Recently various sources have pitched the Pfizer vaccine for India. This parlays the recent western ‘branding’ effort differentiating Pfizer, but it is known that this vaccine has some unique technical requirements.

This thread analyzes the Pfizer logistics in depth.

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Storage
The vaccine must be stored at -60 to -80C, i.e. ultra low temp (ULT), much colder than normal freezer (-20C) or fridge (2 to 8C). Such storage systems are costly but cost depends on capacity. These have alarm systems to notify of failure or temperature fluctuations.

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A major hospital could hold several boxes worth of doses, but the ULT freezers cost between 3-5lakh (pretax) for small ones, up to 25 lakh for ~800L Stirling Ultracold freezers suited to large storage nodes. ULT freezers have high operating cost and require stable power.

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Thawed vials can be kept in a fridge for 5 days. Once opened, each vial (5-6 doses) must be consumed within 6 hrs. Vials must be mixed with saline diluent beforehand. Moderna, J&J, Covaxin, Covishield, Sputnik etc don’t need a diluent.

https://www.cdc.gov/vaccines/covid-19/info-by-product/pfizer/index.html

8/">https://www.cdc.gov/vaccines/...
Typical air transport is only 3-5 lakh doses per flight. This is how much Japan and Israel get per delivery, since not all countries allow much dry ice transport, which poses a cabin pressure risk from dry ice sublimation.

https://asia.nikkei.com/Spotlight/Coronavirus/Japan-receives-2nd-shipment-of-Pfizer-vaccine
https://asia.nikkei.com/Spotlight... href=" https://www.healthcareitnews.com/news/emea/israel-share-data-pfizer-exchange-covid-19-vaccine-doses

11/">https://www.healthcareitnews.com/news/emea...
In effect a plane carries about as much as a freezer trailer truck. This means any place served by air will be significantly costlier per dose, and will lack ability to scale, This is why Pfizer orders have been focused on N.America and EU/UK - local mfg + truck delivery.

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This won’t work with India. Pfizer& #39;s 2021 goal is 2.5 billion doses, but most are already reserved. Any availability will not only take time, but will be far too few, delivered too intermittently at too high cost to have an impact. Cost discussed further....

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Pfizer has manufacturing plants in USA & Belgium. US/Canada/EU deliveries can be trucked cheaply given that a truck and plane carry the same 3-4L doses. Countries dependent on air freight pay much more - data shows this. US $19.50 price was only for the first 100m doses.

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Pfizer renegotiates prices per order and has stalled deliveries until new orders are paid. Anyone negotiating with Pfizer will need leverage. Small volume private orders will likely be more than $50 given govts are paying close to that much.
https://www.jpost.com/breaking-news/banana-republic-pfizer-outraged-israel-failed-to-pay-for-covid-vaccines-664140

16/">https://www.jpost.com/breaking-...
At current production volume, Pfizer cannot supply more than 3% of weekly vaccination rate in India recently, even with weekly 5L shipments like Israel. This supply will cost 8-10x of Indian options, not counting additional ULT infrastructure capital and operating costs.

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Pfizer only makes sense to some private entities willing to invest in ULT infrastructure and have clientele who can afford above Rs.3500/dose. In terms of value for money, it makes no sense at all as an option for government procurement. Too costly, low volume.

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An army moves on its stomach. Pfizer moves on its ULT cold chain combined with very narrow logistics channels for countries where supplies cannot be trucked to destination in a week or less. This makes the Pfizer vaccine a niche product as far as India is concerned.

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It is best suited to N.America+EU which have current production bases and ULT truck supply chain. Or small wealthy nations that can do with half a million expensive doses delivered by air freight once a week or less.

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OTOH, Covaxin cost a fraction of Pfizer and can do normal fridge temp (2 to 8C). India has existing vaccine cold chain for this requirement. Covaxin production rate (20m/month) is almost 10x Pfizer delivery rate to Israel/Japan, and will increase further by summer.

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The only viable option where Pfizer makes sense to India is local production, combined with TRIPS waiver enabling duplication of raw material (e.g. lipid nanoparticles) locally. This would bridge price gap to only a few multiples, rather than over 10x as is the case now.

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Pfizer cannot deliver any significant volume to India and won’t be remotely cost competitive today. They would be best served by leveraging the PLI scheme to set up vaccine production in India as an FDI investment, enabling investment in ULT trucking and storage.

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Pfizer’s current ULT air freight infrastructure makes it too expensive. No bridging trial data on efficacy vs current dominant local strains is a critical problem in the middle of this wave. This makes even the value of such a premium a questionable proposition today.

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