The U.K. was the first country in the world to approve Pfizer and BioNTech's groundbreaking coronavirus vaccine on Wednesday for widespread use. In a way, that was the easy part.
Now, it has to deal with rolling out millions of doses of a vaccine with particular transportation and storage needs, setting up suitable vaccination sites and delivering the shots first of all to the most vulnerable members of its population and healthcare personnel.
The vaccination program begins next week, with top U.K. officials admitting the rollout will not be easy. Health Secretary Matt Hancock, for instance, warned that the vaccination program would be "one of the biggest civilian logistical efforts that we've faced as a nation," while Prime Minister Boris Johnson cautioned that administering the vaccine posed "immense logistical challenges."
"Make no mistake, this is going to be a challenging rollout," Dr Adam Barker and Dr Tara Raveendran, health analysts at investment group Shore Capital, said on Wednesday.
"Although the NHS is well versed in delivering vaccines (it delivers around 15 million flu vaccines per year as an example), the Pfizer/BioNTech candidate has well flagged characteristics that make it more difficult to deliver."
Summing up the logistical challenges posed by transporting and delivering the mRNA-based vaccine — developed at breakneck speed and proven to be 95% effective at preventing Covid-19 infection in a late-stage clinical trials — the analysts said:
"The candidate needs to 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 house 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 a further 30 days (as long as they are replenished with dry ice every five days) and once the vaccine is thawed, it can be stored at refrigerated temperatures (2-8 degrees C) for up to five days."
Pfizer's vaccines for the U.K. are coming from the company's manufacturing site in Puurs, Belgium (which, unsurprisingly, will be used to supply Europe). Thousands of doses. that come in batches of 975, will be placed in special freezer boxes that will then be flown or shipped to the U.K. and distributed to hospital vaccination hubs.
'Preparation, preparation, preparation'
For those charged with delivering the vaccine, John Pearson, chief executive of DHL Express said: "It's a case of preparation, preparation, preparation."
German courier DHL already has a "Medical Express" service specializing in delivering products with specific critical needs, such as the need for consistent and constant temperature control. Pearson said the company was expecting a call "in the very near future" asking them to become involved in the delivery of the Pfizer vaccine to the U.K.
"We're focused on the origin pick-up and the destination delivery and making sure it maintains its temperature throughout, and that's our part, and what we're heavily committed to do," he told CNBC's Squawk Box Europe on Thursday.
Pearson said the logistical challenge was "right in our wheelhouse."
"Our transit time of any shipment to any one of our 220 countries is one to five days. The Pfizer vaccine, for example, can maintain its temperature sensitivity for 10 days, so there is even a buffer there," he said.
"Essentially, what we need to do is ensure we have all the dangerous goods permits, all the active loggers on the boxes that make sure the temperature was maintained for the entire journey, and then we'll deliver it to where we were asked to deliver it to."
When will people get vaccinated?
The U.K. pre-ordered 40 million doses of Pfizer and BioNTech's vaccine — enough to vaccinate 20 million people — but the delivery won't be fulfilled all at once.
"The delivery of the 40 million doses will occur throughout 2020 and 2021, in stages, to ensure an equitable allocation of vaccines across the geographies with executed contracts," Pfizer said on Wednesday.
"Now that the vaccine is authorized in the U.K., the companies will take immediate action to begin the delivery of vaccine doses. The first doses are expected to arrive in the U.K. in the coming days, with complete delivery fulfilment expected in 2021."
Health Secretary Hancock told the U.K.'s House of Commons on Wednesday that each batch of the vaccine would be tested for safety. "I can confirm batch testing has been completed this morning for the first deployment of 800,000 doses of the vaccine," he told Parliament.
The country's National Health Service would begin 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 through to March and April "for the at-risk population."
The government plans to start delivering the vaccine from 50 "hospital hubs," as well as from community settings such as doctors' surgeries at a later point.
Who gets it first?
The Joint Committee on Vaccination and Immunisation (JCVI) in the U.K. set out on Wednesday who it believes should received the vaccine first, noting that "the first priorities for any Covid-19 vaccination programme should be the prevention of COVID-19 mortality and the protection of health and social care staff and systems."
The priority list is as follows:
- Residents in a care home for older adults and their carers
- Those 80 years of age and over and frontline health and social care workers
- Those 75 years of age and over
- Those 70 years of age and over and clinically extremely vulnerable individuals
- Those 65 years of age and over
- Individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality
- Those 60 years of age and over
- Those 55 years of age and over
- Those 50 years of age and over
Shore Capital's health analysts said they expected volunteers across multiple disciplines (from nurses and paramedics, to trained volunteers and even vets) to be involved in the rollout. On Wednesday, the NHS' Volunteers Responders network called for volunteers that could be trained to either deliver the vaccine or assist those receiving it.
Aside from the need to recruit people to deliver the vaccines, other challenges include the need for a robust IT system to track who has been vaccinated. It will also be required to notify individuals when they need to get the second dose of the candidate, which comes 21 days after the first dose.
"In addition, Pfizer/BioNTech's product must be diluted with saline before it is administered, which isn't very common with other vaccines. Coordinating all necessary support components to deliver the candidate (e.g. syringes, alcohol wipes, gloves) will also have to run smoothly," Shore Capital's Barker and Raveendran added.
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