As health systems begin to roll out COVID-19 vaccines, much attention has been paid to the "cold chain," the organizations and equipment that enable their necessary sub-zero storage and transport.

Experts have pointed to the clear logistical and security challenges this unique supply chain presents. But others say that some of these hurdles around vaccine distribution could be addressed with technology – particularly where humidity and temperature controls are concerned.

Paul Daniel, senior regulatory compliance expert at Vaisala Oyj, which develops and markets environmental and industrial measurement services, concedes that the world of temp control monitoring "is not sexy." That said, "it's really critical."

As Daniel explained, it's not quite accurate to think of controlling the ambient temperature around the vaccine as complicating the process. Rather, he said, the temperature control is the process.

"Our primary goal is to not have that vaccine arrive in a state where it's no longer effective," he said. "Getting it there at the right temperature is just as important as getting it there [at all]. So timing is also important."

In other words, the need to keep the vaccines at a certain temperature means it's even more important that your supply chain be seamless, said Daniel – so the dosages don't get stuck in a storage facility or unexpectedly delayed. "The technology that's used really depends on what you're working with."

For instance, a device monitoring the temperatures and humidity in warehouses will likely be much larger than the kinds of devices used in trucks, "when you're trying to save space for medicine."

Daniel acknowledged that the two currently approved vaccines – from Pfiizer and Moderna – have very different storage needs, with Pfizer's requiring much lower temperatures and more specialized equipment. Because of that difference, he said, we'll likely see a major difference in the ways supply chain needs are addressed, particularly as vaccination campaigns ramp up.

"You've gotten two great opportunities to compare," he said, with "these two narratives of a vaccine going through our supply chain in two very different ways."

Chris Wolfe, CEO of PowerFleet, which provides wireless IoT and machine-to-machine communication tools for securing, controlling, tracking and managing high-value enterprise assets, said his logistical concerns were mostly not with this first phase.

"I do think the initial shipments are not going to be the issue," he said. But, from his perspective, when it comes to a broader rollout, "We don't know exactly how it's going to be triaged and distributed." 

"We need direction from the top so the commercial sector can take the lead," he added.

"The devil's in the details," he continued. At the U.S. Centers for Disease Control and Prevention, "they have a structure, a plan, and a capability" for vaccine distribution, "and it hasn't been stress tested" with massive volumes of dosages.

When it comes to managing the temperature of those large-scale rollouts, he said, it's important to use tools that can allow users to make proactive adjustments in response to changes in the environment. He noted, for example, that trucks traveling through the Arizona desert will want to pre-cool their trailers or ensure that the truck is sealed at the dock for unloading. 

In general, if your vaccines require tight controls, he said, "You're going to ship more directly just to avoid temperature incursion." 

He suggested that President-elect Joe Biden could use the Federal Emergency Management Agency or the National Guard to help with the rollout, or rely on the Defense Production Act to drum up necessary resources.

"When the inauguration's over I'm assuming marching orders will come out of the CDC."

"The way to do it I think is to do it through pharmacies," he said, which have wide outreach potential and are generally well positioned. (They're also readying to ramp up assistance plans once more dosages are available.)

Daniel agreed that "the hardest part to control is the last mile," the physical processes of getting vaccines into arms.

"Historically there were no regulations around cold chains, or any attention on this stuff, until like ten years ago," he said. "Even getting people within our own industry to take it seriously" is difficult, "but it is really important."

Despite the hurdles ahead, Wolfe was hopeful for the long term.

"Once we're through this large 'pig in the python'" – meaning the initial push – "the vaccine can go into its normal distribution, scaling up to get Americans vaccinated," he said.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: kjercich@himss.org
Healthcare IT News is a HIMSS Media publication.