The storage, delivery and distribution challenges aroun…

The South African Health Products Regulatory Authority (SAHPRA) is ready to review applications from Covid-19 vaccine candidates (Photo: biopharma-reporter.com/Wikipedia).

Delivering a safe and effective Covid-19 vaccine once it becomes available in South Africa will be complex and costly. Vaccine bottles are only useful if they are administered to humans and acquiring adequate injection equipment is part of critical planning to ensure quick and equitable access to Covid-19 vaccines.

First published by the weekly Daily Maverick 168

South Africa, through the World Health Organization (WHO)-led COVAX facility, has pledged to secure 5.7 million doses for at least 10% of the population at a cost of more than R2 billion. The Ministry of Health (DoH) plans that a vaccine will be available by mid-2021.

Once secured, a Covid-19 vaccine must be approved by the South African health product regulator. The country’s vaccination program, which is primarily focused on children, needs to expand to meet the demand for the introduction of a Covid-19 vaccine for adults.

WHO has outlined steps that countries need to plan before vaccines become available. This includes training health care workers and identifying vaccination sites. Refrigeration is essential so that the vaccine can be stored and transported to centers without breaking the cold chain. Security also needs to be improved to prevent theft in the illegal market.

Ian Wakefield, general manager for Africa at Becton Dickinson (BD), a global medical technology company, says Covid-19 vaccine doses and injection devices – syringes and needles – go hand in hand. “As we saw in the early days of the pandemic with testing and personal protective equipment, SA is likely to be involved in a global competition for … vaccination equipment,” he says.

BD manufactures 12 billion syringe units annually. Of this, three billion are for vaccines. “Given the … pandemic, we are in the process of increasing the supply by a billion [more] Units, ”says Wakefield.

Around 800 million units have been shipped to Canada, the UK and the US, and Saudi Arabia is completing its order, he says.

According to Wakefield, the DoH has not yet entered into official talks with BD about sourcing injection equipment. The company currently supplies syringes for the BCG vaccine in all provinces. Wakefield recognizes that access to a Covid-19 vaccine is high on the Department of Health’s priority list for the pandemic. However, the planning of the delivery cannot be ignored.

“We want to have discussions with health ministries in Africa as the first movers, the US and the UK, have pre-purchased worldwide. There will only be a limited supply of syringes … We want to raise awareness that vaccine delivery includes delivery from the vial to the person being vaccinated. It is important that governments look into this now before it is too late … “

The amount of equipment needed for South Africa is not yet clear and will depend on the vaccine chosen. When asked what a BD injection device would cost, Wakefield said, “We cannot provide exact pricing for our vaccine delivery devices in SA. However, BD supplies UNICEF with vaccine delivery devices for low and middle income countries at market access prices. ”

Professor Greg Hussey, member of the Ministerial Council on Vaccines and Director of Vaccines for Africa, agrees that millions of injection devices will be needed by mid-2021. “It’s a problem, but … there are hundreds of suppliers around the world. The main concern is the distribution and storage of the vaccine, as well as the monitoring and evaluation system for the effectiveness of the vaccine. Delivering a vaccine is challenging and practically doubles the cost. Aside from the equipment, we need to make sure there are enough masks available to both health care workers and those receiving the vaccine. “

BD is not changing the design of its devices for a Covid-19 vaccine, according to Wakefield. The company makes a calibrated syringe with automatic deactivation that is designed to prevent reuse of non-sterile syringes.

He says the company was the first of its kind to manufacture single-use syringes for the polio vaccine. “When the HIV pandemic hit in the 1980s, we ran the first large-scale CD4 diagnostic tests. We have long been the largest provider of these tests in… markets like Africa and India. From a health care perspective, vaccinations and health needs are in terms of price [are] … In line with our focus as a company. ” DM168

Adele Baleta is an independent science writer and vaccine safety communications advisor to WHO.

This story first appeared in our weekly newspaper, Daily Maverick 168, which is available for free to Pick ‘n Pay Smartshoppers in these Pick’ n Pay stores.

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Adele Baleta for Spotlight

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