Covid vaccine: Distribution, not production, is challenge

It is still not clear whether India will getPfizer’s Covid-19 vaccine, whose Phase-III trial data are expected to be ready by mid-December. But one thing is sure: The country does not have the cold-chain infrastructure needed to keep the vaccine at the temperature of (minus)70°C.

According to available estimates, the government may be able to use 35-40 per cent of its existing cold- chain capacity for 600 million doses. As this translates to only 200-250 million doses, it may have to rely on the private sector significantly to cover the rest of the population.

“If one is looking at a vaccine similar to the one developed by Pfizer, cold-chain infrastructure is non-existent. Not just in India, even in the US. We may need at least a year to get such a cold-chain network going,” says Sunil Nair, CEO of Snowman Logistics, India’s largest player in cold-chain storage and distribution network.

But what of a temperature range of 2-8°C that most homegrown vaccines are targeting? “Maintaining a cold-chain of 2-8°C during storage as well as distribution will be not a huge challenge, even though it may require meticulous planning and execution. The government may need to look beyond resources within for achieving the task in the shortest possible time,” Nair says.

Once one or more vaccine is approved for use, India can use its more-than-sufficient manufacturing capacity to produce them in ample quantities. Similarly, making various other components required for vaccination such as vials, stoppers, syringes, gauze and alcohol swabs will not be a problem as the country has adequate capacities. The bottleneck, however, will be the cold storage infrastructure and trained manpower for carrying out the vaccination.

It is estimated that India may need to train an additional 1 lakh people for Covid-19 vaccinationto cover the entire population.

Since India has well established payers in vaccine manufacture, the government did not have to finance them for developing an antidote for Covid. According to a government scientist, the Department of Expenditure has set aside a “substantial sum” that will be used for vaccine procurement, cold-chain management and administration.

According to a November 10 Credit Suisse report, Indian vaccine-makers have a production capacity of 2.4 billion doses, of which almost 1 billion dose capacity is with just Serum Institute.

Cold chain points

Narendra Kumar Arora, Executive Director of INCLEN Trust, a not-for-profit organisation involved in clinical epidemiology that works closely with the government in universal immunisation programme, is confident that India is capable of achieving the targets.

“India has over 28,000 cold-chain points. In 2014-15, our immunisation coverage was around 60 per cent. Before the onset of Covid-19, we had gone up to 88 per cent. Our immunisation sector has done extremely well,” he says.

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