For supply chains hobbled in 2020 by the COVID-19 pandemic, it won’t be easy to hobble the pandemic in 2021 by distributing millions of doses of vaccine in the U.S. alone.

Airlines and trucking companies tasked with delivering the vaccine will need to figure out how to keep the vaccines as cold as minus 70 degrees Celsius. 

The airline industry will need to be ready to transport millions of doses despite being pummeled so badly by the pandemic that it was forced to slash services and reduce fleets.

And both airlines and freight say they will need regulatory flexibility in order to distribute the vaccine efficiently, including being able to move the vaccine through borders and customs with the appropriate safeguards to prevent tampering and theft. Beyond that, distributors will have to be able to deliver the vaccine to hard-to-reach rural areas as well.

“This is a cross-organizational effort like none that’s been seen from a logistics standpoint,” said John Haber, founder and CEO of Spend Management Experts, an Atlanta-based supply chain consulting firm.

During a typical year, the Centers for Disease Control and Prevention distributes about 75 million vaccine doses to health departments and private providers around the country, according to the Kaiser Family Foundation. During the 2009-10 H1N1 pandemic, the government distributed 124 million doses. By contrast, the vaccine for COVID-19 is new. The U.S. population is about 328 million, and the Moderna and Pfizer vaccines will require two doses. 

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Julie Swann, health care supply chain expert who is head of the industrial and systems engineering department at North Carolina State University, said the two primary vaccines, which have mostly been tested on adults, require two doses, meaning that the goal will be to distribute some 510 million doses. Adults constitute roughly 77 percent of the 328 million people in the United States, she said.

But it’s unclear whether the vaccines will need to be renewed annually, like the flu shot, or will last permanently, according to COVID-19 fact sheets on the CDC website.

The distribution of the COVID-19 vaccines, said Kaiser, “will be the largest-scale vaccination distribution effort ever undertaken in the U.S.”

And abroad. Distribution of the vaccine is a global effort, and many of the logistical efforts currently being organized entail shipping doses from overseas. 

‘Hugely complex’

“Delivering billions of doses of a vaccine that must be transported and stored in a deep-frozen state to the entire world efficiently will involve hugely complex logistical challenges across the supply chain,” said Alexandre de Juniac, director general and CEO of The International Air Transport Association.

The task is daunting enough that the Senate Commerce, Science and Transportation Committee will hold a hearing Thursday titled “The Logistics of Transporting a COVID-19 Vaccine.” Officials from FedEx Express and United Parcel Service are among those scheduled to testify.

Among the top challenges: refrigeration. Pfizer’s vaccine requires a temperature of minus 70 degrees Celsius (minus 94 Fahrenheit), while Moderna’s requires refrigeration at minus 20 degrees Celsius (minus 4 Fahrenheit). In anticipation of transporting the vaccines, some airlines have created “freezer farms” or thermal containers that can keep the vaccines at the desired temperature.

More controversially, to keep the vaccines cold they have considered using dry ice, the solid form of carbon dioxide that can displace cabin air and potentially risk combustion.

The Wall Street Journal reported late last month that the Federal Aviation Administration has permitted United Airlines, which is conducting charter flights from Brussels to Chicago with Pfizer’s vaccine, to carry 15,000 pounds of dry ice on charter flights carrying the vaccine — five times more than the roughly 3,000 pounds normally permitted. 

Those flights are cargo-only and carry no passengers, and it’s unclear if the FAA plans to continue to ease its dry ice restrictions as cargo airlines begin distributing the vaccine on a large-scale basis.

“The FAA is working with manufacturers, air carriers and airport authorities to provide guidance on implementing current regulatory requirements for safely transporting large quantities of dry ice in air cargo,” said the agency, which is also giving priority to flights with medical equipment or other supplies aimed at responding to the virus.

Test flights

Delta Air Lines has established warehouses and cooler facilities in Atlanta, Detroit, Los Angeles, New York and Seattle to store the vaccines, as well as a network of 49 certified Pharma airports across the globe.

American Airlines, meanwhile, began conducting trial vaccine flights last month from Miami to South America on its Boeing 777-200 aircraft. 

That airlines have had to make these preparations during a year in which they have been pummeled financially is not lost on House Transportation and Infrastructure Chairman Peter A. DeFazio, D-Ore., who said the need to get airplanes distributing the vaccine is yet another reason to extend federal payroll support for airline workers. The $32 billion airline aid program expired in October. 

He said it will take months to recertify the furloughed pilots and flight attendants. But “if we have a vaccine and a lot of people start flying in April and into the summer, the airlines aren’t gonna be able to meet the demand,” he said.   

Swann said the airlines that have scaled back are still largely in business. “I don’t see air capacity as being a major driver here,” she said.

Still, she said, the vaccines will come out more slowly than people want. During the H1N1 crisis, she said, pharmaceutical companies were sending out 10 million doses a week. If that distribution model holds, “it would take a while for us to get enough vaccines out there to cover the U.S. population sufficiently.”

Haber, of Spend Management Experts, said he expects some headaches caused by the overlap of initial vaccine distribution and the holiday shopping season. He said some online retailers are giving customers money back if they agree to slower shipping options for their purchases. Others are offering promotions for customers who pick up products in the store rather than have them shipped.

“I’ve never seen the issues with last-mile delivery from UPS and FedEx that I’m seeing right now,” Haber said, saying COVID-19 and the shift to more people buying online combined with the vaccine is causing “chaos.”

Add to that other potential wrinkles — say, a snowstorm that hits Louisville and Memphis, shutting down air hubs for UPS and FedEx, respectively — and a complicated process grows more complicated. “There are a lot of operational plans where they’re dependent on a lot of different things working,” he said.  “This is not like shipping a pair of jeans and a polo shirt for Christmas.”

Paul Lewis, vice president of policy and finance at the Eno Center for Transportation, said his concern is related not as much to transportation as it is to logistics. “The real challenge will be trying to distribute this vaccine to millions and millions of people,” he said. “It’s the logistics of contacting them and organizing the actual inoculation not only once, but twice.”

He says cold storage is “achievable” and disputes Haber’s assertion that Christmas could complicate the distribution. “It’s going to take a little while to ramp up production,” he said. “We will learn a lot over the next couple weeks as we start to inoculate health care workers and those most vulnerable, but hopefully those will provide a blueprint when we go from 10 million to 100 million in the late winter and early spring.”