Updated Saturday at 3:30 p.m. ET
With the FDA now authorizing the emergency use of a coronavirus vaccine, a huge logistical challenge looms. That is, transporting and distributing the vaccines quickly and efficiently to those who need it most all around the world.
It's a complex task that will involve not only shipping companies like FedEx and UPS, but also airlines better known for carrying people, not cargo.
Dr. Kate O'Brien, Director of WHO's Department of Immunization, Vaccines and Biologicals, compares the monumental task ahead to climbing the world's tallest mountain.
"Developing the vaccines and getting them licensed is like building base camp at the bottom of Everest," O'Brien said at a recent WHO Q&A session. "And actually getting to the peak - (that) is the delivery part."
In other words, O'Brien suggests developing COVID-19 vaccines in record time was relatively easy, but when it comes to transporting and distributing those vaccines, "There is going to be a struggle, frankly, in every country, about how to do this quickly."
"As a logistical operation, this really is unprecedented in terms of its scale, in terms of its magnitude and in terms of its urgency," says Hani Mahmassani, director of Northwestern University's Transportation Center. "This is not just a one shot operation, this is something that is going to be ongoing over several months in order to get that vaccine to those who need to get it."
Mahmassani says the challenge is not just in quickly putting together a global supply chain for billions of vials of vaccines, but what's particularly challenging is that the first vaccine in line for authorization, developed by Pfizer, must be stored and shipped at temperatures of minus 94 degrees Fahrenheit (-70 Celsius), otherwise it will go bad.
"So that requires speed in moving but it also requires a sort of minimizing the number of hand-offs because it has a limited shelf-life," Mahmassani says. "Once it leaves the deep freezers of Pfizer, it has a limited time before it needs to be in somebody's arm."
That means transporting the vaccines "essentially, you know, it has to be seamless. You can't miss a beat. Otherwise you're losing very valuable product," Mahmassani adds.
And when transporting vaccines hundreds or thousands of miles from coast to coast or overseas, there's one mode of transportation in particular that stands out — air travel.
"There's no replacing the speed of an airplane," says Chris Busch, managing director of Cargo in the Americas for United Airlines.
United is the first commercial airline to fly the first FDA-authorized COVID-19 vaccines to the U.S. and in early December, the airline operated five cargo-only flights delivering COVID-19 vaccines from Brussels to Chicago's O'Hare Airport.
Busch says Pfizer packs the vaccine vials in special deep freezer containers but he says United has to make special accommodations to carry them
"Probably the biggest thing we had to focus on is dry ice," Busch says. "The one way to keep things at that extremely low temperature is dry ice. And dry ice is a dangerous good."
Dry ice is frozen carbon dioxide and when it sublimates, it turns into carbon dioxide gas, which can be harmful or even deadly.
United has taken steps to monitor carbon dioxide gas levels in the aircraft, among other measures to protect pilots and ramp personnel who would go into the belly of the aircraft to unload the freight from possible carbon dioxide exposure.
The FAA is now allowing United and other airlines to carry up to 15,000 lbs of dry ice, five times more than the previous maximum amount allowed, which could allow for carrying up to 1 million doses on each Boeing 777 flight.
Busch says United has also changed its cargo handling process to get Pfizer's special freezer containers off the planes quickly.
"Here in Chicago, for instance, what we do is we park the aircraft directly behind our cargo facility and by doing that, it significantly reduces the amount of time that it takes us to bring that piece of freight from the airplane through our warehouse and onto a waiting truck," he says.
United would not comment on its relationship with Pfizer nor whether it has already flown dosages of coronavirus vaccines, but the FAA confirms a shipment of vaccines has arrived in the U.S. and sources tell NPR that it was a United charter from Brussels to Chicago.
American Airlines is conducting trial flights with its pharmaceutical and cargo partners from Miami to South America to "simulate the conditions required for the COVID-19 vaccine to stress test the thermal packaging and operational handling process that will ultimately ensure it remains stable as it moves across the globe."
American also has a 25,000 sq ft cold storage facility in Philadephia, the largest in the U.S, which can keep shipments frozen down to -4 degrees Fahrenheit, the temperature needed for a Moderna vaccine that is nearing federal authorization.
Delta Air Lines is also expanding its cold storage facilities and running test flights, as are other airlines.
But the major players in transporting and distributing vaccines will be companies like UPS and FedEx, especially once the vaccines are on the ground.
"We have the capability to serve every zip code in the United States of America. We do it every day," FedEx Express executive Richard Smith told senators Thursday in hearing on the logistics of transporting the coronavirus vaccines.
"With this network capacity, whether you live in Chicago, Illinois or Murdo, South Dakota, we're able to ensure time definite deliveries of these shipments and we feel very confident in our capabilities in this regard," Smith said. "This is what our network was built to do."
And even though both shipping companies are in the midst of the busy holiday season, e-commerce deliveries will take a back seat to distributing vaccines.
"There will be no higher priority shipments in our network than these vaccine shipments," Smith said. "They will be the highest priority."
The two giant shipping competitors will work together to ensure speedy delivery of COVID-19 vaccines nationwide.
"UPS and FedEx have split the country into two," said Wes Wheeler, president of Global Healthcare at UPS. "We know exactly what states we have, and they know what states they have."
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