Health worker Arlette Nyange during the UNICEF-supported immunization campaign in Kinshasa, DR Congo.

UNICEF Gearing Up for Historic Immunization Drive

Getting a COVID-19 vaccine — once one is available — to everybody who needs it will be tricky in low- and middle-income countries where cold chain storage and other last-mile logistics are challenging. Overcoming obstacles to reach every child is UNICEF's specialty. 

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The first doses of a safe and effective vaccine that protects people against the novel coronavirus could be publicly available in a matter of months (or possibly even weeks). That in itself will be a major scientific achievement — the breakthrough everyone is waiting for.

But then comes the enormously daunting task of getting that vaccine to everyone who needs it — to orchestrate the most ambitious immunization drive of all time. 

At UNICEF-supported Centre De Sante Le Rocher Maternity in Lubumbashi, Democratic Republic of Congo, a health worker vaccinates three-month-old Zoe against measles and rubella, tetanus and polio.

At UNICEF-supported Centre De Sante Le Rocher Maternity in Lubumbashi, Democratic Republic of Congo, a health worker vaccinates 3-month-old Zoe against measles and rubella, tetanus and polio. © UNICEF/UN0328788/Prinsloo

UNICEF started laying the groundwork for a COVID-19 vaccine launch months ago in hopes of avoiding the same supply snafus that happened with personal protective equipment (PPE) in the early months of the pandemic. As head of procurement and supply for COVAX — a multilateral initiative led by the World Health Organization and Gavi, the Vaccine Alliance, to ensure equitable distribution of an approved vaccine — UNICEF will play a leading role in facilitating delivery in 92 low- and middle-income countries, while also supporting procurement for 90 upper-middle-income and high-income nations.

COVAX partners aim to have 2 billion coronavirus vaccine doses available across 186 countries by the end of 2021 — enough to protect high-risk and vulnerable people, as well as front-line health workers. 

A team of polio vaccinators make the rounds in Gonzagueville, a suburb of Abidjan, Côte d’Ivoire.

A team of UNICEF-supported polio vaccinators makes the rounds in Gonzagueville, a suburb of Abidjan, Côte d’Ivoire. © UNICEF/UNI372015/Dejongh

The hope is that by focusing this first tranche on health sector workers, essential health services that have been on pause due to the pandemic — at great risk to vulnerable children everywhere — can and will safely resume. Vaccinating health workers first is also recommended by a panel of experts in a report released by the U.S. National Academics of Sciences, Engineering and Medicine.

Unless health workers are protected, UNICEF and others point out, health systems will remain overwhelmed. The most vulnerable children will continue to lose access to lifesaving services, undermining decades of progress in child health. And the world's poorest children will fall further behind.

Strengthening the cold chain is critical to ensure success of COVID-19 vaccination efforts 

One of the biggest challenges to effective vaccination in poor countries is the need to maintain the cold chain — temperature-controlled conditions vaccines require to stay potent. The measles, mumps and rubella (MMR) vaccine, for example, must be kept between -58°F and +46°F (-50°C to +8°C). While it's still unclear which specific temperature ranges will be required and for how long for storing promising COVID-19 vaccine candidates from Moderna, Pfizer, BioNTech and others, it's safe to assume that whichever vaccine or vaccines are ultimately approved for use will need some degree of refrigeration.

And despite great strides in equipping developing countries for cold chain storage and transport, the AP reports, nearly 3 billion of the world's 7.8 bilion people live in places where temperature-controlled storage is insufficient.

UNICEF is focusing on addressing this and other hurdles to ensure coronavirus immunization efforts are successful, leveraging its decades of experience working with governments, community health workers and others to vaccinate the most vulnerable children.

For starters, UNICEF is busy mapping out storage facilities and infrastructure needs across the developing world while installing new equipment — including solar-powered refrigerators.

In South Sudan, for example — where less than a third of the population is connected to the power grid, and where it's not uncommon for daytime temperatures to hit 100 degrees Fahrenheit — UNICEF has equipped over 700 health facilities with solar fridges. 

A solution for health facilities that are off the grid: solar-powered fridges

As part of its preparations for the COVAX immunization drive, UNICEF is purchasing nearly 92,000 vaccine fridges — including 11,325 solar-powered ones — as well as cold boxes and vaccine carriers to strengthen cold chain capabilities where needed. UNICEF is also:

The syringes and safety boxes currently being stockpiled in UNICEF's supply hubs in Copenhagen and Dubai will be bundled and shipped to countries in advance — allowing for potential delays such as congestion at shipping ports — so that when coronavirus vaccines arrive, the tools needed to administer them will already be in hand. 

Other preparations include working with governments and community partners to develop awareness campaigns to underline the importance of being vaccinated, and to avoid the spread of misinformation.

Vaccine delivery by bicycle in South Sudan.

Maintaining the cold chain means keeping vaccines cold at every stage of the journey. When UNICEF ships vaccines, they go directly by plane from the manufacturer as refrigerated cargo to the country where they will be used. Once they land, they are stored in cold rooms before being distributed to regional and sub-regional cold storage facilities by refrigerated vehicle. From storage facilities down to the village level, health workers carry vaccines in cold boxes and vaccine carriers — traveling by car, motorcycle, bicycle, donkey, camel or on foot — to immunize every child. © UNICEF

Learn more about UNICEF's all-hands-on-deck approach to securing and helping distribute an equitable supply of COVID-19 vaccines to vulnerable communities and countries. 

Help UNICEF ensure global equitable access to COVID-19 vaccines. Your support can make a difference.

Top photo: Health worker Arlette Nyange carries vaccines in a cold box while making her rounds as part of a UNICEF-supported immunization campaign in Kinshasa, Democratic Republic of Congo. © UNICEF/UN0352667/Mulala.

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