Tuesday, April 5, 2022

With cold chain limits, some vaccines not ‘ideal’ for India – ET HealthWorld


PUNE: Leading health experts in the country have expressed concern over the number of cold chain facilities that’ll have to be readied to deploy vaccines with recommended storage temperatures as low as -70°C.

Former director general of the Indian Council of Medical Research, Dr NK Ganguly, told TOI that most of the Covid vaccines being developed require super-cold storage and may prove difficult for even the most sophisticated cities to store and transport.

“Medical freezers that go down to -70°C or -80°C are rare even in American and European hospitals. Most, if not all the current vaccine frontrunners, require stringent cold chains, making them immensely challenging for India to deploy,” he said.

Their concerns come amidst reports that said the Pfizer vaccine, which promises 90% efficacy, will need to be stored in -70°C. The Moderna vaccine too — its efficacy rating is expected by December-end — needs -20°C to survive.

The experts added such vaccines will not be ideal for developing countries.

Dr Ganguly said the Pfizer vaccine may prove to be a “logistical nightmare” for India, with heatwaves, widespread power outages and large rural belts.

“Also, massive pre-orders for the vaccines (Pfizer and Moderna’s) from the United Kingdom, United States and Japan will make them mostly unavailable for us until 2021,” he said.

Dr Lalit Kant, former head of epidemiology and communicable diseases at the ICMR, said some vaccines will not be feasible for India.

He said, “Both the Pfizer and Moderna vaccines are mRNA (messenger RNA) shots that require ultra-low storage temperatures. We do not have such freezers in our country. Pfizer has announced it will provide a dry ice container that will be able to maintain a temperature of -70°C for up to 10 days. But it is still not logistically feasible,” he said. However, Dr Kant said there are vaccines in development that can be stored in temperatures between -2°C and -8°C.

“I think India should wait for such vaccines that will be affordable, easy to store and transport,” he said.

“The key challenge ahead of Covid-19 immunisation will likely be last-mile distribution and ensuring each vaccination site has enough cooling equipment to maintain efficacy of these valuable vaccines,” Dr Kant added.

Health officials said existing cold storage networks fulfil requirements of three vaccine candidates — from Bharat Biotech, Zydus Cadila and Serum Institute — that are being tested for Indian conditions.

A senior central health official said the doses would require more than 16,000 cold chain storages.

Worldwide too, experts have said governments need to ramp up their cold chain networks.

The World Health Organisation has estimated that 70% of the global population has to be inoculated to end Covid-19. And there’s now growing concern that some populations may be left out of vaccine interventions almost entirely.

In fact, nearly 3 billion of the world’s 7.8 billion people live in places with insufficient storage facilities for a Covid vaccine. The WHO’s chief scientist Dr Soumya Swaminathan said countries will now need to prepare for logistical challenges.

She said, “India has huge experience with the national immunization program. But this has been targeted mainly for childhood vaccines. Apart from cold chain and supply chain issues, countries will need to prepare and train their health workforce, deploy digital tracking systems, ensure safety surveillance protocols are in place and undertake community preparedness activities. Most vaccines being developed require at least two doses and we’ll need follow-ups for the repeat vaccination.”





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