The deployment of the Pfizer Covid vaccine in the UK: how it will play out

The UK was the first country in the world to approve Pfizer and BioNTech’s breakthrough coronavirus vaccine on Wednesday for widespread use. In a way, that was the easiest part.

From now on, it has to cope with the deployment of millions of doses of a vaccine with particular transport and storage needs, to set up suitable vaccination sites and to deliver the vaccines in the first place to the most vulnerable members of its group. population and nursing staff.

The vaccination program begins next week, with senior UK officials admitting the rollout will not be easy. Health Secretary Matt Hancock, for example, warned that the immunization program would be “one of the biggest civilian logistics efforts we have ever faced as a nation,” while Prime Minister Boris Johnson warned that the administration of the vaccine posed “immense logistical challenges”.

“Make no mistake, it will be a difficult deployment,” said Dr Adam Barker and Dr Tara Raveendran, health analysts with investment group Shore Capital, on Wednesday.

“Although the NHS is well versed in vaccine distribution (it delivers around 15 million influenza vaccines per year for example), the Pfizer / BioNTech candidate has some well-identified characteristics that make it more difficult to administer.

Summarizing the logistical challenges of transporting and administering the mRNA vaccine – developed at breakneck speed and proven 95% effective in preventing Covid-19 infection in stage clinical trials advanced – analysts said:

“The candidate must be stored at minus 70 degrees Celsius (minus 94 degrees Fahrenheit) for long periods of time and will be delivered in special delivery containers that can hold the product for up to 10 days,” they noted.

“Once the containers arrive at a vaccination site, they can be used for temporary storage for an additional 30 days (provided they are filled with dry ice every five days) and once the vaccine is thawed, it can be stored at refrigerated temperatures (2 to 8 degrees C) for up to five days. “

Pfizer’s vaccines for the UK come from the company’s manufacturing site in Puurs, Belgium (which, unsurprisingly, will be used to supply Europe). Thousands of doses. which come in lots of 975, will be placed in special freezer boxes which will then be airlifted or shipped to the UK and distributed to hospital vaccination centers.

For those responsible for delivering the vaccine, John Pearson, CEO of DHL Express, said: “It’s all about preparation, preparation, preparation.”

The German courier DHL already has a “Medical Express” service specializing in the delivery of products with specific critical needs, such as the need for constant and constant temperature control. Pearson said the company was expecting a call “in the very near future” asking it to get involved in the delivery of the Pfizer vaccine to the UK.

“We are focused on the original pickup and delivery to the destination and we make sure it maintains its temperature throughout, and that is our role, and what we are strongly committed to doing,” he said. he told CNBC’s Squawk Box Europe Thursday.

Pearson said the logistical challenge was “right in our wheelhouse”.

“The transit time for any shipment to any of our 220 countries is one to five days. The Pfizer vaccine, for example, can maintain its temperature sensitivity for 10 days, so there’s even a tampon there- low, ”he said.

“Basically what we need to do is make sure we have all the dangerous goods permits, all the active recorders on the crates that make sure the temperature has been maintained the entire trip, and then we’ll deliver them to where. we were asked. deliver it to. “

The UK has pre-ordered 40 million doses of the Pfizer and BioNTech vaccine – enough to immunize 20 million people – but the delivery will not be made all at once.

“Delivery of the 40 million doses will take place throughout 2020 and 2021, in stages, to ensure a fair distribution of vaccines across geographies with contracts executed,” Pfizer said Wednesday.

“Now that the vaccine is authorized in the UK, companies will take immediate action to start delivery of vaccine doses. The first doses are expected to arrive in the UK in the next few days, with full delivery expected in 2021.”

Health Secretary Hancock told the UK House of Commons on Wednesday that every batch of the vaccine would be tested for safety. “I can confirm that the batch tests were completed this morning for the first deployment of 800,000 doses of the vaccine,” he told Parliament.

The country’s national health service would start vaccination next week, but Simon Stevens, chief executive of NHS England, stressed on Wednesday that the bulk of the vaccination program would take place from January 2021 to March and April “for the population at risk . “

The government plans to start delivering the vaccine from 50 “hospitals”, as well as from community settings such as doctor’s offices at a later stage.

The Joint Committee on Vaccination and Immunization (JCVI) in the UK said on Wednesday who it said should receive the vaccine first, noting that “the top priorities of any Covid-19 vaccination program should be the prevention of COVID-19 mortality; and protection of health and social workers and systems. “

The priority list is as follows:

1. Residents of a nursing home for the aged and their caregivers
2. People aged 80 and over and frontline health and social service workers
3. These 75 and over
4. People aged 70 and over and those who are clinically extremely vulnerable
5. Those 65 and over
6. People aged 16 to 64 with underlying health conditions that put them at higher risk of serious illness and death
7. Those 60 and over
8. These 55 and over
9. These 50 years and over

Shore Capital health analysts said they expected volunteers from multiple disciplines – from nurses and paramedics, to trained volunteers and even veterinarians – to be involved in the deployment. The NHS Volunteer Responder Network on Wednesday called for volunteers who could be trained to administer the vaccine or help those who receive it.

Besides the need to recruit people to administer the vaccines, other challenges include the need for a robust computer system to track who has been vaccinated. It will also be necessary to advise individuals when to receive the candidate’s second dose, which is 21 days after the first dose.

In addition, the Pfizer / BioNTech product must be diluted with saline before administration, which is not very common with other vaccines. The coordination of all supporting components necessary to administer the candidate ( eg syringes, alcohol wipes, gloves) will also need, ”added Barker and Raveendran of Shore Capital.