This article is part of TPM Cafe, TPM’s home for opinion and news analysis. It first appeared at The Conversation.

Inoculating the planet from COVID-19 presents an unprecedented logistical challenge like none we’ve seen before. Mobilizing for a world war may be the closest comparison – but in this case, the enemy is invisible and everywhere.

Some of the vaccines require super-cold storage at virtually all points along the journey until they reach someone’s upper arm. And the vaccines are primarily being produced in wealthier countries, though the need – especially now – is greatest in the poorest.

While many rich countries such as Israel, Canada and those of the U.K. have managed to inoculate most of their citizens, the vast majority of people overall have yet to receive a single dose.

I have been studying global supply chains for over two decades, including those for drugs and other health-related products. To illustrate the process and how complicated and challenging it is, I’ll take you on the journey of a single dose of Pfizer – which received full Food and Drug Administration approval on Aug. 23, 2021 – all the way from a factory in Missouri to an arm in Bangladesh.

From Missouri to Massachusetts to Michigan

Even though it’s commonly known as the Pfizer vaccine, it was actually developed under a partnership with BioNTech, which is based in Germany.

It is one of two vaccines that use new mRNA technology, which provides genetic instructions that encode a viral protein. Once the vaccinated person’s cells start making the coronavirus protein, it prompts their immune system to design powerful antibodies that can neutralize the virus if they ever encounter it.

A vaccine dose’s 60-day journey to distribution starts with raw ingredients in a Pfizer factory in Chesterfield, Missouri, a suburb of St. Louis. This factory produces the key raw material called plasmids, which are basically strands of DNA that contain the genetic instructions for building coronavirus proteins.

Bottles of the DNA material are frozen, bagged, sealed and packed into a container and shipped to Andover, Massachusetts. There, the DNA is processed into mRNA, which is the active ingredient in the vaccine – also referred to as the “drug substance.”

The mRNA is packaged in plastic bags – each containing enough material to produce 10 million doses – frozen and shipped to Kalamazoo, Michigan, where the vaccine reaches the last stage of the process: formulation and filling.

First, the drug substance is combined with lipid nanoparticles – basically fat – to protect the mRNA and help it enter the human cells. Next, the combination is squirted into glass vials, six doses per vial, packaged and frozen for distribution.

Here I have presented a simplified three-step process. Making a vaccine, however, is more much complex, requiring more than 200 different materials supplied by factories spread across the world.

Keeping vials super-cold

While awaiting distribution, the Pfizer vaccine vials must be stored at temperatures from minus 112 F to minus 76 F (minus 80 C to minus 60 C) in ultra-cold freezers.

To put this in perspective, the average annual temperature at the South Pole is about minus 58 F (minus 50 C). Ice creams and frozen steaks are kept, during storage and transport, below minus 20 F (minus 29 C).

Pfizer designed its own custom cooler box to make it easier to transport its vaccines across the U.S. and around the world. Vials are placed into trays, with 195 vials per tray. Each box can fit five trays. Each box of 5,850 doses has a GPS tracker and contains a monitor that keeps a log of the temperature.

Pfizer’s custom boxes don’t require any other specialized equipment to transport the vaccines, and the ultra-cold temperature in the cooler boxes is maintained during transport using dry ice that needs to be replaced every five days.

A problem with the dry ice is that it’s carbon dioxide in solid form. The dry ice gradually turns from solid to gas, which can be dangerous without proper ventilation.

Once it has a shipment ready for delivery to a given destination, Pfizer contacts one of the global freight carriers it’s partnered with, such as UPS or DHL, which picks up a designated number of boxes and ships them directly to the country in need within one or two days.

A vial’s last mile

For a country to receive Pfizer vaccines, it needs to have the capacity to store ultra-cold medical items.

While this isn’t a problem for wealthier nations, poorer countries are less likely to have the necessary infrastructure in place.

Upon arrival in a country, the shipment goes into a deep freezer, typically at the airport or a central storage facility, until it is ready to be used. The vaccine has to be kept in ultra-cold storage until within about a month before it’s injected into someone’s shoulder.

In poorer countries that do have the right infrastructure, such as Bangladesh, distribution still needs to be restricted to a few select hospitals in large urban areas where there are ultra-cold storage facilities. For example, Bangladesh will use Pfizer vaccines at seven hospitals in its capital city, Dhaka.

