Covid-19 Vaccine: Not All Nearshore Regions to Benefit Equally

There has been some blockbuster news regarding a possible Covid-19 vaccine – first from Pfizer-BioNTech, then from Moderna. These ands other vaccine developments could have profound implications for Nearshore providers.

The initial Pfizer-BioNTech announcement stated that the vaccine had an efficacy rate above 90%, but that it required storage to keep the vaccine at -70 degrees centigrade. This has raised questions about the ability to deliver in Latin America and the Caribbean. The vaccine can last for five days at two to eight degrees Celsius – but is that enough?

“The question of time is going to be linked with the preparedness of those administering and receiving the vaccinations,” says Michael S. Kinch, director at the Centers for Research Innovation in Biotechnology & Drug Discovery at Washington University in St. Louis. “What I mean by this is that it will be important that much planning take place so that once the clock starts moving, with the vaccine moved to warmer conditions, the medical staff administering the shots will need to act quickly.”

Shortly after the Pfizer-BioNTech announcement, Moderna stole the show when it announced a vaccine that was 94.5% effective, and that could be stored at standard refrigerator temperatures.

“Some of the other vaccines have less stringent storage conditions [than Pfizer],” says Kinch, who is also a professor of Biochemistry and Molecular Biophysics at Washington University. “As data emerges from other trials, I am increasingly confident that there will be alternatives.”

Both the Pfizer-BioNTech and Moderna vaccines require candidates to get two shots, several weeks apart. With regard to the Pfizer-BioNTech vaccine, that second shot requirement means that the cold chain can’t be a one-off – it has to have integrity over time.

BPO and Tech: Waiting in Line?

The pandemic has had a significant effect on the BPO industry. More agents are working from home, and call centers are spacing out their workforce. With the promise of a vaccine, one would expect a degree of optimism in the community.

However, one mid-sized BPO in Latin America, with about 15,000 agents, told Nearshore Americas that it was quite pessimistic about government capabilities with regard to the handling and distribution of the Pfizer-BioNTech vaccine.

“Logistical issues are likely to be guided by governmental responses, and will undoubtedly vary from nation to nation, and perhaps within each country,” says Michael S. Kinch

That said, the Pan American Health Organization (PAHO) appears to think that a big roll out is possible across the region.

“Given the -70 degree temperature requirement, countries need to prepare,” said Dr. Jarbas Barbosa, Assistant Director of PAHO, responding in a PAHO webinar to a question posed by Nearshore Americas regarding the Pfizer-BioNTech vaccine. “We are in the process of strengthening the supply chain.”

However, when it comes to BPO operations, the supply chain may not be the major issue – most operations are in well-connected cities. Instead, it is the demographic that is the biggest factor: BPOs are populated with people in their 20s, a low priority for the vaccine. At the end of the day, this will be a logistics consideration, with countries trying to push out vaccinations in the most effective manner to prioritized populations.

“These types of logistical issues are likely to be guided by governmental responses, and will undoubtedly vary from nation to nation, and perhaps within each country,” says Kinch. “Hopefully, guidance provided by the World Health Organization (WHO), Centers for Disease Control (CDC), and others, will help in decision making.”

Getting it Done

A common theme with regard to a possible vaccine – no matter its origin – concerns the supply chain methods that will support the widest distribution.  The PAHO appears to be relying on the public sector, but there may be opportunity for private sector partnerships.

“As far as private sector, this will again likely have a geographical component,” says Kinch. “My practical response would be that it will be important to be as efficient as possible – given the pressing need for protection, as well as the stability of the vaccine. If the private sector can more safely and effectively take the lead in certain places, it would seem foolish not to let them do so.”

Getting Nearshore BPO operations back to normal may hinge on the success of PAHO’s COVAX facility. COVAX, a WHO-backed effort that aims to raise $18 billion to purchase vaccines for poorer countries, is being put together in the region in collaboration with the European Union and the Caribbean Public Health Agency. Almost all countries in the region have joined COVAX, with 11 countries receiving financial support.

“PAHO and UNICEF will be the vaccine procurement mechanism for COVAX,” says Dr. Jarbas Barbosa. “In the health units, we will be able to use the same teams and equipment that we have today.”

UNICEF and PAHO, on behalf of COVAX Facility, have invited all Covid-19 vaccine developers to submit a proposal for supply in 2021.

Barbosa has noted that Jamaica, Costa Rica and Argentina are doing well in monitoring Covid-19. In the context of Nearshore BPO delivery centers, operations in these countries could have a distinct advantage when vaccines come on line, given that they already have lower transmission rates than, say, Peru, which has been hit hard.

Big countries like Mexico and Brazil also have unique challenges in reaching their large populations – particularly for those vaccines with a deep freeze requirement. These, it seems almost certain, will be restricted to urban environments, though with dry ice the Pfizer-BioNTech vaccine can maintain at -70 degrees Celsius for 15 days before requiring a refill.

“As data emerges from other trials, I am increasingly confident that there will be alternatives,” says Kinch. “Likewise, it is safe to presume that even those companies that have unstable vaccines requiring deep freezers will be working on ways to make this more amenable to widespread use.”

To their credit, countries in Latin America are working hard to address the problem. Brazil has set aside $450 million to join the WHO’s COVAX facility, and Peru, Ecuador and Costa Rica have signed agreements with Pfizer.

Mexico also has multiple agreements to acquire up to 198 million vaccine doses from a variety of sources. As of October 13, Mexico had paid $281 million of the $1.6 billion total value of the vaccines. Most recently, it was even considering a deep-freeze investment to support the Pfizer-BioNTech vaccine.