In our latest blog post we’ll explore the World Health Organisation (WHO) led COVID-19 vaccination coalition, COVAX. We’ll look at what it is, how it works, and why it matters, as well as what role cold chain logistics, and in particular cold chain packaging solutions will play in ensuring its success.

If you’d like to skip ahead to read specifically about the role of cold chain in delivering COVAX, you can do so by clicking here.

What is COVAX?

In April 2020, the World Health Organisation announced its Access to COVID-19 Tools (ACT) Accelerator coalition. This new coalition, designed to tackle COVID-19 by bringing together nations, organisations, and philanthropists to work together on some of the pandemic’s biggest challenges focuses on four key areas (known as the four pillars): diagnostics, treatment, vaccines, and health system strengthening. COVAX focuses on the vaccines part of this four-pronged response.

Developed, and administered by the WHO, and with partners including the Bill & Melinda Gates Foundation, the French Government, Gavi, The Coalition for Epidemic Preparedness Innovations (CEPI) and The World Bank to name but a few, the aim of COVAX is to ensure COVID-19 vaccines are developed quickly, safely, and to ensure all its contributor nations (we will get into this specific aspect in more detail later), receive vaccines in a fair and balanced way.

Another key function of COVAX is to make sure less economically developed nations have what it describes as ‘fair and equitable access’ to COVID-19 vaccines, as it seeks to avoid wealthier nations from entering into bidding wars with other wealthy nations, in what could ultimately lead to stockpiling, making vaccines less accessible.

While COVAX aims to pool the resources of as many nations, philanthropists, and associated institutions as possible, it doesn’t rule out governments making bilateral deals direct with pharmaceutical companies. Underlining this is the UK Government’s recent £548m investment in COVAX, despite having multiple bilateral arrangements in place with the likes of Pfizer, AstraZeneca, and Moderna.

How Does COVAX Work?

The role of COVAX can be broken down into four key components: vaccine research, vaccine development, vaccine distribution, and lastly, the negotiation of pricing directly with manufacturers.

Relying on philanthropic donations, direct funding from higher income economy nations (giving them access to the scheme), and the backing of its partner organisations, COVAX aims to raise enough money to support the research, development, and manufacturing of COVID-19 vaccines, while acting as an impartial broker for their equitable global distribution.

So far, they have raised $2.4b, and aim to raise a further $4.6b in order to meet their target of sourcing and distributing 2 billion vaccine doses by the end of 2021. The coalition has already struck deals with both Pfizer and AstraZeneca, with other deals in place with as-of-yet approved vaccines, as it seeks to build a varied portfolio of vaccines to be distributed throughout its contributor nations.

In a recent interview, Dr Seth Berkley, chief executive of Gavi, the Vaccine Alliance, which leads COVAX procurement and delivery discussed the significance of this varied portfolio and equitable access for all its partner nations: “Today marks another milestone for COVAX: pending regulatory approval for the AstraZeneca/Oxford candidate and pending the successful conclusion of the supply agreement for the Pfizer-BioNTech vaccine, we anticipate being able to begin deliveries of life-saving COVID-19 vaccines by the end of February. This is not just significant for COVAX, it is a major step forward for equitable access to vaccines, and an essential part of the global effort to beat this pandemic. We will only be safe anywhere if we are safe everywhere”.1

As briefly mentioned above, the aim of COVAX is to provide equitable access to a wide-range of COVID-19 vaccines to all its contributor nations. As of December 2020, the WHO was reporting that over 190 nations had signed up to the scheme, which includes the 92 lower income economy nations designated as eligible for ‘free access’ to the COVAX scheme as part of its commitment to ensuring vaccines are available to all, regardless of wealth.

This special designation to the lower income economies who have signed up to COVAX won’t be funded by paying, higher income economies, though. This part of the scheme is known as the Gavi COVAX AMC – a funding mechanism developed to ensure lower income economies have access to COVID-19 vaccines either free, or at relatively low cost. This equitable access forms a key cornerstone of the COVAX coalition as it aims to cast a wide and consistent vaccine net across vulnerable people, regardless of where they live, thus providing protection for all, and avoiding potentially harmful stockpiling and price hikes.

For the other, paying member nations, they’re able to secure their own vaccine allotment with their investment, and so regardless of whether certain vaccines fail trials, or become unavailable due to demand, they are guaranteed their pre-purchased allotment of another available, successful vaccine, which is why COVAX aims to build a comprehensive and diverse vaccine portfolio. So far, nearly 100 nations have paid into the COVAX scheme including the UK, Brazil, Israel, Croatia, Canada, Mexico, Greece and many more. A notable absence is the USA, however it is expected that the recently sworn in President Biden will join the COVAX coalition in due course.

