How much is Bangladesh prepared to store and distribute the Pfizer/BioNTech vaccine?

Bangladesh has approved the emergency use of the Pfizer/BioNTech COVID-19 vaccine and more than 100,000 doses are expected to arrive next week. But questions linger over the country’s ability to pull off such a daunting operation of distributing the vials that require ultra-cold storage, which could prove to be a logistical nightmare.

In the announcement of the approval, the Directorate General of Health Services or DGHS on Thursday said the vaccine must be stored between -90 degrees Celsius and -60 degrees Celsius.

It can also be stored at 2 degrees Celsius to 5 degrees Celsius for five days. At 30 degrees Celsius, the vaccine will be valid for two hours.

Last February, the US announced that the vaccine can be transported and stored at -25 to -15 degrees Celsius for up to two weeks.

Taking the existing facilities into consideration, the DGHS says 200,000 doses can be stored in Dhaka and the capacity can be increased to around 1 million doses.

But it does not have suitable transports to deliver the vaccine to other districts; which means the administration of the doses will be limited to the capital.

STORAGE

The vaccine is stored in ultra-cold freezers and transported in thermal shipping containers and ultra-freezer vans.

Md Shamsul Haque, a line director at the DGHS, said they were taking all types of preparations to store and distribute the vaccine.

Vials of the Pfizer-BioNTech Comirnaty coronavirus disease (COVID-19) vaccine are pictured in a General practitioners practice in Berlin, Germany, Apr 10, 2021. REUTERS

The facilities where the doses will be kept will get 24-hour uninterrupted power supply, he said.

Haque said Bangladesh’s capacity to store the Pfizer vaccine depends on the type and size of vials. Some vials have single doses, while others contain multiple doses. Bangladesh currently expects to receive mutli-dose vials.

“What we have at hand, the capacity will be to store 200,000 doses of the vaccine.”

“If more come in, we will ready more freezers. According to our inquiries, we should be able to store between 800,000 and 1 million doses, but those freezers are currently being used for other purposes.”

FROZEN VACCINE

The vaccines will come to Bangladesh in a frozen state, Haque said. They then need to be unfrozen to regular temperatures and mixed into a solution before being administered.

After the mixture is prepared, it can be stored for six hours between 2 and 25 degrees Celsius.

“From what we know, it is a mixed vaccine and it has to be added to a dilutant to form the mixture that is administered to the human body.”

“We have already prepared the materials to prepare the doses. We have also readied training materials and we will determine which centres will get them.”

ONLY IN DHAKA

Haque said they won’t be able to distribute the vaccine outside Dhaka, so they were planning to give the vaccine to some specific institutions in the capital.

“But nothing is final.”

File Photo

Asked who would be receiving the vaccine, he said: “This is still in the planning stages. We’ve yet to decide who will get the vaccine.”

In Bangladesh, only the Public Health Institute, IEDCR, and icddr,b have the refrigerators with such low temperature, according to ABM Khurshid Alam, the director general of DGHS.

Considering the size of the vials for 3mm vaccine containing 10 doses, Bangladesh will initially be able to store the shots and give them to people only in Dhaka, Alam had said earlier.

WHY PFIZER?

This is the fourth COVID-19 vaccine to get emergency use authorisation in Bangladesh.

The authorities had first approved the vaccine developed by the University of Oxford and AstraZeneca before beginning the mass immunisation drive on Feb 7.

After the manufacturer of the vaccine, the Serum of India, failed to send promised doses due to an export ban by the Indian government, Bangladesh scrambled to secure vaccine from other sources. India is struggling to bring under control a deadly second wave of infections.     

The government recently approved Russia’s Sputnik V, and the vaccine of China’s state company Sinopharm.

The authorities began administering 500,000 doses of the Chinese vaccine sent as a gift on Wednesday.

China is sending 600,000 more doses as gift, but commercial supply is unlikely to begin in the first half of this year, according to officials.

Although Pfizer began exporting US-made doses by the end of April, Bangladesh had shown little interest in the vaccine considering the fact that the country has not enough logistics to store and transport the shot, which requires to be stored at -70 degrees Celsius.

MRNA TECHNOLOGY

The Pfizer vaccine, developed by using German biotechnology firm BioNTech’s messenger RNA or mRNA platform, showed over 90 percent effectiveness in trials.

It is playing a major role in controlling the pandemic that has killed nearly 3.5 million people worldwide.

Messenger RNA vaccines work by inserting synthetic mRNA that instructs cells to make a pathogen’s proteins or protein bits, spurring the immune system into action.

Now, the United States and European Union are pushing to stock up on even more of the mRNA vaccines. Japan is also working to secure 100 million doses of Pfizer’s shot by the end of June.

But the higher cost, production limits and demanding requirements for shipping and storage could limit mRNA-based vaccines' availability in lower income countries.

Pfizer will, however, deliver through the international vaccine-sharing facility COVAX some of the 2 billion COVID-19 vaccine doses it announced last Friday as new supplies for low- and middle-income countries.

Although Pfizer began exporting US-made doses by the end of April, Bangladesh had shown little interest in the vaccine considering the fact that the country does not have enough logistics to store and transport the shot.

The health ministry said earlier this month that the global programme, COVAX, is sending at least 100,000 Pfizer doses in early June.   

Bangladesh expects 68 million doses of COVID vaccines from the facility led by the World Health Organization to cover 20 percent of the population with two doses per citizen.

There is currently no confirmation on whether COVAX will only provide doses of the Pfizer vaccine, or it will make use of vaccines from another producer.

On Dec 2 of last year, the UK became the first country to approve use of the Pfizer vaccine. It was later approved for use in the US, Canada and various other countries.

Some countries have begun administering the doses to children as young as 12 years old after studies showed it is efficient and safe among the younger generation as well.  

For successful inoculations against the coronavirus, two doses of the Pfizer vaccine are required.

It was originally authorised in the US for a three-week interval between doses.

However, several countries, including the UK, chose to expand this to a 12-week interval to allow a higher percentage of the population to receive one vaccine dose quicker.