Sep 23, 2021

Vaccine Logistics: The Critical Link in the Chain

  • health
  • logistics
  • cold chain
Vaccine Logistics

Ensuring vaccine access at its designated potency to the remotest areas across India is fundamental to mission Covid eradication.

India has successfully vaccinated over 25% of its population with one dose and over 10% are already fully vaccinated. Yet, the long-term success of this massive national effort still needs to overcome two formidable obstacles - vaccine hesitancy and vaccine availability - to meet its end-of-the-year targets.

And while for a country of 1.4 billion, the numbers already vaccinated are impressive, they are still not comprehensive enough to get the economy growing rapidly and perhaps, more critically, get students back to learning in schools and colleges.

One reason is the high degree of people mobility between cities and villages as the growing urban centres source their unorganised workforce from an influx of seasonal rural labor. Therefore, no part of the country is fully protected unless the whole country is vaccinated. The government and policymakers have involved not only local bodies down to the gram panchayat level but also public sector companies and other civil society organisations in an effort to remove people’s doubts and swiftly increase the numbers that are vaccinated.

Currently available vaccines (primarily Covishield and Covaxin) have been clinically proven to provide 70-90% protection against the virus in India including the Delta variant. They have both proven to be extremely effective against severe infection and have helped reduce deaths significantly.

Logistics, potency and cold chains

Cold chain vaccine logistics are a bigger challenge. India currently has around 30,000 cold storage  points with approx. 100,000 chiller & freezer units in varying storage capacities, spread across 718 districts but given its geographical size and population, this needs to be expanded urgently.

Besides, different vaccines have specific storage and handling requirements, the violation of which plunges its efficacy. So, it is critical to safely store them at depots, transport & store these vaccines to their destinations in rural or remote areas while maintaining temperatures that preserve their potency and efficacy. Additionally, there is also the issue of vaccine wastage, which occurs primarily because of two reasons - cold storage problems or mishandling.

Vaccines currently in use in India need temperatures of 2-8 degree celsius for storage and transportation, barring Sputnik which requires storage at around -25 deg. Once the box of 10 vials is opened they must be used within the next four hours. If partially used, it needs to be carefully stored and transported in a temperature-controlled chamber and returned to the depot storage ( this is as per the guideline of usage and accounting of vaccine vials, provided by MoHFW).

Cities in India that have better infrastructure have adequate cold storage facilities to manage vaccine logistics. However, the more remote rural areas, where even primary healthcare facilities are scarce, are struggling to cope with the high rates of vaccine wastage occurring at the point they are administered.

Power failure

A recent Ministry of Health and Family Welfare (MoHFW) report identifies lack of power supply (from extended/frequent power failures) as one of the key challenges for last-mile immunization infrastructure in India. Unlike cities that have grid-based power supplies that are relatively uninterrupted or have sufficient backups through generators, many panchayats and villages do not have 24x7 power supply.

States where vaccine wastage has been reported in high proportions are also the very states where power supply and distribution is a challenge. In Chhattisgarh and Jharkhand for example, 3% of households still do not have electricity connections. Hence, while some vaccine wastage is inevitable and often accounted for, states need to work to keep it to the minimum to optimise scarce supplies.

The government has been relying on private logistics providers to fill the gap and the refrigeration industry leaders like Godrej & Boyce have risen to the occasion. We have developed and delivered over 12000+ vaccine refrigerators over the last one year, that can deliver the necessary temperatures in tough conditions with modern refrigeration technology. These devices can maintain storage temperatures within the desired range even when there is no power for over 48 hours.

In addition, versatile cold storage systems that can work on alternative sources of energy like solar power or wind power can be deployed as a more realistic long-term power solution for extremely remote regions in the country. There are also new technologies being introduced like direct solar to compressor power supply that eliminates the use of an inverter circuit and battery. These are the parts that fail more frequently and have lower working life than the refrigeration equipment itself. They could also be effective in places where the power supply is unreliable.

Freezers capable of maintaining ultra-low temperatures will also come into play once other vaccines like Pfizer get the Indian government’s nod to speed up the immunization drive further.  

The cold storage industry and logistics sector have the right technology and experience to further speed up India’s drive to eradicate Covid through vaccinations. To finish the job and get India fully jabbed, governments at all levels, NGOs, and the private sector must collaborate, and use all insights and resources at their disposal.