In order to guarantee equitable access for all of its member nations, the maximum number of vaccines any one nation can procure amounts to 20% of their population. While this is the limit set by the WHO, member nations can secure as little or as much as it wants to within this limit.

Why COVAX Matters

COVAX will ultimately bring together pharmaceutical companies, nations, healthcare institutions, logistics providers and philanthropists to fund and deliver effective COVID-19 vaccines in an equitable and fair way to the most vulnerable people on every continent, regardless of wealth. This kind of joined up collaboration with a view to providing fair access isn’t only a morale or philanthropic venture, but a sensible and pragmatic approach to ensuring we can all overcome this pandemic.

Scientists forecast that between 60-70% immunity across the globe will bring about an end to the COVID-19 pandemic2, however without coalitions such as COVAX, and funding initiatives such as the Gavi COVAX AMC, there’s a significant risk that only those nations with the resources and infrastructure to procure and distribute vaccines at the scale required will achieve this level of immunity. Leaving behind those lower income economies isn’t only abandoning their vulnerable populations to the risks of COVID-19, it’s putting a significant barrier between the rest of the world and its ability to return to relative normality.

To put this into perspective, as of January 2021, over 60% of COVID-19 vaccines had been purchased by a small group of countries comprising just 16% of the world’s population.3 If we’re going to emerge from this pandemic, protect our vulnerable population, and begin to restore ravaged economies, it’ll require joined up, collaborative thinking demonstrated by the likes of the COVAX coalition.

The Role of the Cold Chain

The economic might of a nation tends to go hand-in-hand with the state of its cold chain infrastructure. An effective cold chain requires many crucial pieces of the puzzle to fit seamlessly together (international airports with access to national logistics networks, deep-freezer and refrigerated storage facilities, prepared and well-equipped end user hubs etc.), with only one missing or dysfunctional piece capable of undermining the entire cold chain. Whether it’s Pfizer’s -70°C mRNA vaccine, Moderna’s -20°C vaccine, or AstraZeneca’s 2-8°C vaccine, when we talk about COVID-19 vaccines, we need to think about temperature.

Compounding the importance of effective cold chains for COVID-19 vaccine delivery, of the 92 COVAX member nations designated as ‘lower income economies’, the majority exist on and around the equator4 (Bolivia, Cambodia, Nigeria, and Pakistan to name a few), putting the cold chain under increased risk. For many nations, this automatically rules out the Pfizer and Moderna vaccine, as access to deep freezers capable of between -20°C and -70°C just isn’t feasible in many of these nations, not to mention access to the volume of dry ice required to keep the cold chain functioning. This puts increased emphasis on access to 2-8°C and 15-25°C vaccines that require far less cold chain infrastructure to travel in warmer, less equipped nations.

The above infographic shows the location of the majority of the 92 lower income nations approved to take part in the COVAX scheme.

Again, this is where COVAX comes into its own. Acting as a broker and administrator, COVAX can ensure that nations with poorer cold chain infrastructure aren’t left to fend for themselves in the competitive vaccine procurement market, giving them access to more suitable refrigerated or room temperature vaccines that can be distributed safely in warmer climates. COVAX can also work together with cold chain experts and logistics providers to overcome these issues, as it has an overarching end-to-end view of the entire vaccination effort.

Intelsius’ Vaccine Packaging

We have been here throughout the COVID-19 pandemic, providing sample transport packaging for COVID-19 test swabs, and temperature-controlled packaging for vaccine distribution. We’re committed to being part of the solution to overcoming this pandemic and have a range of solutions designed specifically for vaccine distribution in even the most challenging shipping lanes.

ORCA solutions are a range of connected, temperature-controlled packaging systems capable of 120 hours protection against the most extreme temperature profiles. Qualified against ISTA 7D standards, and available with dry ice for vaccines requiring deep frozen temperatures or refrigerated at 2 to 8°C using advanced phase change materials, the entire ORCA range uses vacuum insulated panels, ensuring a longer and more stable temperature profile.

Available with payload volumes of between 4.5L and 50L, and with an easy-to-use, simple design, ORCA solutions can meet the requirements of COVID-19 vaccine delivery anywhere in the world.

You can read a full features and benefits breakdown of all our ORCA solutions here.

To discuss your cold chain requirements, or to find out more about how Intelsius is providing COVID-19 vaccine distribution solutions, get in touch with your local branch.

External References
  1. The Pharma Letter (2020) – COVAX announces new agreements, plans for first deliveries
  2. WHO (2020) – WHO’s Science in 5 on COVID-19 – Herd Immunity
  3. Duke Global Health Institute (2020) – Ensuring Everyone in the World Gets a COVID Vaccine
  4. Gavi (2020) – 92 low- and middle-income economies eligible to get access to COVID-19 vaccines through Gavi COVAX AMC
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