Vaccine’s cold storage dilemma

PETALING JAYA: It’s possibly a gamechanger in the fight against Covid-19 but health experts have pointed out the logistical challenges in obtaining the Pfizer vaccine.

These experts said the cold storage requirements of the vaccine would be a logistical challenge for Malaysia.

The pharmaceutical giant’s vaccine uses the messenger RNA technology that requires the vaccine to be kept at -70°C and below.

Universiti Malaya epidemiologist Prof Datuk Dr Awang Bulgiba Awang Mahmud said the storage of such a vaccine in large quantities even in big towns in Malaysia would be a challenge as -70°C freezers were not easily available.

“For remote clinics in Sabah and Sarawak, this is going to be an even bigger challenge as getting the supplies to the clinics already takes quite a long time, what more to store it for use afterwards, ” he said when contacted.

A report in Time explained that the freezer in most home kitchens could be as low as -20°C.

“Pfizer’s promising Covid-19 vaccine, by contrast, must be stored at about -70°C – a temperature cold enough to harden ice cream into a spoon-breaking block of ice, and that only specialised freezers can produce, ” the report said, quoting Paula Cannon, an associate professor from the University of Southern California.

Dr Awang Bulgiba noted that -80°C freezers were available in university and research labs to store research bio samples.

However, he said that such storage capacity was not found in community clinics as it was expensive to purchase, uses a lot of electricity and was unnecessary for the usual cold chain that community clinics maintain for vaccines.

“Pfizer claims that the vaccine can be distributed in special containers which utilise dry ice to keep temperatures low but that is not a viable solution for long-term storage and to distribute such vaccines, ” he said.

Dr Awang Bulgiba also raised concerns for the future use of those special freezers once the vaccines have been administered.

Pfizer’s announcement that its experimental vaccine with German partner BioNTech had been 90% effective based on initial trial results generated world headlines last week.

Health director-general Tan Sri Dr Noor Hisham Abdullah told reporters last Tuesday that Malaysia would adopt a wait-and-see stance.

He acknowledged the logistics issues, saying: “This is an ongoing logistics evaluation.

That’s why it is important for us to review the phase three clinical trial data before we make any commitment.”

Universiti Malaya virologist Prof Dr Sazaly Abu Bakar, when contacted, said if the Pfizer vaccine was purchased by the government, then logistical issues must be addressed.

“We have to figure out how to store and deliver it, especially to the end user, because it has to be maintained at -70°C.

“To maintain the cold temperature, it is beyond the usual cold chain that we know, ” he said.

Dr Sazaly said buying the vaccine came with the cost of the entire logistical chain of transporting the vaccines here.

As such, he doubted that the government’s allocation of RM3bil would be enough.

“That (the RM3bil) is just the price of the vaccine, it does not include the price of storage, transport and delivery.

“But I believe, as time goes by, more vaccines will become available and with competition, perhaps it will drive down prices. Other technologies will also not require vaccines to be stored in that kind of temperature, ” he said.

Dr Sazaly said that that there is still a long way for the government to make a decision on which vaccine to purchase, noting that Pfizer’s vaccine trial was “not over yet” and was merely a peek into its current status.

Universiti Putra Malaysia medical epidemiologist Assoc Prof Dr Malina Osman concurred that the main concern of Pfizer’s vaccine was at the transportation level from the manufacturer till the end user due to its cold storage requirements.

“It is relatively difficult to maintain temperatures as low as -70° C throughout the transportation phase. It is well known that any transportation of any product is subjected to the probability of time delay, humidity, human factors, technical limitation and the weather, ” she said.

However, Dr Malina was confident that the country will be able to provide a storage system within the suggested temperature range.

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