Why should the COVID-19 vaccines be stored in icy temperatures?

The most difficult stage of deployment of the initial COVID-19 vaccines – which are actually made and tested – is usually less than a year after the start of the coronavirus pandemic, the fastest achievement in history.

“No one in the vaccine, if you asked them in March, would have said, ‘Yes, we have a vaccine by the end of December,'” said Kawsar Talaat, MD, a doctor of infectious diseases. vaccine researcher, and assistant professor in the Department of International Health at Johns Hopkins University. “The fact that we’ve been able to get vaccines tested and evaluated, and that it’s so incredibly effective, is really amazing.”

However, we are not yet clear: the shipping and storage of the vaccines is a huge, expensive challenge. Both the Moderna and Pfizer-BioNTech vaccines, which have been authorized by the Food and Drug Administration for emergencies, must be kept below zero until they reach their destinations, a technical problem that could hamper the vaccination effort. As Americans anxiously await their chance to receive their two doses, the country’s public health system is putting together a very cold distribution plan.

First, the COVID-19 vaccines should be stored at freezing temperatures.

The two approved COVID-19 vaccines require very low temperatures to remain viable, but this is not uncommon. According to the Pan American Health Organization, a specialized international health agency for the Americas, most vaccines are stored between -58 ° F and 46 ° F – but both options are at the low end of the scale.

Pfizer’s vaccine must be stored and shipped at a shocking -94 ° F to remain effective. The Moderna vaccine, meanwhile, needs to be stored at -4 ° F. If these temperatures are not maintained through each stage of the cold chain, certain elements can deteriorate and leave the vaccine useless. Only in the last phase of the journey, when they are thawed to perform vaccinations, can vaccines come out of the deep freezing point.

The Moderna vaccine can be stored for up to 30 days in normal refrigerator conditions; the Pfizer vaccine, up to five days. Both have a cool container of up to six months, so doses do not need to be used immediately as long as they are stored properly.

Their storage temperature is probably so different due to the development and manufacturing processes, says dr. Speak, but because their wording is private, there is no way to know.

Why should the COVID-19 vaccines be kept so cold?

The ultra-cold storage temperatures are the result of both the vaccines’ mRNA technology. Any vaccine of this type is relatively fragile, explains dr. Talate, which means it should be kept at lower temperatures. Heat them too much and their power (or the vaccines themselves) may decrease.

“When we create biological substances, we want to prevent something from happening to them, so often we place them in very cold temperatures to keep them stable,” she says. ‘It helps them stay [effective] as long as possible. ”

When vaccines are developed, they go through stability tests – basically take them out of the freezer and see if they hold up well. Lower storage temperatures generally equate to higher stability, at least first, explains dr. Talaat. To store it at higher (but still cold) temperatures, researchers prove that vaccines remain effective at the new temperature, or add certain stabilizers to their ingredients.

No COVID-19 vaccine has been around long enough for thorough stability tests that result in more comfortable temperatures. “You want to make sure it works before you get there,” says Dr. Talaat. Because experts worked so hard to get these vaccines out quickly, they did not necessarily have the free time to see what could keep the vaccines stable at higher temperatures. (After all, more than 300,000 Americans died this year from COVID-19.)

Now that researchers have the benefit of time, future generations of the vaccine are likely to be much easier to store; some COVID-19 vaccines already developed do not require such an intense freezing point to survive. The next generation of vaccines, including AstraZeneca, which are kept at normal refrigerator temperatures, already offer some hope for easier storage.

How will the storage temperature requirements affect the initial distribution of vaccine?

The types of freezers that can keep current COVID-19 vaccines stable, especially Pfizer’s, are expensive and are usually only found in hospitals and laboratories. A clinic, a nursing home or even [regional] health departments may not have freezers that can keep things at -94 ° F, ”says dr. Talaat.

Transport and storage are two of the biggest barriers to global vaccination. A Reuters report last month called the complex requirements of the vaccine “a barrier to even the most sophisticated hospitals in the United States”. Rural and underfunded healthcare providers without the resources to improve their cooling face even greater obstacles.

Since Moderna’s vaccine holds up well in normal freezers, Pfizer’s under-zero option will be the most difficult. The company is currently shipping its vaccine in so-called ‘pizza bowls’, which contain 195 bottles that remain stable for several weeks, thanks to a steady supply of dry ice.

At present, the Pfizer vaccine is stored at the company’s production facilities and on ‘freezer farms’, large storage sites equipped with special freezers as large as refrigerators. (Interestingly, Dippin ‘Dots is one of the only freezer-producing companies to reach such low temperatures, shipping and storing its distinctive ice cream at -40 ° F.)

Vials with Moderna vaccine are still difficult to ship, but have so far caused less headaches. “You go from special freezers that only have laboratories and hospitals, to freezers that any clinic will have,” explains dr. Talaat. Both vaccines are already being distributed to government officials, health workers and nursing home residents.

Even with such a cumbersome storage, experts breathe a sigh of relief that the spread is finally underway. ‘I’m so glad I have a vaccine, even if it’s stored [so low], it’s 95% effective and can hopefully make a dent in this terrible pandemic, rather than waiting for one that is stable in a fridge but has to wait longer, ‘says dr. Talaat. “I’m just so glad these vaccines are available.”

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