As the GoAir flight landed at the Kochi International Airport on Wednesday morning, Kerala received its first consignment for Covishield vaccines from the Pune-based pharmaceutical company, Serum Institute of India (SII). Later in the day, two more flights carrying the next batches of COVID-19 vaccines landed at the Thiruvananthapuram airport. With this, the state received 4,33,500 doses of Covishield, said Kerala Health Minister KK Shailaja. A total of 1,100 doses will be reserved for Mahe, which borders between Puducherry and Kerala. A total of 3.75 lakh healthcare workers in the state will receive the vaccine as part of the first phase of India’s biggest vaccination drive.
While the Union government has purchased 1.1 crore Covishield doses from SII for Rs 210 per dose, it will purchase an additional 4.5 crore doses in April. Meanwhile, it has placed orders for 55 lakh doses of Covaxin by Bharat Biotech for Rs 295 per dose, although the vaccine is in its phase-three clinical trial and the data to determine its efficacy and side-effects are still awaited. These vaccines will then be distributed to the states.
However, manufacturing the vaccine and transporting it to other states by road and air are only the first two legs of the entire vaccine supply chain. For a state, the real challenge begins now, as it involves transporting lakhs of vaccine vials from the airport to a central cold storage facility, then to various districts and then to all district level and Primary Healthcare Centres (PHCs), all the while maintaining its requisite temperature of 2° to 8° Celsius (for Covishield and Covaxin). A variation in the temperature could impact the efficacy of the vaccine.
According to the Kerala government, the state is prepared with its vaccine cold chain supply and is set to conduct the entire process, including the administration, “like an election.” A total of 133 vaccine centres have been set up across the districts, with Ernakulam having the highest number of vaccination booths, followed by Thiruvananthapuram and Kozhikode with 11 centres each. The other districts will have nine centres each.
As the first wave of the COVID-19 vaccine drive is set to commence on January 16, Saturday, here’s a look at what the vaccine chain looks like, that is, how it will reach the recipients located in various parts of Kerala. The key throughout the cold chain of a vaccine is maintaining it at the optimum temperature, from the time of manufacturing until it is administered.
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Crores of vaccine vials are being transported from the manufacturing units, be it SII or Bharat Biotech, to various state-run cold storage depots across the country by air and road.
The cold chain logistics service provider, Kool-Ex Cold Chain Ltd, is the lead vendor in transporting the vaccine consignments from the manufacturing plant to the airport and from the destination airport to the government storage facilities. The vaccines will be transported in air-conditioned, temperature-controlled and GPS-enabled trucks.
For transportation by air, the vaccines are packed in boxes with dry ice. Airlines such as Air India, Spice Jet, GoAir and Indigo have been roped in for the first phase. These boxes are either stored in the lower-deck of the cargo compartments or passenger cabin area of the aircraft. Considering the risks and hazards of temperature variation while transporting vaccines in dry ice (carbon dioxide can sublimate from solid to gas form), the ventilation and pressurisation system of the aircraft is ensured to be fully operational and the cabin crew staff are trained about the risks.
On Wednesday, the GoAir flight brought the Covishield vaccine doses to Kochi airport, from where the doses were transported to the Regional Vaccine Stores (RVS) in Ernakulam (1,80,000 doses) and Kozhikode (1,19,500 doses) for storage. The doses that reached Thiruvananthapuram airport (1,34,000) were transported to the Thiruvananthapuram RVS. From the RVS, the vaccines will be transported to various districts, where those will be stored at the District Vaccine Stores.
Incidentally, starting from vaccine depots to the Primary Healthcare Centres (PHCs), Kerala already has a strong cold chain infrastructure — cold chain points and cold chain equipment — for the storage of vaccines as part of the Universal Immunisation Programme (UIP). The family health centres and PHCs have ice-lined refrigerators and deep freezers.
The state has made similar arrangements for COVID-19 vaccination drive.
The district unit will be the main centre for vaccine distribution in Kerala. From the District Vaccine Stores, the district unit will distribute the jabs to the vaccine centres concerned on the day of the vaccination programme. These will be brought to the vaccination centre in ice boxes.
The District Collector will head this unit, along with the District Immunisation Officer. The list of people who will get the vaccine will be drawn up by the district centre. Each vaccination booth in a district will have the capacity to administer vaccines to 100 people per day. For example, since Thiruvananthapuram has 11 vaccine centres, 1,100 people will get the vaccine per day.
Watch: COVID Vaccine dry run in Karnataka