With the likelihood of a vaccine against coronavirus being available within months, the government has begun a massive exercise to map out cold chain storage facilities to ensure the vaccine is delivered quickly across the country.
A national expert group is talking to public and private sector entities in the pharmaceutical sector, food processing industry and agro businesses as well as food delivery start-ups such as Swiggy and Zomato to identify cold storages or fridges at the taluka level that can stock and distribute the vaccine, sources with direct knowledge of the discussions said.
A draft scheme for the vaccine distribution is likely to be released around the middle of next week, they said. At least one domestic and three foreign vaccines are likely to be available to India in the coming months.
Most of the vaccine candidates will require a cold supply chain, with temperatures that can go well below zero degree Celsius, down to -80 degrees Celsius, though most need to be kept at between 2 and 8 degrees Celsius. The sources said that majority of vaccine candidates are in liquid form except a few freeze-dried products. They are to be administered through intramuscular injection/ route and requirement will be a two-dose regimen.
The majority of vaccine candidates would be available in multi-dose vials (2.5, 10, 20, and 50 doses per vial). An estimation of cold chain space needed for vaccines has been made considering 18 per cent of the population would need to be covered within six months, they said, adding that both the current temperature ranges (+2 to +8 degrees Celsius and -15 to -20 degrees Celsius) have been considered for the scenario to account for adequate storage in either condition.
The Union health ministry has already initiated a cold chain augmentation plan to address the additional cold chain space required for the vaccine. The sources said there will be a temporary requirement (2-3 months) of surge capacity for large cold storage at the state/ regional level to store and distribute large incoming quantities of the vaccine.
While most of the vaccine products under development require traditional cold chain temperature range (+2 to +8 degrees Celsius and -15 to -20 degrees Celsius), some products might require -60 to -80 degrees Celsius temperature for which support of the private sector which maintains such storage can be sought. With multiple immunisation sessions getting planned, additional support by increasing the fleet of refrigerated vans to transport vaccines will support the mega immunisation drive, they said.
The sources said cold chain capacity needs to be augmented most in Uttar Pradesh, Maharashtra, West Bengal, Rajasthan, Andhra Pradesh, Karnataka, Gujarat, Kerala, Telangana, and Delhi in that order. Other states that need to augment cold chain capacity are Assam, Jharkhand, Punjab and Odisha. Taluka-wise capacity augmentation has also been mapped, they said. The sources also said some discussions on the pricing of the vaccine have also been held and it was being debated if they are to be administered free or for a price.
Earlier this week, Union Health Minister Harsh Vardhan said the government expects to receive and utilise 400-500 million vaccine doses for COVID-19, and cover approximately 20-25 crore people by July 2021. The Centre has also reportedly directed states to make a robust plan for vaccine storage and distribution by October 15. According to experts, the safe delivery of vaccines for mass immunisation against COVID-19 is a massive challenge and that the country will need to significantly ramp up its cold chain facilities.
PawanexhKohli, the founding CEO of India's National Centre for Cold-Chain Development (NCCD), agreed that protocols will require COVID-19 vaccines to be kept between 2 and 8 degrees Celsius, while in transport and storage until delivery. While a bulk of the vaccines will be distributed through the Centre's Universal Immunization Programme (UIP) mechanism, experts also suggest that the government rope in private cold chain operators.
The vast scale of India's UIP is supported by more than 27,000 functional cold chain points of which 750 (3 per cent) are located at the district level and above. The rest are located below the district level, according to the government's comprehensive multi-year UIP plan for 2018-22. This includes 76,000 cold chain 'equipment', 2.5 million health workers, and 55,000 cold chain staff, the plan report said.