Philippines faces delivery nightmare for super-cooled coronavirus vaccines

By Arjay L. Balinbin, Senior Reporter

YASMIRA P. MONER, a 34-year-old resident of Linamon town, Lanao del Norte in southern Philippines, is eager to get a coronavirus vaccine shot because of the hassle she has to go through every time she comes home from Iligan City, where she works as a university lecturer.

“I have to queue at the local health office to get a medical certificate,” she said by telephone. “Before that, I also need to get a village clearance. I’m worried that I might get the virus there.”

Getting a coronavirus vaccine from manufacturing sites to remote areas of a developing country such as the Philippines will be a big challenge given the need to store some vials at temperatures of as low as minus 80 degrees Celsius.

Pfizer, Inc., Moderna, Inc. and AstraZeneca Plc have started manufacturing their COVID-19 vaccines. Pfizer said it would have enough to vaccinate 25 million people this year, while Moderna will have enough for 10 million people. AstraZeneca has said it could make vaccines for more than 100 million people this year.

The US Department of Defense and the Centers for Disease Control and Prevention (CDC) will manage distribution in the United States that is likely to start in mid-December, with an initial release of 6.4 million doses.

The UK is expected to roll out vaccines in December, while in Europe, each country in the 27-member bloc will decide on their vaccination plans.

In the Philippines, the private sector, government and AstraZeneca signed a deal last month for the purchase of 2.6 million doses of the coronavirus vaccine, which is expected to be delivered by June.

Local vaccine czar Carlito G. Galvez, Jr. last week said the government was expecting to finalize a deal with Chinese drug maker Sinovac Biotech for the purchase of 25 million doses of its vaccine for distribution in March.

Sinovac is the government’s top pick for vaccine orders for its mass immunization program that will start next year. The government seeks to immunize 20 million Filipinos yearly in the next three years.

Aside from Sinovac, at least three more drug makers have applied for clinical trials in the country, including Russia’s Gamaleya Research Institute of Epidemiology and Microbiology, Janssen Pharmaceutical Companies of Johnson & Johnson, and Clover Biopharmaceuticals, another Chinese company.

The government and Serum Institute of India Ptv. Ltd. are also in talks for the supply of 30 million doses of coronavirus vaccine Covovax.

Before the vaccine could reach any areas in the Philippines, the government must ensure that it has the facilities and manpower for the distribution.

“We need to know the type of vaccines that we will be procuring so that we know what kind of logistics we will have to prepare,” Health Undersecretary Maria Rosario S. Vergeire said by telephone.

She said the government already has freezers for vaccines that can be stored at refrigerator temperatures of 2 to 8 degrees Celsius.

Some private partners can convert their existing freezers to accommodate vaccines that require minus 20 Celsius, Ms. Vergeire said.

Two private suppliers have also committed to set up freezers for vaccines that require temperatures of negative 70 to negative 80 Celsius, she added.

LOGISTIC PLANS
Zuellig Pharma, a pharmaceutical distributor, said it’s beefing up its storage capacity nationwide. The company said its facilities can handle vaccines with different temperature requirements.

“From warehouses all the way to delivery where the vaccine is needed, we can meet the quality requirements of a client,” Zuellig Pharma Chief Business Officer Jannette Jakosalem said in a phone interview.

She said the company, which has warehouses in the cities of Parañaque, Santa Rosa, Cebu and Davao, might partner with Air21, 2GO and other third-party truckers to transport the vaccines.

The company will ensure that temperature requirements are met while the vaccines, which will be stored in special boxes, are in transit, Ms. Jakosalem said.

Special coolers can maintain temperatures of minus 80 to 8 degrees Celsius using the right mix of either ice gels or dry ice or both. There will also be temperature monitoring devices inside the boxes.

“If the manufacturer says 2 to 8 degrees, you cannot go lower or higher,” Ms. Jakosalem said. “You have to be just within the required temperature.”

She added that transporting vaccines is a very risky task because they could have a different effect on people if mishandled. “Western vaccine manufacturers are very particular about the supplier, warehousing and delivery because a vaccine that turns sour could hurt their reputation,” she added.

DHL is in talks with both private and public organizations in the Philippines on logistics support, Leonora Lim, vice-president of Life Science and Healthcare, DHL Customer Solutions and Innovation, Asia Pacific, said in an e-mail.

“We are looking both internally and externally on what we have and what we need to meet the challenges of vaccine distribution,” she said. “We are leveraging over 20 years of experience and the expertise of our 9,000-strong life sciences and healthcare community.”

UPS Philippines is also looking at how it can help deliver the coronavirus vaccines once these become available locally, Managing Director Chris Buono said.

“There’s definitely going to be a space for many firms to be involved because we are talking about the population of the entire country that’s going to need this,” he said via Zoom Cloud Meetings. “It’s not about competition, it’s not about who gets it first, it’s about ensuring the right thing for humanity.”

Freight forwarder Airspeed International Corp. is studying both transportation and storage requirements of the vaccine, General Manager Mariz C. Regis said.

“We have been handling vaccines for several years — both in international and domestic movements,” she said in an e-mailed reply to questions. “We can immediately implement and adapt to the handling requirements of the vaccine and of the companies,” she added.

‘TEDIOUS’
Truck body builder Centro Manufacturing Corp. said in a social media post recently that it was planning to build freezer vans designed for the coronavirus vaccine.

Having different types of coronavirus vaccines with varying temperature requirements would be “tedious” for the government given the logistical challenges, Ms. Vergeire said.

“We may have specific requirements for transport carriers when we go to the communities,” she said. “If we can’t get hold of these logistical needs, then we need to do the vaccination at the facilities.”

But access to these facilities might be a problem for some target populations. The Philippines has enough vaccinators, Ms. Vergeire said, citing the government’s strong immunization programs in the past.

Daryl G. Gallardo, a 26-year-old resident of Santa Cruz, Laguna province, expects to get vaccinated but doubts the government’s ability to reach far-flung areas.

“People in remote areas may have to wait because the vaccines are limited,” the medical student from Lyceum-Northwestern University said by telephone. “We also know healthcare is not a government priority.”

Senator Leila M. de Lima has filed a bill that seeks to mandate the vaccination of the country’s more than 100 million Filipinos against the coronavirus for free.

Congress has approved a P4.5-trillion national budget for next year that allotted P2.5 billion for vaccines under the Health department budget and P70 billion more in unprogrammed funds.

There is also a P10-billion standby fund under another law, bringing the total vaccine allocation to P82.5 billion.

Beyond logistics, the government must also deal with public resistance. “There’s a conspiracy theory that has been circulating via text messages that the vaccine could actually make people sick,” Ms. Moner, the lecturer, said.

“I received a chain message in Maranao warning people to avoid the vaccine at all costs,” she said. “Some people see it as a bioweapon.”

Ms. Moner said her primary concern is whether the vaccine would reach her hometown in Mindanao. “Will we ever get it? I really hope we don’t get left behind.”