Immunity by air: The Cargo Cool Chain Readies Covid Vaccine Delivery

In mid-February as U.S. states began reporting their first COVID-19 cases, desperate requests to tap into supplies of personal protective equipment (PPE) housed in the federal government’s Strategic National Stockpile began to pile up. In a code-red supply chain gaffe, most warehouses lacked the inventory necessary to supply the 3.5 billion masks required were a pandemic to hit the United States. As cases skyrocketed, the uplifting tale that defined airfreight in 2020 began to unfold, with industry stakeholders transporting billions of masks. As PPE deliveries by air have been scaled back, attention now shifts to the second leg in the race against the virus, which has infected more than 33 million and tragically taken more than 1 million lives globally as of Sept. 30, according to Johns Hopkins University. The development of a much-needed vaccine is shaping up to be the encore of airfreight’s pandemic participation. Unlike mask supply chains, which increased the availability of ready-to-ship volumes in a matter of days, it’s not yet possible to define where and when vaccine-related shipments will originate. To further complicate matters, hundreds of COVID-19 vaccine studies are underway with at least nine candidates now in advanced stages of development, according to the World Health Organization. Vaccines that may never materialize have been pre-ordered by the billions well in advance of their existence. While the shape of the supply chain will depend on where safe and effective vaccines are ultimately produced, estimates regarding the role of airfreight vary greatly. The International Air Transport Association (IATA) estimates it would take 8,000 flights utilizing a 747 freighter to vaccinate the world’s population. A study from DHL and McKinsey estimates as many as 15,000 flights could be needed to move vaccines. “We think these numbers are too high,” said Frederic Horst, managing director of Cargo Facts Consulting. “Our initial estimates point to a number closer to around 1,500 -747 equivalents, or about 160,000 tonnes.” More crucial than forecasting what could be an unprecedented volume of vaccine shipments, is trying to understand and prepare for what could be a stringent set of cool chain conditions required for their transport. The unprecedented pace of development currently underway with COVID-19 vaccine candidates has opened up doors for novel vaccine types, with a new set of logistics challenges waiting on the other side. “It's a bit more intricate once you start to peel back the layers and you start to realize what some of the challenges are,” said Larry St. Onge, global president of life sciences and health care at DHL. RECODING VACCINE DEVELOPMENT Responding to the need for urgency, large bets have been wagered on RNA vaccines, which, if proven successful against the virus, may dramatically cut production time compared to other vaccine types. Compared to conventional vaccine types, which rely on the use of a protein or virus component that helps the body develop an immune response when a target virus is detected, RNA vaccines do not require manufacturers to synthesize a purified protein. Instead, RNA vaccines delegate protein production to the host by delivering a set of instructions in the form of an mRNA strand that informs the body how to produce a viral response. RNA-type vaccines represent nearly one-third of the announced vaccine production capacities within the year-end 2021 timeframe, or 3.3 billion of nearly 10 billion doses, according to DHL and McKinsey. Given the condensed nature of clinical trials that are being completed in a matter of months rather than years, empirical evidence related to temperature sensitivity is not yet comprehensive. “I believe that they [RNA vaccine producers] will take a stringent scenario approach, at least in the initial phases of distributing the product,” said St. Onge. This would likely involve transporting the vaccine in deep-freeze conditions at a range between -70 C and -80 C. Though it’s unclear when any COVID-19 vaccine may be deemed safe and ready to ship, air cargo is already interpreting these early indicators as a mandate to look beyond lift and toward unique cool-chain solutions that are compatible with RNA vaccines — even if they may never actually be fully utilized at the scale they are being developed. SPACE IN THE FREEZER Even taking into account the most stringent temperature requirements, there’s no doubt among various links in the air cargo supply chain that airfreight is capable of delivering. “Everything that's been done up to date has pretty much gotten us ready for this in terms of the capabilities, processes and some of the regulatory guidance that’s out there,” said Stephen