News Feature | May 5, 2014

Can Pharma Take The "Cold" Out Of Cold Chain?

By Lori Clapper

More than 22 million children around the world do not get vaccinated. Vaccines are some of the most important life-saving medical tools in the world, and each year, organizations such as Doctors without Borders/Médecins Sans Frontières (MSF) facilitate the delivery of measles, yellow fever, meningitis, and other vaccines to children in developing countries. Yet, according to a release from MSF the current thermostability requirements of these vital vaccines could stand in the way of saving millions of children’s lives.

Roadblocks on the way to global health

Most vaccines will spoil if they aren’t kept at 35 to 46°F. In developed countries, where electricity and refrigeration are reliable and available, this isn’t a problem. However, MSF workers travel to some of the most remote parts of the world and have to store, transport, and administer meds in extreme conditions.  For example, in African countries like Chad, electricity is unstable and temperatures can reach 113°F — far above the range to keep vaccines safe, thus negatively impacting the health of children for which they were intended.

According to MSF, “The inability to keep some vaccines in the cold chain leads to vaccine shortages, causing one in five children under the age of one to miss the full schedule of vaccinations each year.”

Changing courses

MSF currently operates a meticulous “cold chain” through every step of their trip from the manufacturer to the children who need them. Starting at a warehouse in Brussels, Belgium, vaccines are transferred to the destination countries via airplane. That’s when things get challenging.

“The closer to the patient, the more critical transport can become,” MSF Cold Chain Logistician Malcolm Townsend said. “For example, large cold boxes are hand-carried over rough paths, which sometimes need to be cleared of vegetation, or include river crossings, in order to reach the vaccination sites.”

Looking for a solution

MSF is lobbying for pharmaceutical companies to develop easy-to-use vaccines that can tolerate extreme heat and that don’t need to be refrigerated. Part of its plan is for manufacturers to test how their current vaccines perform outside the cold chain to make storage requirements more flexible. So far, the only vaccine approved is MenAfriVac for Meningitis A, developed for the parts of Africa where the disease is common.

MSF has tested a tetanus toxoid vaccine that was left out of the cold chain for 30 days at temperatures up to 40°C. Initial results showed that “study participants who received this vaccine reached adequate levels of protection against tetanus.”

If more vaccines can perform without strict refrigeration guidelines, it could enable MSF and other humanitarian organizations to safely and more easily deliver vaccines all over the world.