A delicate, precious cargo, and hope for the world after the dark months of the pandemic. This is what the Covid vaccine is to the world of logistics which is now faced with an enormous challenge. Those working in the sector must now provide rapid and reliable solutions for transporting medicine, particularly pharmaceutical products that require temperature-controlled storage and transport.

Hundreds of millions of doses to be made available across every EU member state in a short space of time and according to the procedures each nation has set out for their country. Logistical resources already available are being mobilised en masse, laying the foundations for fluid networks capable of transporting the vaccine from manufacturer’s headquarters to major airports, and from airport hubs to the hospitals where the drug will eventually be administered to citizens. 

In Italy, there are essentially two distribution strategies in place. For the more complex vaccine type, vials needs to be kept at a constant temperature of -80 degrees, which is why the manufacturer themselves will be responsible for its direct transportation to the 300 hospitals acting as administration hubs for the public. The majority of these hospitals are already equipped to store the vials at a controlled temperature, using refrigeration technology provided by Italy’s Civil Protection Department in some cases.

The other vaccine types obtained by Italy call for more common standards of temperature control and will instead be managed through the Pratica di Mare Air Base. The doses will be flown in through the military air base and then distributed to 1,500 hospitals throughout the country, which will be responsible for storage and delivery to the public. The vehicles transporting vaccines overland to these administration hubs will be escorted, at least initially, by the Italian Armed Forces, ensuring that operations launch with the highest degree of security.

The situation’s exceptional nature not only casts logistics and temperature-controlled transport in a central role, but also demonstrates just how vital it is that everyone in the sector “speaks the same language” and is ready to work under unprecedented circumstances. This is why in December the Pharmaceutical Division of OITA, the Interdisciplinary Food Transport Observatory, made a memorandum of recommendations and technical advice available to Domenico Arcuri, the Extraordinary Commissioner for the Covid-19 emergency, with the intention of maximising cooperation between all the forces involved in distributing the vaccine.

The multidisciplinary panel assembled by the experts at OITA has, in fact, highlighted some critical points which, if left unresolved, could compromise the goal of achieving herd immunity throughout the entire Italian population by the autumn. More importantly, the panel defined a comprehensive approach for preventing and overcoming these critical points, setting out practical solutions that can be immediately implemented.

The document sets out almost 40 recommendations, all stemming from analytical thinking and based on planning. Italy’s Mass Covid Vaccination Programme is an undertaking that can only be successfully carried out with an industrial approach, applying the most advanced logistics and production theories from the manufacturing industry.

At the heart of the process is vaccine administration, which can be seen as the vaccination 'factory', and must operate with maximum efficiency. It must be continuously fed by three supply chains: vaccines, ‘vaccinees’, and vaccinators. Adopting this model is the only way risks of not reaching all vaccination candidates or experiencing unacceptable delays in population immunity can be avoided with reasonable certainty.

Some of the main recommendations brought to Commissioner Arcuri's attention:

-        Utmost simplification of the user interaction, in terms of hardware and software required by the user, the complexity of the interface and in the booking process: a web browser, email address and ability to receive SMS messages should be sufficient

-        Any data input from and to other information systems must be asynchronous to vaccine administration operations, except in special cases relating to equipment and vaccine logistics

-        Administration of each vaccine type must be simulated in advance in order to determine the most efficient times and procedures, and staffing requirements should be calculated based on the results

-        Close attention should be paid to resource sizing and how vaccinations are delivered in Residential Care Homes (RSAs), at home and in remote and disadvantaged locations (nearly 20% of the population to be reached according to OITAf calculations)

-        The sourcing, operating, managing and maintaining of Mobile Units for vaccination needs mentioned in the previous point should be paid careful attention

-        The Moderna vaccine, which is becoming more important following delays in alternatives, is a medicine that needs to be handled and transported in a frozen state. Its logistics from the central hub to regional hubs to last mile hubs should receive as much attention as the Pfizer/BioNtec vaccine logistics

-        Reverse logistics of medical waste collection and disposal generated from administration in non-hospital or non-medical settings should be managed centrally

-        Wherever possible, walk-in vaccination centres should be set up in existing facilities equipped with most of the necessary basic equipment, including non-health facilities, as in other European Countries. For ad-hoc facilities, the best options are field hospitals set up by the Red Cross, the Armed Forces, or similar private organisations.