The frosty journey of the Pfizer vaccine itself is just one part of getting people their jabs. Ancillary supplies needed for vaccination include special syringes delivering a 0.3-milliliter (mL) dose, needles, sterile alcohol pads and personal protective equipment for the health care worker delivering the shot.

Preparing the injection of the Pfizer vaccine requires a complex dance. First the nurse thaws the vaccine in a refrigerator to a range of 36 F to 46 F (2 C to 8 C), where it can be held for up to 31 days. Just before vaccination, the nurse brings the vial to room temperature of 36 F to 77 F (2 C to 25 C), at which it can survive no more than six hours.

Because the Pfizer vaccine is shipped as a concentrate, the nurse needs to dilute it with 1.8 milliliters of saline, resulting in a mixture sufficient for six doses.

There’s a further complication in that many low- and medium-income countries use syringes that ensure a fixed maximum dose and are automatically disabled after single use. This takes away the guesswork and prevents mistakes. UNICEF is responsible for delivering these extra supplies to poorer countries that are getting their vaccines through COVAX, the global initiative set up to distribute COVID-19 vaccines to low- and middle-income countries.

A monumental achievement

Other vaccines have much less demanding cold supply chain requirements, don’t require dilution and use syringes with standard dose sizes, allowing more countries to use them, including in rural areas.

Most of the COVID-19 vaccines approved for use by the World Health Organization, such as those made by AstraZeneca and Johnson & Johnson, require only standard cold storage of 35.6 F to 46.4 F (2 C to 8 C).

I focused on Pfizer in part because it makes up the lion’s share of doses donated by the U.S. to COVAX.

As of Aug. 22, 2021, a total of 4.97 billion COVID-19 vaccine doses had been administered, a feat unimaginable in the fall of 2020. But global coverage has been highly uneven. While a little over half of the population in high-income countries have been vaccinated, only 1.4% of low-income populations have received theirs. Many of these countries are in Africa.

The development of several vaccines, 10 of which are WHO-approved, many within a year, was a monumental achievement of science and global collaboration – especially since it previously took on average a decade.

But creating supply chains to deliver all those lifesaving vaccines to people all over the world will be an equally remarkable accomplishment.

 

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Ravi Anupindi is a professor of Technology and Operations at the University of Michigan.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

This article is part of TPM Cafe, TPM’s home for opinion and news analysis. It first appeared at The Conversation.

Most of America’s 107,000 gas stations can fill several cars every five or 10 minutes at multiple pumps. Not so for electric vehicle chargers – at least not yet. Today the U.S. has around 43,000 public EV charging stations, with about 106,000 outlets. Each outlet can charge only one vehicle at a time, and even fast-charging outlets take an hour to provide 180-240 miles’ worth of charge; most take much longer.

The existing network is acceptable for many purposes. But chargers are very unevenly distributed; almost a third of all outlets are in California. This makes EVs problematic for long trips, like the 550 miles of sparsely populated desert highway between Reno and Salt Lake City. “Range anxiety” about longer trips is one reason electric vehicles still make up fewer than 1% of U.S. passenger cars and trucks.

This uneven, limited charging infrastructure is one major roadblock to rapid electrification of the U.S. vehicle fleet, considered crucial to reducing the greenhouse gas emissions driving climate change.

It’s also a clear example of how climate change is an infrastructure problem – my specialty as a historian of climate science at Stanford University and editor of the book series “Infrastructures.”

Over many decades, the U.S. has built systems of transportation, heating, cooling, manufacturing and agriculture that rely primarily on fossil fuels. The greenhouse gas emissions those fossil fuels release when burned have raised global temperature by about 1.1°C (2°F), with serious consequences for human lives and livelihoods, as the recent report from the U.N. Intergovernmental Panel on Climate Change demonstrates.

The new assessment, like its predecessor Special Report on Global Warming of 1.5°C, shows that minimizing future climate change and its most damaging impacts will require transitioning quickly away from fossil fuels and moving instead to renewable, sustainable energy sources such as wind, solar and tidal power.

That means reimagining how people use energy: how they travel, what and where they build, how they manufacture goods and how they grow food.

