COVID-19 vaccines to save the world: don’t neglect supply chain challenges

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By Gilles Paché

Since the spring of 2020, due to the spread of a new, very virulent coronavirus, the planet has been going through an economic crisis of unknown intensity. For many months, it was announced that salvation would come from a miraculous vaccine that would allow a massive recovery of trade. So, it was with great relief that Pfizer and BioNTech announced in November 2020 the development of a vaccine based on a new technology called messenger RNA (mRNA). After a brief euphoria, the logistical reality caught up with many observers: how to efficiently organize a freeze or deep-freeze supply chain to ensure the vaccination of billions of people over the world?

Since the WHO announced in March 2020 a pandemic situation following the spread of COVID-19 (SARS-CoV-2), the world has been experiencing a crisis of a magnitude not seen since the WWII. Although the number of deaths is much lower than that caused by the Spanish flu, many sectors of activity have suffered a shock of unprecedented violence, including air transport and tourism. It was therefore with relief and hope that the announcement in November 2020 of a vaccine against SARS-CoV-2 developed by Pfizer and BioNTech, which is 95% effective after second dose (52% after first dose) [1], was welcomed. Very quickly, however, it became clear that the success of a large-scale vaccination required an effective logistical organization with a unique deep-freeze supply chain [2]. The most critical element was the extremely low transport and storage temperature of about -70° C, when traditional vaccines are transported and stored at about -20° C.

Deep-freeze supply chain

The Pfizer/BioNTech vaccine supply chain is composed of two main links: production and distribution. Production is shared between the United States and Europe. Two U.S. plants, in St. Louis (Missouri) and Andover (Massachusetts), produce the raw materials and drug substance. They supply Kalamazoo (Michigan) and Puurs (Belgium) where the vaccines are formulated, packaged, and shipped. At the same time, BioNTech also produces the vaccine at two sites in Germany. Physical distribution is organized by each European country. France, for example, has chosen to receive the vaccines at 130 delivery points (establishments of accommodation for dependent old persons, private and public hospitals). 11 transit platforms are responsible for receiving and storing the vaccines by acting as “freezer farms” before delivering them to the 130 delivery points. Figure 1, proposed by Daher et al. [3], summarizes the distribution phases of the Pfizer/BioNTech vaccine and air freight implications.

Figure 1. Physical distribution of the Pfizer/BioNTech vaccine

Of course, doses of vaccine are not injected at -70° C but defrosted beforehand and stored at +2° C to +8° C for up to five days. If the five-day period is exceeded, the level of protection offered to individuals by the vaccine rapidly collapses, although the lack of academic works on risk factors for physicochemical degradation of mRNA vaccines should be noted [4]. Anticipating the logistical difficulties, Pfizer has created dry ice packs that can transport up to 5,000 doses of vaccine. Sticks of dry ice are inserted into the dry ice packs, and because they change from a solid to a gaseous state without a liquid phase, the vaccines do not deteriorate. As for the transport itself, UPS has already invested in industrial cooling units in the United States and the Netherlands and is ready to organize intercontinental shipments without difficulty.

The logistical constraints for Pfizer/BioNTech vaccine are much greater than those for Moderna and AstraZeneca, its main competitors. The Pfizer/BioNTech vaccine requires thermal shippers, while Moderna vaccine uses only freezers and AstraZeneca vaccine uses only refrigerators [5]. These differences in transport and storage are significant. As Table 1 underlines, the result is a need for facilities and timeliness that is unmatched. In particular, the Pfizer/BioNTech vaccine requires a very short reaction time (five days), whereas this is much more long for its competitors. For several years, the manufacturing and retailing industries have adopted lean approaches that increase the speed of product delivery and eliminate a large portion of stocks [6]. The Pfizer/BioNTech vaccine is subject to similar requirements for billions of doses of vaccine, not for thousands of items to be delivered to a supermarket.

Avoiding over-enthusiasm

Despite this critical observation, one might therefore think that the logistical issue has been largely resolved by the time large-scale vaccination has started in the United States and Europe. It is true that in management research, it is traditional to write that once a marketing strategy has been defined, the implementation of the accompanying logistical operations has never raised major difficulties in the past [7]. The example of the exceptional development of online sales over the last 10 years underlines the fact that the most suitable supply chain solutions have been found very quickly to ensure a high level of logistics service to customers. However, enthusiasm for the total success of the Pfizer/BioNTech vaccine seems excessive for two reasons:

  • On the one hand, while logistics operators know how to efficiently manage the traditional cold chain for food products (-20° C), these are old and perfectly controlled technologies [8]. For example, in the 1870s, an old sailboat was transformed into a refrigerator ship and it crossed the Atlantic in 105 days from France to Argentina with 30 tons of meat in good condition. The Pfizer/BioNTech vaccine cold chain is radically different and involves a major “technological leap” that can be achieved in just a few weeks. The slightest failure in cold chain logistics, in a simple delivery truck somewhere on a road, threatens the effectiveness of the vaccine.
  • On the other hand, the difficulties associated with managing the last mile appear to be underestimated; numerous works in business logistics have shown that the performance of the last mile delivery comes up against very significant technical and urban constraints. If getting vaccines from factories to centralized platforms is not a true problem, distribution to decentralized units is extremely expensive and complex. Many hospitals and pharmacies do not have sufficient infrastructure to store doses of vaccine. This is problematic because dry ice packs will only be able to be opened twice and will only be able to store vaccines for a maximum of 10 days.

Logistics is back!

The success of the largest vaccination operation in human history is therefore dependent on a seamless logistical organization. From this point of view, it is clear that business logistics, often reduced to commercial and financial performance objectives, can also be at the service of the Society when it is faced with one of its most serious health and economic crises. We can speak here of a kind of revenge of an underestimated function because, for many years, the most powerful pharmaceutical companies in the world considered R&D and branding as the pillars of their winning strategy [9]. The organization of physical distribution of medicines is usually entrusted to intermediaries (wholesalers and central purchasing units) who ensure deliveries to hundreds of urban pharmacies, to hospitals and to establishments of accommodation for dependent old persons.

In other words, step by step, pharmaceutical companies have considered logistics as a set of technical operations that are not part of their core competence. These low value-added operations of transport and storage were naturally outsourced to “experts”; one of the most famous in Europe is OCP. With COVID-19 vaccines, and the complexity of the freeze or deep-freeze supply chain they generate, logistical performance is back at the “center of the game”. More precisely, pharmaceutical companies, especially Pfizer/BioNTech and Moderna, are (re)discovering that the scientific progress they are at the origin of, risks being annihilated in case of poor logistical performance. While this statement is a surprise to some observers, it is not the case for researchers and practitioners in strategic management. Hopefully, the lesson will be learned in the next pandemics.

About the Author

Gilles Paché is Professor of Marketing and Supply Chain Management at Aix-Marseille University, and Director of the University Press of Aix-Marseille, in France. He has more than 450 publications in the forms of journal papers, books, edited books, edited proceedings, edited special issues, book chapters, conference papers and reports, including the recent two books Images de la logistique: éclairages managériaux et sociétaux (2017) and La distribution: organisation et stratégie (2020).

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