米、新型コロナワクチン輸送体制の準備と課題

【ワシントンＡＦＰ＝時事】歴史上最も大掛かりなワクチン作戦の一つは米国から始まるかもしれない──米国は新型コロナウイルス感染症（COVID-19）のワクチン最大6億回分を、今後数か月以内に配布・投与する計画だ。（写真は資料写真）
　大規模なワクチン作戦自体は、これまでにもはしかやインフルエンザの例があり新しくはない。だが、新型コロナウイルスの撲滅をこれまでとは明らかに違う難題にしている要因が３つある。膨大な人数に短期間でワクチン接種を行うこと、大半のワクチンで接種が２回必要なこと、一部のワクチンは極めて低温で保管する必要があることだ。
　米製薬大手ファイザーが独ビオンテックと共同開発し、米国内初の新型コロナワクチンとして認可取得を目指しているワクチンは、マイナス７０度での保管が必要だ。
　さらに米ミシガン州カラマズーにある同社最大規模の製造工場から出荷するためには、輸送用のコンテナ、トラック、航空機を時計仕掛けのように正確に連係させる必要がある。
　保冷コンテナ１個につき、ワクチンが入った瓶９７５本がドライアイスとともに収納される。１本の瓶のワクチンは５回分で、コンテナ１個当たり計４８７５回分となる。
　ファイザーによると毎日トラック６台分のワクチンが、米フェデックス、同ユナイテッド・パーセル・サービス、独ＤＨＬなどの航空貨物輸送業者に出荷され、米国内は１～２日以内、世界各地には３日以内に配送される。世界各地へは１日平均２０機の貨物機が輸送を担う見通しだ。

■日本は１億２０００万回分発注
　米バイオ製薬大手モデルナも、ワクチンの製造を進めている。このワクチンは冷凍庫の通常温度であるマイナス２０度で保管できる。米政府は、モデルナのワクチンを各州および海外領土に無償で配布する準備を進めている。
　米政府の目標は、最も深刻なリスクがある人々には１２月末までに、医療従事者には来年１月末までにワクチンを提供し、４月初めまでに全国民に行き渡らせることだ。
　ファイザーは今年中にワクチン５０００万回分、２０２１年には１３億回分の製造を見込んでいる。米国は１２月末までに配布するための２０００万～３０００万回分を含む計１億回分をすでに発注している。一方、欧州連合（ＥＵ）は２億回分、日本は１億２０００万回分、英国は３０００万回分、カナダは２０００万回分をそれぞれ発注している。【翻訳編集ＡＦＰＢＢＮｅｗｓ】
〔ＡＦＰ＝時事〕（2020/11/13-15:47）

The United States could be the first country to launch one of the most ambitious vaccine operations in history: distributing and administering up to 600 million doses of a Covid-19 vaccine in just a few months.
Massive vaccine campaigns are nothing new -- they have been carried out for decades in the fight against the measles and flu, for example.
But stamping out the coronavirus is a distinctly new challenge due to three factors: the short time frame for inoculating a huge number of people, the fact that most vaccines will require two doses, and the very low temperature at which some of the vaccines must be stored.
The vaccine developed by US pharmaceutical giant Pfizer and Germany's BioNTech, on track to be the first authorized for use in the United States, must be stored at -94 degrees Fahrenheit (-70 degrees Celsius), whereas the flu vaccine can be kept in a normal refrigerator.
Pfizer vaccines distributed in the US will come from its largest manufacturing plant located in Kalamazoo, Michigan. Their ship-out will include a precise, clockwork-like dance of containers, trucks and planes.
Thermal shipping containers will each be filled with dry ice and 975 vials of the vaccine which each contain five doses, for a total of 4,875 doses.
Every day six trucks will take the doses to air carriers such as FedEx, UPS or DHL, which will deliver them across the United States in one to two days and across the globe in three, Pfizer told AFP.
The company expects an average of 20 daily cargo flights worldwide.
FedEx had to obtain special permission from civil aviation authorities to transport so much dry ice, which could pose a danger to the crew should it accidentally undergo sublimation and pass from a solid to a gas, the company told AFP.
Once the boxes have reached their final destination, they can be opened only briefly just two times a day.
To run a large mass vaccination clinic, it's fine, said Julie Swann, a pandemic response expert at North Carolina State University.
But the vaccine would not be suitable for distribution at doctors' offices or pharmacies, which are too small, she warned.
At least in the beginning Americans will have to go to hospitals or maybe even large distribution centers set up in parking lots much like Covid test sites, she said.
The vaccines can remain in their boxes for two weeks meaning hospitals will not need a special freezer.
We're not recommending at this time that hospitals or clinics purchase ultra cold equipment, said Janell Routh of the Centers for Disease Control and Prevention.
- Poor countries later -
US biotech giant Moderna is also manufacturing a vaccine, which can be stored at -4 degrees Fahrenheit, the temperature of a normal freezer.
The US government is organizing a free distribution of this vaccine to US states and territories, with each jurisdiction to decide how to distribute the doses to hospitals, pharmacies, doctors or even universities and companies will distribute the doses, in a decentralized system much like what was used for the H1N1 flu pandemic in 2009.
The federal government does not intend, with very, very few exceptions, to touch a single dose of vaccine before it goes into the arm of Americans, said Paul Mango, an Operation Warp Speed official, during a briefing.
The objective is to offer vaccines to the most vulnerable populations before the end of December, to healthcare workers before the end of January and all Americans by the beginning of April.
Pfizer expects to produce 50 million doses this year and 1.3 billion in 2021: The United States has already ordered 100 million total including 20-30 million for delivery before the end of December. The European Union meanwhile has ordered 200 million, Japan 120 million, Britain 30 million and Canada 20 million.
Moderna, AstraZeneca, Johnson & Johnson, Sanofi and others are hoping their own vaccines will also prove safe and effective, and their global rollout will follow suit.
Carrier DHL estimates that 15 million cooling boxes would need to be delivered over the next two years, with approximately 15,000 flights needed worldwide.
Poorer countries that lack storage capacity for large quantites of vaccines that need super-cold storage have little hope of benefiting from the first doses, said Prashant Yadav, an expert in global health supply chains at the Center for Global Development.
Ultracold freezers that can reach temperatures of -112 degrees Fahrenheit cost five times more than standard freezers and are only made to order, he said.