Elaborate vaccine distribution logistics pose next big coronavirus hurdle

The vaccines on the horizon that will protect billions from the virus that has laid the world low for nearly a year faces a final, formidable hurdle: a complex, ultra-cold distribution process.

The immense, near-simultaneous delivery of several new coronavirus vaccines will strain demand at the downstream end of logistics, likely through a shortage of specialized transportation resources. Refrigerated air and truck cargo carriers are already in relatively short supply. And carriers must focus on more than just the vaccine. Pfizer’s will be shipped separately from the supplies — such as syringes, needles, face shields, and alcohol wipes — needed to administer it. In addition, the rush to market with large quantities of the inoculation may make it difficult for manufacturers to vet all their transport suppliers.

What’s Getting Overlooked?

But one thing that the media and supply chain experts are focusing on less is the fact that pharmaceutical companies will need to sustain large supplies of raw materials for the vaccine for a year or more. These manufacturers are experienced at maintaining specialized ingredients for the drugs they make, but not at the gargantuan scale mandated by the need for coronavirus vaccinations for most of the world’s population.

Another potential distribution disrupter will arise from delivering the vaccine in emerging markets such as India, Brazil, and Mexico or in developing countries in Sub-Saharan Africa, at times through licensing agreements. Ordinary supply-chain challenges in these countries — from counterfeiting to diversion to theft — are more daunting than in the U.S. or Europe, but these markets also face trying physical distribution logistics. Funding and capacity for adequate modes of transit, ultra-cold storage facilities, and the reliable infrastructure demanded for smooth delivery of the vaccine are severely compromised in some countries. The bottom line: there are major supply chain challenges in emerging markets in normal times; however, the urgency and unique requirements of the vaccine will make it likely we’ll see a long delay for vaccinations arriving and being administered there.

In the U.S., the vast size of the country could create uncommon distribution hoops for vaccine delivery to jump through in the coming months. In more remote, rural areas of the country, the infrastructure needed to store vaccines for long periods of time may be absent, and local health authorities could be overwhelmed by the details of tracking inventory and ensuring that everyone in their communities gets an effective vaccine.

Furthermore, there is no U.S. national health authority that can fund and drive this effort; the country instead has a patchwork of public and private healthcare providers that will jointly play a role. In smaller municipalities and for health systems that are already stretched by months of COVID emergencies and deaths, coordinating the effort will be more difficult.

Cyber Hacking Defenses

Another less visible, but possibly more insidious, threat to the vaccines' successful distribution is cyberattacks. Already, at least one unidentified hacker believed to be a “state actor” has targeted the international inoculation delivery “cold chain” by sending phishing emails to members of the global alliance that circulates vaccines to some of the world’s poorest regions, according to IBM.

Cyber-espionage can be minimized by securing information throughout the entire organization, not just in their technical departments. Therefore, it is vital organizations:

For all three of these phases, it’s critical to ascertain that internet of things (IoT) devices, such as temperature trackers, being used in the vaccine’s manufacturing and distribution are secure. These devices tend to be vulnerable to cyberattack because they contain lots of information or serve a critical role in the process — and can be penetrable.

1. Limit the number of people who know about and have information on their computers regarding these shipments;
2. Embargo shipment details until right before they are distributed; and
3. Ensure that third parties (typically the weakest logistical link) have solid cybersecurity protections in place.

 

For all three of these phases, it’s critical to ascertain that internet of things (IoT) devices, such as temperature trackers, being used in the vaccine’s manufacturing and distribution are secure. These devices tend to be vulnerable to cyberattack because they contain lots of information or serve a critical role in the process — and can be penetrable

Security of Distribution at Smaller Pharmacies

Another point of weakness in the distribution of the COVID inoculation could lie at smaller pharmacies outside the large national chains, if they are allowed to administer the shot. Some of these sites lack sophisticated inventory management systems like their bigger competitors have, so they may be less able to detect and track fraud or theft of the vaccine.

However, steps can be taken to carefully monitor the use of the shipments, protect information about inbound vaccine shipments, and train employees to recognize signs of suspicious activity. If these smaller pharmacies in the U.S. already dispense drugs controlled by the federal Drug Enforcement Administration (DEA), they should consider using some of those protocols for the new coronavirus vaccine as well.

At least three other vaccines beyond Pfizer’s are undergoing trials to contribute to the millions of doses needed around the world. But the one being developed by other pharma companies may not be as challenging to distribute because it requires less-strict temperature controls. As a result, it will not face the potential of as many capacity constraints or concerns about contaminating the quality of its handling.

Consumer Awareness Recommended

When people are able to go to pharmacies and other distribution points to get the vaccine at the final point of its complex distribution chain, they should remain aware of any announcements from the Centers for Disease Control (CDC), Food and Drug Administration (FDA) and the drug manufacturers themselves about vaccine distribution, potential side effects, or recalls. Consumers also should find out whether they are eligible to get the vaccine earlier because of age, working in health care, pre-existing health conditions, or other considerations.

Conclusion

From high-volume ingredient storage to ultra-cold transport requirements to myriad external threats, the new coronavirus vaccine faces the ultimate distribution test in our lifetime.

Near-simultaneous delivery to most parts of the world will conspire to stress our existing distribution chains. The 2020 coronavirus outbreak already has highlighted the fragility of global supply chains, underscoring how the failure of one link in the chain has the potential to cause extensive disruptions throughout. Now, countries around the world, and companies involved in the manufacture or delivery of this lifesaving drug, should ensure the security and integrity of their end-to-end strategies to convey the vaccine, rather than simply working haltingly from one step to the next. This can start with a holistic, risk-based assessment and audit across your most sensitive supply and distribution chain operations and continue with ongoing support, monitoring, and improvement for the year or longer it will take to roll out vaccines around the world.

By Tony Pelli, Practice Director, Security and Resilience, BSI