Maietta, head of market development of container manufacturer Envirotainer. “The issue is going to be really just overall capacity — and that's air freight capacity and deep frozen or cryogenic temperature contorl packaging and storage facilities for further distribution.” Whereas air cargo capacity was the key variable at a deficit with masks and PPE shipments, “there are lots of aircraft out there with good temperature-control capabilities,” said Henrik Ambak, SVP of cargo operations worldwide at Emirates SkyCargo . “The aircraft part of it is probably less of a concern than, for example, airport infrastructure.” Airport pharma capabilities vary greatly by region in terms of the equipment and facilities put in place by the airport or handling agents. “The European airports are more prepared for any kind of temperature control,” said Fedor Novikov, marketing director of Volga-Dnepr Group . This is because ground handlers and other transportation intermediaries have long been familiar with standards such as good distribution practice (GDP) after an EU Directive in 2017. The region also counts the most airports with IATA’s CEIV-Pharma standard. “You will of course hope that we will get the vaccine or vaccines from places that already have the necessary airport infrastructure,” said Ambak. Bottlenecks are a concern even among airports with high pharma throughput and developed infrastructure. With 12,000 square meters of dedicated temperature-controlled warehousing space, Frankfurt (FRA) is already a major nexus for pharma goods. However, only a fraction of its existing pharma throughput passes through ultra-cold facilities — held at less than 8 C. “The 2 C to 8 C range is not that big at any airport,” said Joachim von Winning, executive director of Air Cargo Community Frankfurt. “So we’re thinking about what we can do if it is [in that range of] 2 C to 8 C,” he said. The airport recently added two airside pharma dollies to make 22 airside pallets that can be cooled simultaneously. COLLABORATE TO REFRIGERATE Taking a page from its PPE handbook, the carriers, ground handlers, forwarders, and other logistics intermediaries comprising the FRA cargo community are working to streamline cool storage and dolly utilization. A COVID-19 task force will monitor capacity constraints and share resources, should vaccine shipments materialize and threaten to overwhelm any one stakeholder at the airport. When some ground handlers at FRA reached their limits, “this strategy proved to be very successful and how we managed the whole PPE workload,” said von Winning, noting that minor trucking congestion was the only bottleneck it encountered. Air France KLM Cargo is less concerned about the capabilities of its major hubs in Amsterdam (AMS) and Paris (CDG), and is focusing on some of the other destinations in its network. “We have this big task to fulfill; it’s not about my capabilities or your capabilities, it’s about how we can collaborate together to make sure that we’re doing our job,” said Enrica Calonghi, global head of pharmaceutical logistics at Air France KLM Cargo. For destinations where Air France KLM doesn’t have a large cooling facility, “we might use capacity provided by some of our customers, or the other way around.” THINKING OUTSIDE THE WAREHOUSE Investments are accelerating in packaging and containers and airfreight capacity, to accommodate the possibility of a surge in ultra-low-temperature volumes. UPS purchased 600 subzero freezers that are likely compatible with an RNA-type vaccine from Stirling Ultracold to construct freezer pharms at hubs in Europe and North America. However, the uncertainty around which vaccine or vaccines — and any accompanying temperature requirements — will prevail, is “driving everybody nuts right now,” said Tim Root, director of marketing of Stirling Ultracold. Unlike most traditional compressor-based ultracold (ULT) freezers that can’t be warmed above -50 C, Stirling’s set temperature range is adjustable, with set points up to -20 C. Other 3PLs are considering the addition of ULT freezers, according to Root. “This has become a new market for us.” “We’ve made the investment to add more than 170 ultra-low-temperature storage units into our European theater,” said DHL’s St. Onge. The containers “are able to support, potentially, some of the requirements around deep-frozen storage capability for some of the vaccines,” either as they come off the manufacturing line, or as they’re awaiting shipment. “Whether or not those units get used, it’s going to be dependent on what vaccine or vaccines are successful and arriving to the market, and the time,” said St. Onge. The non-express carriers Air Cargo World spoke to are bullish on their ability to keep cool and carry on with improved container and packaging solutions. “Every