From the distribution by air perspective, this is particularly complex: this kind of temperature means dry ice, and there are fairly strict limits to the amount of dry ice allowed in any one aircraft. Think 1000kg for your average widebody.
The pharma companies have been looking at this for the best part of a year now, but this kind of -80°C temperature is very much not in cargo airlines' normal operating windows.
Emirates SkyCargo built what it says is the world's largest #COVID19 cargo hub at DWC (new Dubai) — but temp-limited.

"Overall, it is estimated that the facility can hold around 10 million vials of vaccine at a 2-8 degrees Celsius temperature range at any one point of time."
We're going to be hearing a lot about #CoolDolly technology (regrettably not Parton-related) at airports — note temp range at -20°C here — but the key part will be on aircraft.
Just last month, @envirotainer — who make refrigerated cargo containers — boosted their RAP e2 network capabilities in the US.

It's not especially clear how or if these can combine with the in-house -80°C vaccine packaging Pfizer (and others) are planning.
There are key pharma distribution centres at many hub airports. Here's the outside of Finnair's, in Helsinki, back in 2018, when I was already fascinated by this kind of thing.
If indeed we're looking at a -80°C vaccine scenario, I'd expect quite a lot of repurposing of facilities like this fresh seafood transit storage hub in Helsinki as part of the infrastructure to distribute.

(That's salmon in those boxes, back in 2018, but you get the idea.)
Keep in mind that I'm primarily a commercial passenger airlines person, but that most of the world's cargo is carried in belly freight — and it may well be that there can be some restrictions of dry ice limits in particular on non-pax aircraft, with strong regulatory supervision.
I have been trying to write the "is air cargo ready to transport a COVID-19 vaccine?" story all summer for @theaircurrent.

"Trying", because there are too many variables for anyone to be able to give a response beyond "probably, but it will require rethinking the way we work."
You can follow @thatjohn.
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