Once a vaccine has reached pre-approval stage following clinical trials, it is assessed by the relevant regulatory body for compliance with quality, safety and efficacy criteria. Following regulatory approval, manufacturers can submit a vaccine to WHO for prequalification (PQ), an assessment process that ensures quality, safety and efficacy and helps the UN and other international procurement organizations determine the programmatic suitability of a vaccine.
During global health emergencies, the WHO Emergency Use Listing Procedure (EUL) may be used to allow emergency use of the vaccine. The EUL exists because, in a pandemic situation, products that could benefit the lives of people all over the world may be prevented from coming to market with sufficient speed. The EUL is a fast-tracked but rigorous process, designed to bring impactful products to all those in need, as quickly as possible, on a time-limited basis and based on a risk-versus-benefit evaluation. The WHO PQ/EUL recommendation may be used by UN agencies such as UNICEF and the Pan American Health Organization Revolving Fund for procurement decisions in low- and middle-income countries. Gavi also relies on WHO EUL/PQ to specify which vaccines its funds may be used to purchase.
How it’s packaged
Once the vaccine has been made in bulk quantities, it is bottled in glass vials and then carefully packaged for safe cold storage and transport.
Vaccine packaging must be able to withstand extreme temperatures, as well as the risks involved in being transported globally. Therefore, vaccine vials are most commonly made from glass, as it is durable and able to maintain its integrity in extreme temperatures.
How it’s stored
When a vaccine is too hot or too cold, it becomes less effective or even inactive. If stored at the incorrect temperature, vaccines can be ruined or unsafe for use. Most vaccines require refrigerated storage at between 2 and 8 °C. Some vaccines require temperatures as cold as -20°C. Some of the newer vaccines need to be kept ultra cold at -70°C. For frozen vaccines some of them can be safely stored for a limited time between 2 and 8°C.
Regular refrigerators cannot maintain an even temperature consistently, so specialized medical refrigerators are required for these precious products.
How it’s shipped
To maintain this cold chain, vaccines are shipped using specialized equipment that does not compromise the integrity of the product. Once shipments land in the destination country, refrigerated lorries transport the vaccines from the airport to the warehouse cold room. From there, portable iceboxes are used to transport vaccines from the cold room to regional centres where they’re stored in refrigerators. If vaccination takes place outside of the regional facility, the final step often requires portable iceboxes to transport the goods to local areas for vaccination campaigns. New technologies have invented some portable devices that can keep vaccines at their cold temperature for several days without needing electricity.
Quality control
Once vaccines start being administered, national authorities and WHO constantly monitor for – and establish the severity of – any possible adverse side effects and responses from people who have received the vaccine. The safety of the vaccine is paramount, with regular assessments and post-approval clinical studies to report on its safety and effectiveness.
The Philippine’s Cold Chain Process for COVID-19 Vaccine
As part of the preparations for the COVID-19 vaccine deployment, the Philippines has three (3) cold storage facilities that can potentially be used in the first wave of COVID-19 vaccine roll-out: the First Pioneer Distribution Center of UNILAB located in Biñan City, Laguna; the Research Institute of Tropical Medicine (RITM) in Muntinlupa City; and the Zuellig Pharma Corporation in Parañaque City.
The Unilab’s cold storage facility has a temperature range of +2 to +8 °C and can store a maximum of five million doses of vaccines while Zuellig Pharma’s cold storage facilities can accommodate pharmaceutical products with temperature requirements ranging between -80°C to +25 °C, with +2 to +8 °C cold rooms that can store up to 629 million doses in various warehouses. Its -15 to -25 °C walk-in freezers can hold up to 40 million doses, and its 14 ultra-cold freezers with -80 to -70 °C temperature range has the capacity to store up to 6.5 million doses. RITM on the other hand, currently has four cold rooms with a +2 to +8 °C temperature range, one -20 °C walk-in freezer, and two ultra-low temperature freezers with a -70 to -80 °C temperature range. Presently, RITM commits its ultra-low temperature storage facility for storage of COVID-19 vaccines.
Apart from cold chain facilities, the Philippine vaccine cluster will also link with third-party logistics providers to ensure efficiency of the entire supply chain management of COVID-19 vaccines, from the receipt of vaccines from the COVAX Facility to its deployment.
Author: Alona Estanilla Teo
Sources:
