Inside the COVID-19 vaccine airlift: How cargo carriers plan to distribute the world's soon-to-be most valuable drugs to market

• Air cargo carriers are gearing up to transport a vaccine for the novel coronavirus if one is approved, in the second COVID-19 airlift of 2020.
• Each vaccine comes with its own requirements for shipping, with Pfizer's being among the most challenging as it requires storage temperatures of -94 degrees Fahrenheit, presenting a problem for aircraft.
• Vaccines from Moderna and Johnson & Johnson can more easily be transported as they have less strict temperature requirements.
• Over-the-road trucking will also play a large role in distribution as a safer method of transport than airplanes for some vaccines.
• The vaccine comes with security concerns as vaccines will be the most sought-after drugs post-approval.

A vaccine to end the coronavirus pandemic is nearing the finish line and getting it from the manufacturing point to the injection site will be one of the cargo aviation industry's most consequential missions to date.

In the pandemic's nascent period, the most valuable commodity was personal protective equipment. The easy-to-transport essentials like face masks, hand sanitizer, and toilet paper replaced passengers on the world's aircraft and airlines quickly began converting their planes to makeshift freighters, flying as much cargo as possible in the first COVID-19 pandemic airlift.

Now, Pfizer and Moderna are close to declaring success with their COVID-19 vaccines that are at least 90% effective and nearing emergency authorization. Both companies have said they'll seek the green light for their vaccines soon, as early as Friday, at which point regulators will begin the potentially weeks-long review process.

Anticipating a positive result, airlines are once again preparing to take to the skies in yet another global cargo-transporting endeavor— one that has the potential to end the pandemic but nevertheless presents its own set of problems.

How airlines are preparing

Only certain airlines have the infrastructure and certifications to fly vaccines and pharmaceutical cargo, both of which have special handling requirements that vary by product. Airlines who saw the writing on the wall began improving their pharmaceutical handling capabilities early in the pandemic to be ready for this airlift.

Read more: 6 cargo airlines and freight operators poised to win big when Pfizer's coronavirus vaccine is ready to go

In the US, FedEx Express and UPS Airlines have built freezer farms at their respective hubs in Memphis and Louisville.

The Louisville farm, along with another newly-constructed facility in the Netherlands, will be able to store 48,000 vials of vaccine at -112-degree Fahrenheit temperatures, as Business Insider's David Slotnick reported. FedEx Express also grew its infrastructure to 90 cold storage facilities scattered across nearly every populated continent and added to its fleet of freezers, refrigerator trucks, and sensors.

The Middle Eastern mega carriers will also play a major role in transporting the vaccine, utilizing their extensive passenger and cargo route networks to reach every corner of the globe.

Earlier this year, Emirates SkyCargo shifted its entire cargo operation from Dubai's Al Maktoum International Airport to Dubai International Airport, freeing up an entire cargo processing facility at the former that's now been dedicated to vaccine transport for once the airlift begins.

Julian Sutch, Emirates SkyCargo's global manager for pharma, described the facility to Business Insider as "world's largest dedicated air site distribution hub." And despite the surrounding desert climate, it boasts cold storage capacity of "4,600 pallets at a temperature of 2 to 8 degrees."

Qatar Airways Cargo signed a leasing agreement in September for more temperature-controlled shipping containers produced by Skycell, increasing its daily temperature-controlled cargo processing capability by 270 units at Hamad International Airport. The hub is also equipped with a 30,000-square foot facility with temperature-controlled zones going as low as 35 degrees Fahrenheit or 2 degrees Celsius.

These facilities can't keep the Pfizer vaccine at its preferred -94 degrees Fahrenheit but they won't need to, according to Sutch, as Pfizer's vaccine will be packed to survive up to 10 days in exterior temperatures of 20 degrees Celsius or 68 degrees Fahrenheit.

"We have specially designed, temperature-controlled shippers utilizing dry ice to maintain recommended temperature conditions up to 10 days unopened," the Pfizer spokesperson said.

To maximize that 10-day span, Pfizer will work closely with its chain to ensure seamless transfers along the way. Pharma cargo can already be processed at a quicker rate than normal cargo, according to Sutch, and airlines will pull out the stops to ensure the fastest delivery times.

Quick ramp transfers, for example, allow cargo planes to park "tail to tail" so containers are seamlessly unloaded one from one plane and get immediately reloaded to another.

"Generally anywhere in our network - let's say we're uplifting from Brussels - we can get that cargo to destination within two to three days, maximum," Sutch said.

Passenger airlines will also take part in the airlift, using a mixture of cargo-only and scheduled passenger flights to move the vaccine. The big three US carriers are likely participants thanks to their existing pharmaceutical capabilities and are formulating procedures for when the day comes.

"We've also put a team in place over the past couple of months to develop our preparation for vaccines," Chris Busch, managing director for United Cargo, told Business Insider. "In that, we've even further enhanced the priority and the tracking that we would have for a vaccine shipment."

Not knowing which one will cross the finish line first, United has developed standard operating procedures for each of the frontrunners. The extent to which the airline can participate will ultimately depend on the shipping requirements from the drug's manufacturer.

Delta Air Lines similarly has a vaccine task force that's working with the pharmaceutical industry and government agencies in preparation for the first approval, an airline spokesperson told Business Insider. Delta Cargo already has four pharma-specific shipping options and has expanded the cooling capabilities in its Atlanta warehouse.

