A Complex Logistical Problem
There are several aspects that make the vaccine distribution challenge so consequential, not the least of which is the scale. IATA reported that providing a single dose to 7.8 billion people would fill 8,000 747 cargo aircraft, but the actual figure will depend on many assumptions that are yet to be determined. For instance, we now know that some vaccines will require a second dose. Ancillary items such as syringes, swabs or further treatments may also add to the traffic flows.
Another important aspect that should be considered is how much of the distribution will be done by surface transport, acknowledging the proximity of some populations to the manufacturing sites. For example, Pfizer reported that while its U.S. manufacturing locations will be used for demand within the Americas, its site in Belgium will distribute vaccines within Europe and to the rest of the world. It is also expected that vaccine candidates in other parts of the world will reach production stage later on. This will ultimately shorten the distribution channels, for those reaching Asia for example.
Indeed, the distribution model is one of the many uncertainties that cloud air cargo’s ability to prepare for this event. This not only applies to the origin point, but also to the complete end-to-end network. For instance, vaccines could be shipped directly from manufacturing location to point of use and/or via a regional distribution point. For this purpose, UPS and Lufthansa are building “freezer farms” at their European hubs to store vaccines in transit. It is also expected that distribution networks may vary between the first and subsequent distribution waves and may make use of multiple transportation modes, depending on demand and time sensitivity.
Naturally, temperature control is a major aspect behind the difficulty of shipping the Covid-19 vaccines. Pfizer’s doses need to be stored at -70 °C, a requirement far more stringent than that of most vaccines. In fact, most air cargo cold chains are equipped to handle temperatures between +2-8 °C and a few can even store cargo at temperatures as low as -20 °C. Hardly any have facilities designed to handle cargo at considerably lower temperatures.
To that end, Pfizer has developed tailored packaging and boxes containing dry ice to maintain the required temperature. These will be shipped within temperature control ULDs (Unit Loading Device) which also utilise dry ice to control temperature throughout the end-to-end delivery. This means that logistics players will need to follow a strict process to regularly control temperature, replenish dry ice and minimize transit times as they may only have up to 10 days to deliver the vaccine from manufacturing site to vaccination points.
Figure: A possible distribution model for the COVID-19 vaccine (direct delivery model) and Air Freight Implications (based on information from Pfizer, CDC and other industry sources)
The Wisdom of Experience
Even though this is a challenge for which there may be no precedent, there are lessons to learn from past experiences. Air cargo has been widely used to transport vaccines and other temperature-controlled products. As pharmaceuticals grew faster than general air cargo commodities, so did the cool chain infrastructure worldwide. In addition, many airports, airlines, ground handlers and freight forwarders have become certified to handle pharmaceuticals. Several pharma cargo facilities have been opened in recent years at airports worldwide.
It is also expected that other vaccine candidates – namely the Moderna vaccine – may be stored at a more conventional freezing temperature (-20 °C) and will have longer shelf life when refrigerated (at +2-8 °C). These requirements are more in line with existing air cargo capabilities worldwide. In such cases, it is possible to deliver the vaccines through a central distribution point, making the end-to-end logistics chain more practical.
Despite the modernisation of infrastructure, there are several “pain points” that cool chains encounter. Historically, around 20% of vaccines are spoiled due to temperature excursions or mishandling issues. This risk can only be compounded when handling high spikes of demand within short timeframes. Air cargo’s recent experience with PPE shipments revealed that there is a reasonable risk of bottlenecks, inherent in the nature of post-Covid-19 uncertainty. Naturally, the margin of error in the case of vaccines will be much narrower as cold storage capacity is smaller and the handling protocols much stricter.
To that effect, cold chains need to plan for streamlined end-to-end distribution and at greater precision than usual. For instance, vaccines should not be air-shipped to the destination airport unless there is guaranteed capacity to distribute the goods downstream.
Otherwise, shipments should remain stored in a (large) freezer site at the origin and only be dispatched when capacity is available. Data exchange plays a crucial role in these operations; not only in monitoring shipments’ temperature in real time, but also in coordinating schedules, predicting delays and preventing risks and bottlenecks. Truly, the situation calls for military precision.
Failing to Prepare is Preparing to Fail
Preparing for the vaccine distribution challenge is extremely difficult in light of the uncertainties around the scale, timing, network and evolving handling requirements. Yet airports and cargo companies need to “plan with moving parts”. In other words, start from a high-level approach and refine the details over time as more information becomes known. Airports in particular have a central role to play in rallying the air cargo ecosystem around a common goal. For that, airports will need to follow what we term “the three Cs” – Coordination, Capacity Assessment and Contingency Planning – in order to prepare effectively:
Coordination with Stakeholders
Unsurprisingly, preparedness will largely rely on the quality of coordination between cargo stakeholders. This is a concept that the air freight industry embodies on a daily basis. Yet in the case of the Covid-19 vaccines, it will take a greater amount of organisation to work around the “moving parts” affecting planning. Air freight and logistics companies need to work together, but also with pharmaceutical laboratories, specialised industry bodies (Pharma.Aero), hospitals and government agencies tasked with national preparations.
In addition, cargo communities will need to reach out to their counterparts in various origins/destinations in the vaccines’ journey. This will ensure precision just-in-time planning for the “go live” and better predictability along the supply chain.
Cargo operators will also need to jointly assess the capabilities available for fast processing of the vaccine shipments. It is critical to evaluate the total cool chain capacity at the airport in terms of infrastructure, equipment and labour. Ground handlers should carefully plan ahead and consider exchanging capacity among operators if needed.
In the event that capacity is insufficient, cargo operators can consider using temporary freezing units to provide additional capacity – these are already in high demand. Re-purposing other perishables facilities could also be an option.
There are other actions that airports can coordinate to manage throughput. These include enabling expedited border control processing, coordinating the right traffic slots for exceptional flights and possibly, extending airfield opening times. The objective is to “flatten the traffic curve” to the greatest degree and create the right circumstances for seamless flows.
To build on their existing cool chains, airports need to review “pain points” along the air freight supply chain and minimise risk for temperature excursions. For instance, shipments are the most vulnerable when waiting while in transit in an uncontrolled environment (such as an airport ramp pre-loading in warm climates). Other risks will no doubt vary across airports and supply chains. Various technologies, such as thermal blankets, could help resolve some of these issues.
We may ultimately come to identify many of the uncertainties around vaccine transportation, given time. However, it is critical to start the planning for various conditions. Plans could apply to a range of temperature requirements, scale and predictability of vaccine traffic. Airports should also prepare different planning scenarios according to whether they will act as (regional) distribution points, or as “pass-through” for local demand. Saturation points will vary widely across these scenarios.
In conclusion, thorough planning should be the keywords to mitigate foreseeable risks. Besides this, a degree of agility will also be needed in responding to shortcomings in planning. It is true that the challenge we face is unprecedented due to various compounding aspects. However, air cargo is also a resourceful, proactive and resilient industry that keeps surprising its observers. The coming months will provide a world stage for air cargo to demonstrate just how accurate this statement may be.