What will it take to get a covid-19 vaccine to the world?

Once a vaccine is approved, the race is on to overcome the biggest logistics challenge in history to distribute it around the globe

By Carrie Arnold

IN KALAMAZOO, Michigan, millions of vials of a covid-19 vaccine may soon be rolling off production lines. There are still many hurdles to leap before that vaccine – the candidate from US drug company Pfizer and its German partner BioNTech – or any other is approved and distributed, but governments, manufacturers and shipping firms around the world have already spent months preparing for what happens next.

That comes down to a simple but easily overlooked fact: a vaccine by itself is useless. “Vaccines don’t save lives,” says Kelly Moore at the Immunization Action Coalition in the US. “Vaccination does.”

When a covid-19 vaccine is approved, it will trigger a staggeringly complex chain of events. These events must occur in perfect lockstep using a global supply chain that needs to reach even the planet’s most remote areas – the same supply chain that left parts of the world in desperate need of things like disposable gloves and protective equipment just months ago.

“The scale and magnitude of what we’re talking about doing is just unparalleled,” says Orin Levine, director of vaccine delivery at the Bill & Melinda Gates Foundation. The list of potential catastrophes has been keeping Levine up at night for months. But overcoming these logistical challenges is what it will take to end the pandemic. And “the key to overcoming complexity is planning and planning early”, says Levine.

Exactly how many people need to be vaccinated to end the pandemic depends on how effective the vaccine is, and how long the immunity it provides lasts (see “Vaccine front runners” ). Seth Berkley, head of Gavi, an international group that promotes …