With 330 000 Pfizer doses now landing weekly at OR Tambo International Airport and consignments nearly doubling to 630 000 per week by the end of June, proper cold chain management will prove crucial for South Africa’s vaccine roll-out.
The Pfizer vaccine can be stored at -70°C for up to six months, after which it can be stored at -20°C for a further 14 days. Vials can be transferred to a refrigerator for an extra five days of storage only.
According to the Mail & Guardian’s sources in the Covid-19 vaccine cold chain management programme, most provincial hospitals and depots have adequate cold chain storage capacity, but most district clinics do not. This means that skilful logistics management will be required for supply management between hospitals, depots and vaccination clinics, especially in rural areas, where clinics have refrigeration capacity of just 2°C to 8°C.
One source said childhood polio vaccine campaign cold storage protocols were strengthened for the expanded programme on immunization three years ago, resulting in most district hospitals now having -20°C refrigeration capacity.
This explains why the Pfizer vaccines are scheduled to arrive at provincial vaccination and distribution sites every fortnight.
Dr Stavros Nicolaou, the leader of Business for South Africa’s health stream, said once batches of newly arrived Pfizer vaccines pass the three to nine day quality assurance testing process, they’re transported to the BioVac depot in Midrand for national distribution. The first batch of 330 000 doses arrived at Midrand on 11 May and was stored at -70°C.
“If we work smartly and efficiently, the first supplies should start arriving at the district vaccination sites by Monday, 17 May. The entire process is a lot more complex than for the (single-dose) Johnson & Johnson vaccinations,” he said.
Pfizer’s strict cold storage requirements mean that if a vaccine batch arrives at a district clinic on a Thursday or Friday, the weekend will consume two of the precious maximum five days of ordinary fridge storage, resulting in wastage.
Nicolaou said that by Wednesday, 12 May, about 180 vaccination sites had been accredited and curated for handling the phase two rollout.
The current vaccination accredited sites represent 6% of the 3 000 sites envisaged nationally — staffed by appropriately trained healthcare staff.