Covid-19: Vaccine production is not a problem for India, cold chain is

As India prepares a road map for a Covid-19 vaccination drive next year, the lack of cold chain infrastructure is a key bottleneck

India is likely to start vaccination drive around January 2021 and is now preparing the road map for what will be perhaps the world's largest vaccination drive next year. Data shows that India has ample manufacturing capacity (about 2.5 bn doses) that would be sufficient to meet both domestic and export demand, however, analysts point out that cold chain infrastructure is a key bottleneck.

According to Credit Suisse analysts India would need about 1.7 bn Covid-19 vaccine doses to vaccinate a majority of its adult population. The target is to administer 500 mn doses (or 250 mn people) by July next year. The key vaccines the country is banking on are from AstraZeneca, Novavax and Bharat Biotech and the earliest efficacy data is not expected before November-December 2020.

As for the cold chain infrastructure, India's current immunisation programme handles around 600 mn doses and the private sector has a capacity of about 250-300 mn doses. With this, the potential vaccinations reach 550-600 mn doses annually, claims Credit Suisse. Add to this manpower required to give the jab would be around 100,000 people. Mass inoculation of India's population is likely to be achieved only by end of 2023, analysts feel.

The government has already started preparing database of priority beneficiaries and has issued advisory at district and state levels to prepare database and upload to Covid-19 Vaccine Beneficiary Management System. The database of healthcare workers is expected to be ready soon, database of people above 50-years and frontline workers is ready. Challenge is in preparing the database of people with co-morbidities where data is currently limited to screening of people at 48,000 health centers.

Syringe and vial makers are already in ramp up mode and India is unlikely to face any supply constraint at least in the first half of 2021. In the cold chain, analysts feel the storage is not the issue, but transportation is. The organised sector does not have reach into the hinterlands and the government is likely to use existing fruit and vegetable cold storage and the Universal Immunisation Program network to serve these areas.

India needs 1.7 bn doses for its population
Total Population (mn)	1380
Population above 14 yrs	80%
Population with antibodies by March 2021 (estimates)	25%
Number of Indians to be vaccinated (mn)	828
Dose per person	2
Total Doses (mn)	1656

Priority groups identified for first phase of CoViD-19 vaccination in India
Priority Population Segment	No. of Beneficiaries (mn)
Healthcare Workers	7
MBBS doctors	1.1
Nurses	1.5
Frontline workers	21
Municipal workers, public transport drivers etc	15
Police and Armed forces	6
People above 50 yrs	260
People less than 50 yrs but with co-morbidities (estimates)	12
Total	300

Vaccine production and Clinical Trial timelines
Players with candidates	Capacity (mn doses)	Clinical Trial update	Temperature Requirements
Serum - AstraZeneca	1000	Phase 3 by December 2020	2-8 degree celsius
Serum - Novavax	500	Phase 2/3 to start by Dec 2020	2-8 degree celsius
Cadila - DNA vaccine	100	Phase 3 by March 2021	2-8 degree celsius
Aurobindo- Viral vector facility	300
Russian vaccine	100	Phase 2/3 India trials to end by March 2021	2-8 degree celsius ***
Biological E-J&J **	400	J&J global data expected in Q1CY21	2-8 degree celsius
Bharat Biotech *	150	Phase 3 started in October	2-8 degree celsius
Total (estimates)	2550

* Bharat Biotech is trying to take capacity up to 500 mn doses/yr

** Biological E has capacity to make 1 bn doses for Texas based Baylor College of Medicine (BCM)'s recombinant protein vaccine candidate

*** one variant may need -20 degree celsius

Key domestic logistics players offering cold chain storage and transportation across the country
Company	Capacity	Remarks
Snowman Logistics	1 lakh pallets, 289 vehicles, 33 warehouses	Largest organized player, can ramp up storage capacity to 650mn doses if it can repurpose all the food storage warehouses
Gati Kausar	5500 pallets, 160 vehicles	Primary/Secondary distribution, dedicated reefer fleet, customized cold chain solutions for multiple industries, including healthcare
Future Supply Chain Solutions	8400 Pallets, 4 Distribution Centers	Storage temperature ranges from -25°C to +25°C
Transport Corporation of India	7000 pallets	Stores and transports agricultural products, processed foods, FMCG, healthcare products, etc
Mahindra Logistics	NA	State-of-the-art temperature controlled warehouse for pharmaceuticals opened recently

Current Cold Storage - electric and non-electric  - in use in India
ELECTRIC
Equipment	Temperature (degree celsius)
Cold Rooms	2 to 8
Walk in cooler	2 to 8
Walk in Freezers	-15 to -25
Ice Lined Refrigerators	2 to 8
Deep Freezer	-15 to -25
NON-ELECTRIC
Cold Box	2 to 8
Vaccine carrier	2 to 8

Source: Company Updates, Credit Suisse