ASHRAE Journal - February 2022 - 14

TECHNICAL FEATURE
for the rest of the world. The mass
distribution of any vaccine has historically
been a challenge. According
to the International Air Transport
Association (IATA), about a quarter
of the vaccine cargo is delayed due to
oversights, and the distribution infrastructure
can be improved to avoid
such lapses. It also has been reported
that about 5% to 20% of the temperature-sensitive
vaccine shipments have
deteriorated during transportation,
but there are no confirmed statistics.4
Therefore, strong vaccine logistics
management is critical for the vaccine
distribution to ensure the packaging,
transport and delivery of vaccines
without compromising the safety,
FIGURE 1 Cold chain logistics for effective distribution of vaccine.
Pharmaceutical Manufacturers
Track and Trace
Packing and Container Manufacturers
Ensure Vaccine Integrity During Transport
Distribution Center/Freezer Manufacturers
Ensure Quality and Safety
Manufacturers of Temperature Gauges and Sensory Devices
Conform to New Test Protocols
Logistic Providers
Open Communication and Monitor
Across All Transportation
Health-Care Providers
Safe and Effective Administrations of Vaccines
POC Retailers
Safe and Effective Administration of Vaccines
security and effectiveness. This requires comprehensive
coordination and communication among vaccine
manufacturers, federal and local governments, freezer
manufacturers, logistics providers and health-care providers.
As governments, industries and other entities
continue COVID-19 vaccine distribution efforts worldwide,
cold chain management has emerged as a crucial
factor for ensuring an effective and safe vaccine distribution
framework.
A major requirement in this regard is the maintenance
of necessary refrigeration levels for highly temperaturesensitive
coronavirus vaccines across manufacturing,
storage, transportation and distribution processes.
Effective vaccine cold chain management will require
varying degrees of coordination and cooperation among
multiple, distinct stakeholders (Figure 1).
The general practices for primary operations of vaccine
distribution are:
* Reception of Vaccine, Personal Protective Equipment
(PPE) and Ancillary Products: For effective distribution
and to maintain an uninterrupted supply chain,
the World Health Organization (WHO) defines the tasks
to be completed by the cold chain.5 Major tasks include
pre-arrival, customs clearance and transport to national
storage, an inspection of shipment, stocking of shipment,
reporting of problems and follow-up actions.
* Storage of Vaccines and Ancillary Products:
Storage of the COVID-19 vaccine and temperature
monitoring depends on the country's supply chain
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F E B R U A RY 2022
infrastructure, the government's cold chain storage and
equipment capacity, availability of cold chain storage in
the private market and the characteristics and thermostability
requirements of the vaccines. More details
of vaccine storage are described in the Vaccine Storage
section later in this article.
* Preparation of Vaccine Shipment: Repackaging
vaccines and ancillary items and production or purchase
of coolant packs are critical components at this
stage. Since most COVID-19 vaccines will necessitate
cold chain transport of 2°C to 8°C (35.6°F to 46.4°F) and
some of them require ultracold temperature transport,
e.g., -80°C to -60°C (-112°F to -76°F) for Pfizer vaccines
and -25°C to -15°C (-13°F and 5°F) for Moderna vaccines,
a combination of refrigerated vehicles and vehicles
supporting refrigerated containers are required. For
vaccines requiring ultracold temperature transport,
fixed COVID-19 vaccine administration sites are recommended
rather than mobile sites, and repackaging
is not recommended. If internal transport within the
same facility is required, specialized containers, phase
change material (PCM) or a thermal shipper containing
dry ice should be used. Table 1 has details on temperature
requirements.
* Transportation of Vaccines: Vaccine and ancillary
products can be transported to all sites by land, air or
sea. Data loggers are the preferred option for monitoring
the temperature during transportation. For the data
loggers installed inside the containers, temperatures are
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