Maintenance – what it will take to get a super-cold Covid-19 vaccine for W. Africa

Dakar – A promising new coronavirus vaccine must be kept at Antarctic temperature, raising concerns about delivery in Africa

Hopes are rising that a new vaccine could stop the COVID-19 pandemic – for some – but lessons learned from previous vaccination programs in West Africa suggest millions of others will miss it.

The exceptional storage temperature required for the new vaccine will make it nearly impossible to deliver in rural parts of Africa, Evelyn Castle said.

“We need all new infrastructure,” said Castle, executive director of the non-profit organization eHealth Africa, which helped distribute an Ebola vaccine in Sierra Leone in 2016 at similar temperatures.

“(In Sierra Leone) we had to completely renovate some of the facilities we worked in.”

The pharmaceutical company Pfizer and its partner BioNTech SE said on Monday that initial trials showed that their experimental COVID-19 vaccine was more than 90% effective.

But the vaccine should be kept at temperatures of minus 70 degrees Celsius (-94 F) or lower – colder than the North Pole. Even sophisticated American hospitals say they do not have the capacity.

Routine vaccines usually need to be stored at 2-8 ° C, about the temperature of a normal refrigerator, and even that is a challenge for much of West Africa, where electricity does not exist or is unreliable. , Castle said.

The Ebola vaccine trial in Sierra Leone involved the immunization of about 8,000 health workers – a fair amount of work, but nothing compared to the work to protect millions from COVID-19, Castle said.

Coronavirus has killed nearly 1.3 million people worldwide and infected 50 million. European countries have already agreed with Pfizer to buy millions of doses of the vaccine.

Other companies, including Moderna Inc, Johnson & Johnson and Novavax Inc, are working on developing vaccines that do not require such low temperatures.

But the first time in the block, if it would get U.S. approval in distress as hoped this month, it would be Pfizer, which would ensure a global scramble for infrastructure to make it work.

COLD COMFORT

In Nigeria, there are many refrigerators in rural health centers, but Castle said they do not have the strength to reach -70 ° C.

Generators would be needed, along with someone to ensure they are constantly maintained, fueled and constantly monitored so that they do not fall below the temperature threshold, she said.

Transportation would also be challenging, and not just due to temperature constraints.

“Obviously there are a lot of challenges to keep it cold during transport, but you may not even have cars, you may not have fuel, and you may not have drivers to do the actual delivery,” she said.

In Sierra Leone, health centers had to be equipped with running water so that the Ebola vaccine could be administered safely, and with internet to keep track of the patient record.

Given all this, a likely scenario is that any vaccine would first go to urban areas, Castle said – in itself a possible problem.

“If we have a limited number of vaccines, who are we going to target? Are we really just giving it to the rich people who live in cities?”

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