Vaccines are known to prevent millions of infections and save numerous lives every year, be it eradication of smallpox, or drastically reducing incidences of polio, measles and other childhood diseases. These are mostly conventional vaccine approaches comprising weakened viruses and inactivated pathogens that trigger an immune response in the body to provide durable protection against a variety of dangerous illnesses. However, scientists have now developed a promising alternative to the conventional vaccine approaches that use a genetic material called messenger RNA or mRNA, ushering in a new era in vaccinology.  

An mRNA vaccine, when injected into a body, comes in contact with the cells without entering its nucleus where the DNA resides. It uses the information in genes to create a blueprint for producing viral proteins. Once the cells finish making protein, a normal immune system recognizes it as foreign and produces specific proteins called antibodies that help protect the body against infection by identifying individual viruses and marking the pathogens for destruction.  

mRNA isn’t a new concept in the medical industry. Researchers have been reviewing it for decades to conduct tests on rabies, influenza, cytomegalovirus and Zika primarily because mRNA vaccines can be developed in a laboratory using readily available materials. This makes the process standardized and faster than traditional methods of making vaccines. The mRNA molecule has also been used by cancer research to trigger the immune system during terminal illnesses. Meanwhile, as soon as the necessary information about the virus causing COVID-19 was revealed, scientists began using it for cells to build the unique spike protein into an mRNA vaccine.

mRNA vaccinations need extra care

Even though mRNA technology emerges as a critical component in developing safe and effective vaccines quickly, it is incredibly fragile and can break down very rapidly and easily. This natural volatility of mRNA is what made developing an mRNA-based vaccine tremendously challenging in the past. Moreover, the material used for the packaging of mRNA to deliver it as a vaccine is also somewhat unstable.

Fortunately, efforts are being made to develop methods and technology that can make mRNA more stable, so it can be successfully incorporated into a vaccine. That being said, the first two COVID-19 vaccinations developed by Pfizer-BioNTech and Moderna are mRNA vaccines. While they have high efficacy rates and demonstrate strong protection against the SARS-CoV-2 virus, they require cold storage  with temperatures going as low as -73 degrees Celsius to ensure the mRNA within them remains stable. However, these ultracold temperatures are only required for transporting and storing the vaccines as they are thawed before being injected. 

Today, more than 100 countries across the world are relying on these two vaccines. As per the Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA), the cartons of the Pfizer-BioNTech COVID-19 vaccine should arrive in any country in thermal containers with dry ice. They can be stored in an ultra-cold freezer between -90°C and -60°C until their mentioned expiry date. Once a carton is opened, the vials should be stored at -25°C to -15°C for up to 2 weeks, or in the refrigerator between 2°C and 8°C for up to 1 month (31 days) before mixing. Meanwhile, the cartons of the Moderna vaccine should arrive frozen between -50°C and -15°C. Its un-punctured vials need to be stored in the freezer between -50°C and -15°C, or in the refrigerator between 2° to 8°C for up to 30 days.

The cold chain infrastructure in India for easy distribution of mRNA vaccinations

The storing and transportation of both these vaccines do not require a huge investment. In fact, the logistic cost of bringing the Pfizer vaccination to India will be even less than a rupee per dose. However, the need of the hour is to have the technical know-how and experience of delivering an ultra-low cold chain as it is different from the usual 2°C to 8°C cold chains.  It is crucial to maintain temperature uniformity across the entire cabinet, irrespective of the frequent door opening or other events. These performance factors are nowhere close to what a normal household refrigerator or a 2° to 8°C refrigeration can deliver. Considering that vaccinations worth lakhs of rupees are at stake, India needs a reliable a  smooth and systematic medical ultra cold chain facility .

While the dialogues between the Indian government and vaccine manufacturers like Pfizer and Moderna are on, agreements have been made  with respective stakeholders in the vaccine cold chain infrastructure to ensure efficiency and feasibility in distribution towards a successful vaccine drive. Having already helped more than 50 countries roll out Pfizer-BioNTech’s and Moderna’s COVID-19 vaccines, including in remote locations of Ghana, Nigeria, etc., organisations are now geared up to provide medical-grade transportation of the vaccines to any part of India.

With a smooth and systematic medical cold chain facility, India is indeed ready for the mRNA vaccines and clearing out apprehensions around vaccine potency and its effective distribution.