Editor’s Note: This article offers additional details related to a recent Healthcare Packaging (HCP) story reporting on a recent delivery of nearly 100,000 influenza vaccines in prefilled syringes that traveled more than 5,000 miles in just three days, maintaining a 3° to 7°C temperature range throughout the journey.
The first portion of this article is a Q&A with Dr. Joseph Bresee, Chief of the Epidemiology and Prevention Branch in the Centers for Disease Control and Prevention’s (CDC) Influenza Division.
HCP: For this particular delivery of nearly 100,000 flu vaccinations to Laos, please describe the process from CDC’s perspective.
Bresee: Typically, CDC connects vaccine manufacturers that want to contribute to the public health mission of preventing influenza with countries’ ministries of health that are ready and able to efficiently administer donated vaccines in their country. CDC then works with both the donor and the country public health authorities to provide technical support for the program, including supporting policy development and program evaluation.
HCP: How is it determined what packaging, logistics, and distribution needs are required for this particular shipment, and what company makes these decisions?
Bresee: This program is still quite new, but in the recent past donor companies have worked directly with logistics and shipping companies such as UPS to coordinate transport of vaccine and related supplies. CDC facilitates communication and planning between partners and recipient countries, as needed.
HCP: Describe CDC’s history with working with UPS. How significant is the partnership to CDC and what makes CDC seek UPS for such projects? What does UPS do well that encourages CDC to use their services?
Bresee: Spring 2013 is the second year that UPS has partnered with the Influenza Division International Program and other key players to move influenza vaccine to recipient countries. UPS clearly has the geographic reach and the expertise to ensure that the vaccine reaches the country in good shape, and therefore brings unique skills to the project.
HCP: What is the current status of the recent shipments to Laos? Describe what happens once the UPS shipments get to Laos.
Bresee: This year, influenza vaccine was received by Laos beginning in May, and was administered at vaccination clinics all over the country over a period of a few weeks, with the vast majority of the vaccine being administered during a two-week vaccination campaign.
HCP: What has been the response from Laos? How are these doses helping, and what would be the result if such a program didn’t exist?
Bresee: This is the second year that Laos has held a seasonal influenza vaccination program, thanks in part to contributions from the coalition of donors and also due to their own hard work and dedication to the mission of preventing flu.
With each year that Laos holds its own flu vaccination program, the country is better able to protect its people from death and illness caused by seasonal flu viruses. This year, for instance, we hope to ensure that pregnant women are vaccinated throughout Laos, thereby protecting a vulnerable group of women and their babies from influenza.
Additionally, by managing a seasonal flu vaccination program each year, Laos is better prepared to distribute pandemic vaccine if a flu pandemic occurs.
HCP: Describe the project involving the 5,000 doses of the flu vaccine to Uganda and how it works.
Bresee: The donor coalition provided Uganda with 5,000 doses of flu vaccine. The donation provided Uganda with a valuable learning opportunity; CDC met with Ugandan public health experts and shared key findings from Laos and others, giving Uganda insight into the resources and capabilities the country will need to develop in order to manage a full-scale seasonal flu vaccination campaign.
The following portion of this article is a Q&A with Dimitri Zacharenko, Manager of Temperature-Sensitive Healthcare Solutions, UPS.
HCP: What company provided the prefilled syringes? Do they send them to CDC in case quantities or on pallets?
Zacharenko: This year, an Australian-based manufacturer provided the flu vaccines for the move, coordinated by the CDC. The prefilled syringes were packaged in cases that were then packaged in eight pallets; each PharmaPort 360™ held one pallet. Unlike last year, these vaccines were already in pre-filled syringes, which required more space while in transport. As a result, UPS used additional PharmaPort 360™ containers for the move, providing a tailored solution for this logistics feat. (The PharmaPort 360™ containers are supplied by Cool Containers.)
HCP: Did the biopharmaceutical firm have to prepare and package doses for the CDC differently than for other customers using the same product? What are the special needs for this shipment?
Zacharenko: In this pharmaceutical shipment, the primary package is the syringe, then the box, which is then placed in the tertiary packaging at the case level. Multiple cases are then included in a pallet, which is enclosed in the fourth level of packaging, the PharmaPort 360™. It is used as another layer of reliable packaging, providing product protection as it renders a very controlled environment and maintaining the required temperature range over the necessary period of time. Through the PharmaPort 360 TM, along with the UPS Temperature True® services, the temperature is monitored at every step of the way and through a wide variety of environments—from the air to transport via truck. And, the unit is able to hold its temperature for up to 100 hours. When this particular shipment was loaded, it was loaded in a controlled environment provided by the shipper, to ensure a consistent environment throughout the process.
HCP: Describe what happens once the UPS shipments get to Laos:
Zacharenko: The vaccines were administered in May to pregnant women and other adults with higher risk of serious flu-related health threats over a period of a few weeks. Once the shipment reached Laos, it was unloaded and immediately put into a temperature-controlled environment, and was then utilized by those working in the vaccine administration program to reach the patients in need.
HCP: Is there anything else you'd like to raise regarding the move to Laos or the move to Uganda?
Zacharenko: Both moves took advantage of UPS's robust logistics and regulatory compliance team and expertise. Coordinating a move across multiple countries and continents, all with different logistics and regulatory requirements can be quite a challenge. But the UPS team worked to find a custom solution to meet those requirements while safely and quickly transporting the product.