6 ms·

The Ebola vaccine required -80 C storage as well and they got it into literal war zones. It’s a difficult problem, but a solved one.

FiReaNG3L 6y ago
Depends on the scale - we are talking mass vaccination of the whole planet here.
- foolmeonce 6y ago
  Not really, if every airport runs a vaccination program that takes 2 months before someone can fly there's very little need for more global infrastructure. The problem with lockdowns, etc is reinfection mostly by air travellers.
  - rocgf 6y ago
    How could that possibly be the problem? This maybe _was_ the problem in the beginning of the pandemic. Now, it's in the general population and will spread even if you ban all airplanes and repurpose airports into petting zoos.
    - foolmeonce 6y ago
      We already know how to drop the R value in a given place. It is pointlessly expensive to do so for long enough to eliminate the virus in any place that is going to be reconnected to the air network until travellers have a very low chance of infection. Sure some places will find total vaccination the best option, but places with out the infrastructure and money can simply do one lockdown that isn't compromised again by air travel. China is an example that would have left the pandemic if not for the need to resume Air travel.
danesparza 6y ago
My understanding is that -80c cold storage isn't widely available. The Ebola outbreak might have shown how to get small numbers of doses into a warzone, but scaling this up might prove to be a logistical difficulty. "Once a provider receives that vaccine, it really starts the clock that the vaccine needs to be administered within five days of when it's put in the refrigerator" Source: https://www.cbsnews.com/news/coronavirus-vaccine-distribution-storage-financial-needs/ https://www.cbsnews.com/news/coronavirus-vaccine-distributio...
- bluGill 6y ago
  Sure it is. Any small city (> 50,000 people) has someone who can get you liquid nitrogen in far larger quantities than will ever be needed (thus stuff is used for a lot of industrial processes). Put it in a cooler from wal-mart and you have a week. Any you get a week after thawing it to use is anyway, so you don't need the cold storage where the end user is. I don't know what the thawing protocols are of course.
  - chasd00 6y ago
    i'm involved in some state government COVID vaccine projects. The issue is you can't just knock together cold storage like this, there's (naturally) a long process to get "approved" and "certified" for vaccine administration. Storage is one of these criteria, they're not going to hand over a batch of vaccine to some doc with a cooler of dry ice.
    - bluGill 6y ago
      Of course not. they need to ensure the cooler is packed correctly - those standards exist. Those I don't think the doc even needs a fancy cooler, if I understand correctly they need to thaw this first, by the time the individual doc gets it they need to be thawing it and then using it quick. (I don't know what thaw procedures are though)
      - deleted 6y ago
        [deleted]
    - wbl 6y ago
      Don't they know their's a plague on? There are lots of rules that should have stopped the Atlantic Conveyor from sailing.
  - danesparza 6y ago
    So I appreciate that liquid nitrogen can keep things cool. And I appreciate that it can keep things cooler than the required -80c. (Nevermind that keeping it inside of a temperature range might be important as well). But I think you're overlooking something rather important: Storing liquid nitrogen in a vacuum flask only keeps the liquid nitrogen cold for hours or days. It doesn't keep the thing cold that you're cooling with liquid nitrogen. The week you get to use it is after the dose has been created. If it's brought below temperature for any length of time, it can presumably DESTROY the dosages affected by temperature. See the current flu vaccine storage protocols, for example: https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/vac-storage.pdf https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/vac-sto... "Regular temperature monitoring is key to proper cold chain management. Store frozen vaccines (Varicella, MMRV, and Zoster) in a freezer between -58°F and +5°F (-50°C and -15°C). Store all other routinely recommended vaccines in a refrigerator between 35°F and 46°F (2°C and 8°C). The desired average refrigerator vaccine storage temperature is 40°F (5°C). Exposure to temperatures outside these ranges may result in reduced vaccine potency and increased risk of vaccine-preventable diseases."
studius 6y ago
Ebola was localized. COVID-19 is not. I like your optimism, and what you said isn't incorrect about Ebola at the time, but I don't think it's correct about our current situation. How many locations globally have this level of refrigeration? Given that there would be high demand for it, wouldn't prices on any available refrigerators exceed what even the most altruistic companies and organizations could pay? This still needs to be solved. We have a lot of entrepreneurs, investors, and engineers reading this, so let's not be hasty in hand-waving over something serious.
- sekai 6y ago
  > Ebola was localized. COVID-19 is not You could easily localize COVID-19, just make a vaccination passport. No entry to a country if you're not vaccinated. > How many locations globally have this level of refrigeration Almost all developer countries, urban centres, where majority of people live anyway.
  - chinathrow 6y ago
    > Almost all developer countries, urban centres, where majority of people live anyway. At -80C? Edit: There are hardly storage places right now for these temperatures. https://www.youtube.com/watch?v=byW1GExQB84 https://www.youtube.com/watch?v=byW1GExQB84
    - bluGill 6y ago
      You can buy dry ice at your local grocery store. You can probably buy a cooler to put it in. And you get a week to use it after thawing, so if there is a break in the supply chain you only need to detect it and announce a vaccination clinic to that area. There might be some small town that gets 100% vaccination early on just because the truck broke down nearby and so local doctors were suddenly called upon to vaccinate their whole town just to use doses that couldn't be shipped any farther.
      - nemothekid 6y ago
        The linked video claims Pfizer has a similar solution and the currently tested parameters limit the cooler can only be opened 2x per day, and not more than 1 minute at a time, and the box only lasts 10 days, and carries doses in multiple of 1000s. A breakdown scenario in a rural area could mean 1000s of wasted doses
ksk 6y ago
While you may call it a 'solved' problem, in reality, its a problem that every single pharma company in the world wants to avoid, due to the high costs and other challenges. Source: I work in vaccines, and our company works on thermostable formulations, among other things.

