Rural hospitals say they can't afford ultra-cold freezers needed to store Pfizer's coronavirus vaccine

Pfizer Inc. has a promising coronavirus vaccine, but most rural hospitals can't afford the ultra-cold freezers to store it, so rural residents may have a harder time getting it, Olivia Goldhill reports for Stat. That means some of them may have to wait for other vaccines that don't need special handling.

Pfizer's vaccine has to be stored at -94 F., -70 C. "Typical freezers don’t get that cold, making distribution of this vaccine a logistical nightmare," Goldhill reports. "The Centers for Disease Control and Prevention has advised state health departments against purchasing ultra-cold freezers — which cost $10,000 to $15,000 each — saying other vaccines with less demanding storage requirements will be available soon. Hospitals with money to spare are flouting this guidance. Four major health care systems, from North Carolina to Ohio, North Dakota, and California, told Stat they had bought additional ultra-cold freezers, while Jefferson Health in Philadelphia said it has leased five units."

"This purchase is out of reach for poorer hospitals, especially those in rural areas that can barely manage daily expenses," Goldhill writes, noting that nearly half of rural hospitals in the U.S. lost money in April, and the pandemic has continued to hurt their bottom lines, according to Alan Morgan, chief executive of the National Rural Health Association. But rural people need the shots the most, he said.

“Hundreds of rural, small towns all across the U.S. have a higher percentage of elderly, low-income [residents], a higher percentage of the community with multiple chronic health issues,” Morgan told Goldhill. “In this financial environment, you can imagine that there is simply no consideration of rural hospitals purchasing storage equipment for this ultra-cold distribution.”

Another problem is that Pfizer will ship the vaccine in dry-iced containers with at least 1,000 doses. Once the containers have been opened, the vaccines are good for more than 15 days, and only then with scrupulous attention to re-icing and limited box opening. "The time pressure is more intense in rural areas, where the longer delivery time eats into the number of days when the vaccine can be safely stored in their boxes upon arrival," Goldhill reports. "Regions with smaller populations will struggle to use the 1,000-dose supply in the necessary time period, creating a risk some of the vaccines will go to waste, though Pfizer plans to have smaller boxes available by early 2021. In contrast, the vaccine can be stored in ultra-cold freezers for six months."