Airlines are also looking back to manufacturers including Airbus and Boeing, as well as government regulators such as the Federal Aviation Administration, for any wiggle room in the top limiting factor for frozen vaccine transportation: dry ice.

Transporting a frozen vaccine

Pfizer's vaccine will be among the first to cross the finish line and while that's good news for a pandemic-stricken world, it can be a logistical hassle for the shippers tasked with transporting it around the globe.

As Pfizer says it must be kept at -94 degrees Fahrenheit (-70 Celsius), well below requirements for its competitors, and necessitating use of the dry ice containers.

"The only way to keep vaccines at that temperature for any period of time is using vast quantities of dry ice," Neel Jones Shah, global head of airfreight at Flexport, told Business Insider. "It's the only way."

Though a tried and true substance for shipping, dry ice is actually classified as a dangerous good as it sublimates and turns directly from solid ice into gaseous carbon dioxide. As it can potentially incapacitate the passengers and crew on an airplane, carriers are severely restricted in how much dry ice they can load onto a plane.

A Boeing 777 Freighter, for example, can only carry around 6,000 kilograms of dry ice, Sutch said. While that seems like a generous allowance, it's actually a small portion of a freighter's total capacity.

Emirates' 777 Freighters have a cargo payload of 107,000 kilograms each and the containers carrying the vaccine will hold around 23 kilograms of dry ice each, according to Sutch. That means Pfizer's vaccine can only fill 5% of the plane's total capacity.

Read more: Pfizer's top scientist tells us the pharma giant is already thinking about a new version of its coronavirus vaccine for 2021 that can overcome one of its biggest limitations

And as Pfizer's vaccine will require two-doses for recipients, the distribution process is further complicated as they'll have to ship twice the amount of drug. For a vaccine like Pfizer's, more planes will be required, not just more cargo space.

But not all vaccines require such high quantities of dry ice or a double dose. Moderna's candidate, for example, has a 30-day shelf life when stored between 36 and 46 degrees Fahrenheit frozen at a temperature of -4 degrees, it can last for six months. Johnson & Johnson's requires storage at 2 to 8 degrees Celsius, or around 35 to 46 degrees Fahrenheit.

"We will see full freighters of COVID vaccines flying around, but not ones currently that are using dry ice," Sutch said.

An over-the-road solution for an expensive endeavor

While we won't likely be seeing entire planeloads of the Pfizer vaccine, we will be seeing truckloads. Two of Pfizer's manufacturing centers for the vaccine are in Michigan and Belgium, centrally located in their respective continents so much so that over-the-road trucks may be used to transport the vaccine more effectively than planes.

Trucks have better ventilation capabilities than aircraft, Shah says, allowing them to hold more of the dry ice-cooled cargo without posing a danger to the drivers. Vaccines are kept in shipping containers that are separate from the trucks as they're driven so once the vaccines arrive by air, they'll be trucked to their destination.

"The intent is to utilize Pfizer-strategic transportation partners to ship by air to major hubs within a country/region and by ground transport to dosing locations," a Pfizer spokesperson told Business Insider in an email.

And for the regions where Pfizer is making the vaccine, trucks may replace aircraft entirely. Team truck driving - where drivers take turns driving one truck to minimize the journey time - can see the vaccine transported from Michigan to the far edges of the US in just a few days, according to Shah. The same goes for Belgium with Europe.

Read more: Pfizer picks 4 US states to trial transporting its COVID-19 vaccine at temperatures far below freezing. It's a key test of the 'cold chain' the vaccine will rely on.

Johnson & Johnson also has plans for over-the-road trucking to play a role in intra-country transport. Using its existing distribution network, transporting a COVID-19 vaccine is no different than moving most of its current medicines, says Luis Roman, Global Vice President, Deliver at The Janssen Pharmaceutical Companies of Johnson & Johnson.

"The candidate and the specifications that we're putting around it are really the standard vaccine distribution channels that we see globally," Roman told Business Insider. "And it's not going to require a new infrastructure to get it to the people that need it."

Regardless of the method of transportation, pharmaceutical companies will likely be shelling out more this time around than they've ever needed to for a particular drug. Cargo space has been at a premium in recent months as passenger airlines grounded their international operations, taking away valuable cargo capacity in the holds of their aircraft.

"For all of these pharmaceutical companies, for sure, it might be the most expensive supply chain they'll ever run," Shah said.

Addressing challenges in getting the vaccine to remote areas

The higher temperature-control requirements will undoubtedly make any vaccine more difficult to get to remote regions of the world but are just the tip of the iceberg as security concerns are rife in underdeveloped countries.

The vaccine will be among the most sought after drugs in the world as it represents shelter from the virus and a return to normal life. Shippers are concerned about hijacking attempts, according to Shah, and discussing what preventative measures can be taken as groups try to get vaccines for themselves, sell it on the black market, or demand ransom from authorities.

Read more: 7 unanswered questions about the coronavirus vaccines from Pfizer and Moderna

Johnson & Johnson told Business Insider that using its existing supply chain will minimize this risk by working directly with countries to distribute the vaccine. This isn't a new frontier for the company and the vaccine won't be going to any nation Johnson & Johnson hasn't been before.

While developing the vaccine in record time was a feat of science, getting to the end-user is shaping up to be a feat of logistics.