As FedEx and other couriers gear up for the “peak season” of the holidays, another peak is looming: the mass distribution of a COVID-19 vaccine.
Companies are now beginning late-stage trials for their vaccine candidates. Many require freezing temperatures for storage, like Pfizer’s vaccine, which needs to be stored at minus 94 degrees Fahrenheit.
A vaccine requiring cold storage to combat the pandemic will put unprecedented strain on the global “cold chain,” a temperature-controlled supply chain for goods that would otherwise perish in transit like food, flowers and vaccines.
There’s ample cold chain capacity if it’s largely dedicated for vaccine distribution, said Tom Goldsby, Haslam Chair of Logistics at the University of Tennessee’s Department of Supply Chain Management. Vaccines don’t take up much space, and less urgent items can get pushed to the back.
“Millions or even billions could be amply transported and stored,” he said.
That’s what it will likely take. In a paper published in September, global logistics giant DHL estimated 15,000 flights, 200,000 movements by pallet shippers and 15 million deliveries in cooling boxes would be required to ship 10 billion vaccine doses, which would ensure global coverage for two years.
FedEx: We’re ready, cold chain built up
Memphis-based FedEx already has experience working with government agencies during the COVID-19 pandemic. FedEx Express helped speed up shipments of personal protective equipment and other supplies earlier this year, as part of a federal government-managed public-private partnership called Project Airbridge.
The company is planning to be called again once a vaccine is ready for distribution. FedEx has talked with major health care manufacturers and customers, along with government agencies, about COVID-19 vaccine distribution for months, Express CEO Don Colleran said on an earnings call earlier this month. The company’s global shipping network gives it the tools to take on the ambitious task, he added.
“There’s a very good chance that the raw ingredients are going to be made in one country, the manufacturing of the vaccines in another country, another region, and the consumption and need for this is global, and this is why we’re uniquely positioned,” Colleran said then.
Vaccines are trickier to ship than the PPE delivered through Project Airbridge. Consistent, cold temperatures are key in making sure they don’t spoil in storage and transit, and leading candidates from Moderna and Pfizer require freezing temperatures for storage. Vaccines stored outside their recommended temperature range “may have reduced potency, creating limited protection and resulting in the revaccination of patients and thousands of dollars in wasted vaccine,” per the CDC.
“We are not sure if it would be effective, number one, and we are not sure of the safety of that product outside of its recommended storage requirements, either, so we would not use it if it gets to that point,” said Jillian Foster, system pharmacy administrator at Baptist Memorial Health Care, of problems with spoiled vaccines.
In recent years, FedEx has touted its growing suite of “cold chain” services, including packaging for vaccines and other products that need to stay cold, a temperature-controlled vehicle fleet through FedEx Custom Critical and temperature monitoring. The company also has more than 90 cold chain facilities in its network to keep goods cold while not in transit.
A linchpin in FedEx’s temperature-controlled network is the FedEx Cold Chain Center. Located at Memphis’ FedEx Express World Hub, the facility provides temporary storage for temperature-sensitive goods encountering unexpected shipping or clearance delays.
The Cold Chain Center has 20,000 square feet worth of temperature-controlled storage and stores health care shipments separately from other perishable items like food and flowers. Goods can be stored within three different temperature ranges there, according to FedEx: frozen (minus 13 to 14 degrees Fahrenheit), cold (35.6 to 46.4 degrees) and controlled room temperature (59 to 77 degrees).
The center opened in 2016, with FedEx already operating smaller cold chain facilities in France, Germany and Japan prior to its debut. A McKesson representative said the health care company often shipped vaccines and other products through FedEx, the Commercial Appeal reported when the center opened. McKesson announced in August it will be a centralized distributor of COVID-19 vaccines.
Distribution challenges for ‘enormous’ delivery
The DHL paper outlined three different delivery approaches for COVID-19 vaccines: direct shipments to the final destination, flying vaccine-filled pallets to their destination country before final distribution and shipping pallets to a warehouse for storage and last-mile delivery.
Pfizer’s vaccine would be shipped in a dry ice-filled container, although some candidates would remain stable in a traditional refrigerator, Foster said. She added that Baptist is comfortable with its current vaccine cold storage capacity but noted storage requirements could change.
“The information we’re getting, of course, is changing almost daily, because the drug manufacturers are continuing to study both the safety and the efficacy of the vaccines, and also their stability and how they will be transported and stored,” she said.
A heavy dose of air transit is expected to help move vaccines quickly across the globe.
“The potential size of the delivery is enormous,” the International Air Transport Association said in a news release. “Just providing a single dose to 7.8 billion people would fill 8,000 747 cargo aircraft. Land transport will help, especially in developed economies with local manufacturing capacity. But vaccines cannot be delivered globally without the significant use air cargo.”
FedEx Express had 679 aircraft in its fleet as of May 31. Some of these are aircraft are wide-body planes like the Boeing 777, while others are smaller, feeder aircraft.
Air transport hasn’t been flawless in delivering vaccines — the International Air Transport Association reported in 2015 that 25% of vaccines reach their destination degraded due to improper shipping.
The air cargo industry is also facing a capacity crunch, as many passenger planes that carried cargo in their belly holds remain grounded due to the pandemic. Regular customers for air cargo and trucking services are expecting the market to get even tighter in the coming months because of the holiday shipping rush and the looming vaccine distribution effort, Goldsby said.
Not every country has an extensive cold chain infrastructure like the U.S. does, either.
“Given that temperature requirements are likely to be the main challenge, regions with a particularly warm climate and those with limited cold-chain logistics infrastructure will pose the biggest challenge in a stringent vaccine distribution scenario,” the DHL paper said.
Still, those involved have had months to prepare and coordinate for widespread distribution, a luxury unavailable early in the COVID-19 pandemic. Sudden demand spikes for personal protective equipment and everyday items like toilet paper strained a lean global supply chain. This time, “there is no excuse for us failing,” Goldsby said.
“We are afforded that opportunity for preparation and planning,” he said. “There’s going to be a lot of explaining to do if you fumble the ball.”
Max Garland covers FedEx, logistics and health care for The Commercial Appeal. Reach him at firstname.lastname@example.org or 901-529-2651 and on Twitter @MaxGarlandTypes.