety of doses, price and storage necessities. It might be that in high-income international locations, vaccinating weak populations with a product that requires two doses and -80℃ storage is workable. In sub-Saharan Africa, a extra helpful product might doubtlessly be one which wants one dose and has a much less stringent chilly chain, even when total vaccine effectiveness is barely decrease.
The quick and medium-term future for COVID-19 vaccine growth seems to be very thrilling. Nevertheless, success in medical trials remains to be a great distance from the endgame of a extremely efficient immunisation distributed to all corners of the globe. For now, we await additional growth with hope, however maybe additionally greater than slightly expectation.