Gas stations were transport infrastructure, too

Gas-powered vehicles with internal combustion engines have completely dominated American road transportation for 120 years. That’s a long time for path dependence to set in, as America built out a nationwide system to support vehicles powered by fossil fuels.

Gas stations are only the endpoints of that enormous system, which also comprises oil wells, pipelines, tankers, refineries and tank trucks – an energy production and distribution infrastructure in its own right that also supplies manufacturing, agriculture, heating oil, shipping, air travel and electric power generation.

Without it, your average gas-powered sedan wouldn’t make it from Reno to Salt Lake City either.

Fossil fuel combustion in the transport sector is now America’s largest single source of the greenhouse gas emissions causing climate change. Converting to electric vehicles could reduce those emissions quite a bit. A recent life cycle study found that in the U.S., a 2021 battery EV – charged from today’s power grid – creates only about one-third as much greenhouse gas emissions as a similar 2021 gasoline-powered car. Those emissions will fall even further as more electricity comes from renewable sources.

Despite higher upfront costs, today’s EVs are actually less expensive than gas-powered cars due to their greater energy efficiency and many fewer moving parts. An EV owner can expect to save US$6,000-$10,000 over the car’s lifetime versus a comparable conventional car. Large companies including UPS, FedEx, Amazon and Walmart are already switching to electric delivery vehicles to save money on fuel and maintenance.

All this will be good news for the climate – but only if the electricity to power EVs comes from low-carbon sources such as solar, tidal, geothermal and wind. (Nuclear is also low-carbon, but expensive and politically problematic.) Since our current power grid relies on fossil fuels for about 60% of its generating capacity, that’s a tall order.

To achieve maximal climate benefits, the electric grid won’t just have to supply all the cars that once used fossil fuels. Simultaneously, it will also need to meet rising demand from other fossil fuel switchovers, such as electric water heaters, heat pumps and stoves to replace the millions of similar appliances currently fueled by fossil natural gas.

The infrastructure bill

The 2020 Net-Zero America study from Princeton University estimates that engineering, building and supplying a low-carbon grid that could displace most fossil fuel uses would require an investment of around $600 billion by 2030.

The infrastructure bill now being debated in Congress was originally designed to get partway to that goal. It initially included $157 billion for EVs and $82 billion for power grid upgrades. In addition, $363 billion in clean energy tax credits would have supported low-carbon electric power sources, along with energy storage to provide backup power during periods of high demand or reduced output from renewables. During negotiations, however, the Senate dropped the clean energy credits altogether and slashed EV funding by over 90%.

Of the $15 billion that remains for electric vehicles, $2.5 billion would purchase electric school buses, while a proposed EV charging network of some 500,000 stations would get $7.5 billion – about half the amount needed, according to Energy Secretary Jennifer Granholm.

As for the power grid, the infrastructure bill does include about $27 billion in direct funding and loans to improve grid reliability and climate resilience. It would also create a Grid Development Authority under the U.S. Department of Energy, charged with developing a national grid capable of moving renewable energy throughout the country.

The infrastructure bill may be further modified by the House before it reaches President Joe Biden’s desk, but many of the elements that were dropped have been added to another bill that’s headed for the House: the $3.5 trillion budget plan.

As agreed to by Senate Democrats, that plan incorporates many of the Biden administration’s climate proposals, including tax credits for solar, wind and electric vehicles; a carbon tax on imports; and requirements for utilities to increase the amount of renewables in their energy mix. Senators can approve the budget by simple majority vote during “reconciliation,” though by then it will almost certainly have been trimmed again.

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Overall, the bipartisan infrastructure bill looks like a small but genuine down payment on a more climate-friendly transport sector and electric power grid, all of which will take years to build out.

But to claim global leadership in avoiding the worst potential effects of climate change, the U.S. will need at least the much larger commitment promised in the Democrats’ budget plan.

Like an electric car, that commitment will seem expensive upfront. But as the recent IPCC report reminds us, over the long term, the potential savings from avoided climate risks like droughts, floods, wildfires, deadly heat waves and sea level rise would be far, far larger.

 

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Paul N. Edwards is a William J. Perry Fellow in International Security at Stanford University’s Center for International Security and Cooperation.

This article is republished from The Conversation under a Creative Commons license. Read the original article.