aircraft has some limit on the quantity of dry ice that can be placed on board,” said Air France KLM’s Calonghi. One of the major undertakings of the airline group’s recently formed COVID-19 vaccine task force has been to maximize this limit. “We are all looking into regulations, and we are in contact with IATA to see whether we can raise the level of dry ice,” she said. AFKLM has seen an uptick in interest from forwarders inquiring how much dry ice they can move on an aircraft-by-aircraft basis. The group will also begin leasing passive containers in October. “We are getting ready for all the packaging solutions that customers will choose, or the vaccine might require.” With most containers being leased to carriers rather than owned, Volga-Dnepr’s Novikov said that some manufacturers have shouldered much of the investment cost in ramping up container fleets. “They have invested in increasing the fleet of containers on average by 30% to 40% of the existing fleet, simply to meet the demand of vaccines,” estimated Novikov. Envirotainer has increased production for new products that had been in development prior to the crisis, as well as for its legacy offerings. Looking at the upper-bound of vaccine volume forecasts, “we’re using those numbers to measure our bandwidth with our current capacity and the flows of our units, and how they are managed, to go after the reported 50,000-pallet volume” said Maietta, “and without compromising current business.” There are enough containers to match vaccine transport forecasts, “even if you take the optimistic forecast,” said Novikov. The main problem is one of directionality — an issue that is well understood by freighter operators. Vaccines only travel one-way while containers, on the other hand, must be returned. Without knowing precisely where cargo will originate or need to travel, container manufacturers are currently reluctant to commit containers, especially to freight forwarders, “simply because they understand that they need to return the containers somehow,” said Novikov, and that requires a carrier partner. “Manufacturers are still in waiting mode,” he said. One possible solution could include utilizing charter flights to reposition containers, but that lends itself to another issue that most airports aren’t used to dealing with — recharging an onslaught of containers arriving simultaneously. If two charter flights show up with 80 empty containers, and there are only 50 recharging positions, that could create a bottleneck Envirotainer’s Maietta agrees that conversations across government, vaccine manufacturers, airport authorities, airlines and solutions providers on how to minimize the duration of a container’s use are ongoing. “It really becomes a discussion around processes and efficiency to really shorten the length of time that our customers and partners have the asset,” he said. LOWERNIG THE TEMPERATURE CURVE Although the early days of an RNA-type COVID-19 vaccine’s existence could test even some of the best-laid contingency plans, pharma manufacturers may bring transport requirements more in line with conventional vaccines as more stability data becomes available. While ultra-low temperatures for transportation may initially be required, this will change once it’s proven a vaccine can remain stable and effective at higher temperatures. “I believe, even for the RNA solutions that are out there, that with more temperature stability data, you will potentially be able to move [the vaccine] for a period of time at a 2-to-8C environment,” said St. Onge. Back in the lab, other innovators are working to decouple vaccines and biologics from the cool chain entirely. Perhaps not an option for the first round of COVID-19 vaccines, alternative vaccine-delivery methods are being researched that could enable pharma transport at ambient temperatures. Jurata Thin Film is one such biomedical company that has developed a cellulose-based film that can store up to 500 doses of vaccine on a 5-gram sheet the size of a standard piece of office paper. The doses can be rehydrated at the vaccination site with “a variety of solutions ranging from sterile water to saline,” said Dr. Maria Croyle, scientific founder of Jurata. For now, the cool chain remains a vital link between pharma manufacturer and end user. In contrast to COVID-19’s first act — a surge in PPE demand — air cargo stakeholders know that the pandemic’s second act could inject large volumes into the supply chain. “So we can handle two, three or four full-pharma flights at the same time. [We have] no idea if it will come, but if [they] come, we’ll be prepared,” said von Winning. This article originally appeared in the October/November issue of Air Cargo World, accessible here .

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