FiReaNG3L 6y ago

Depends on the scale - we are talking mass vaccination of the whole planet here.

foolmeonce 6y ago
Not really, if every airport runs a vaccination program that takes 2 months before someone can fly there's very little need for more global infrastructure. The problem with lockdowns, etc is reinfection mostly by air travellers.
- rocgf 6y ago
  How could that possibly be the problem? This maybe _was_ the problem in the beginning of the pandemic. Now, it's in the general population and will spread even if you ban all airplanes and repurpose airports into petting zoos.
  - foolmeonce 6y ago
    We already know how to drop the R value in a given place. It is pointlessly expensive to do so for long enough to eliminate the virus in any place that is going to be reconnected to the air network until travellers have a very low chance of infection. Sure some places will find total vaccination the best option, but places with out the infrastructure and money can simply do one lockdown that isn't compromised again by air travel. China is an example that would have left the pandemic if not for the need to resume Air travel.

danesparza 6y ago

My understanding is that -80c cold storage isn't widely available. The Ebola outbreak might have shown how to get small numbers of doses into a warzone, but scaling this up might prove to be a logistical difficulty. "Once a provider receives that vaccine, it really starts the clock that the vaccine needs to be administered within five days of when it's put in the refrigerator" Source: https://www.cbsnews.com/news/coronavirus-vaccine-distribution-storage-financial-needs/ https://www.cbsnews.com/news/coronavirus-vaccine-distributio...

bluGill 6y ago
Sure it is. Any small city (> 50,000 people) has someone who can get you liquid nitrogen in far larger quantities than will ever be needed (thus stuff is used for a lot of industrial processes). Put it in a cooler from wal-mart and you have a week. Any you get a week after thawing it to use is anyway, so you don't need the cold storage where the end user is. I don't know what the thawing protocols are of course.
- chasd00 6y ago
  i'm involved in some state government COVID vaccine projects. The issue is you can't just knock together cold storage like this, there's (naturally) a long process to get "approved" and "certified" for vaccine administration. Storage is one of these criteria, they're not going to hand over a batch of vaccine to some doc with a cooler of dry ice.
  - bluGill 6y ago
    Of course not. they need to ensure the cooler is packed correctly - those standards exist. Those I don't think the doc even needs a fancy cooler, if I understand correctly they need to thaw this first, by the time the individual doc gets it they need to be thawing it and then using it quick. (I don't know what thaw procedures are though)
    - deleted 6y ago
      [deleted]
  - wbl 6y ago
    Don't they know their's a plague on? There are lots of rules that should have stopped the Atlantic Conveyor from sailing.
- danesparza 6y ago
  So I appreciate that liquid nitrogen can keep things cool. And I appreciate that it can keep things cooler than the required -80c. (Nevermind that keeping it inside of a temperature range might be important as well). But I think you're overlooking something rather important: Storing liquid nitrogen in a vacuum flask only keeps the liquid nitrogen cold for hours or days. It doesn't keep the thing cold that you're cooling with liquid nitrogen. The week you get to use it is after the dose has been created. If it's brought below temperature for any length of time, it can presumably DESTROY the dosages affected by temperature. See the current flu vaccine storage protocols, for example: https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/vac-storage.pdf https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/vac-sto... "Regular temperature monitoring is key to proper cold chain management. Store frozen vaccines (Varicella, MMRV, and Zoster) in a freezer between -58°F and +5°F (-50°C and -15°C). Store all other routinely recommended vaccines in a refrigerator between 35°F and 46°F (2°C and 8°C). The desired average refrigerator vaccine storage temperature is 40°F (5°C). Exposure to temperatures outside these ranges may result in reduced vaccine potency and increased risk of vaccine-preventable diseases."

studius 6y ago

Ebola was localized. COVID-19 is not. I like your optimism, and what you said isn't incorrect about Ebola at the time, but I don't think it's correct about our current situation. How many locations globally have this level of refrigeration? Given that there would be high demand for it, wouldn't prices on any available refrigerators exceed what even the most altruistic companies and organizations could pay? This still needs to be solved. We have a lot of entrepreneurs, investors, and engineers reading this, so let's not be hasty in hand-waving over something serious.

sekai 6y ago
> Ebola was localized. COVID-19 is not You could easily localize COVID-19, just make a vaccination passport. No entry to a country if you're not vaccinated. > How many locations globally have this level of refrigeration Almost all developer countries, urban centres, where majority of people live anyway.
- chinathrow 6y ago
  > Almost all developer countries, urban centres, where majority of people live anyway. At -80C? Edit: There are hardly storage places right now for these temperatures. https://www.youtube.com/watch?v=byW1GExQB84 https://www.youtube.com/watch?v=byW1GExQB84
  - bluGill 6y ago
    You can buy dry ice at your local grocery store. You can probably buy a cooler to put it in. And you get a week to use it after thawing, so if there is a break in the supply chain you only need to detect it and announce a vaccination clinic to that area. There might be some small town that gets 100% vaccination early on just because the truck broke down nearby and so local doctors were suddenly called upon to vaccinate their whole town just to use doses that couldn't be shipped any farther.
    - nemothekid 6y ago
      The linked video claims Pfizer has a similar solution and the currently tested parameters limit the cooler can only be opened 2x per day, and not more than 1 minute at a time, and the box only lasts 10 days, and carries doses in multiple of 1000s. A breakdown scenario in a rural area could mean 1000s of wasted doses

ksk 6y ago

While you may call it a 'solved' problem, in reality, its a problem that every single pharma company in the world wants to avoid, due to the high costs and other challenges. Source: I work in vaccines, and our company works on thermostable formulations, among other things.