Ultra-cold chain freezers: boosting Indonesia’s COVID-19 vaccine rollout

Indonesia, with a population of 270 million people, is the world’s fourth most-populous country. It is also the biggest island country on the planet. This combination of a large population spread across often remote, rugged terrain means that rolling out COVID-19 vaccines is no easy feat. However, UNICEF, on behalf of the COVAX Facility, has been providing crucial support to the government in its vast vaccination campaign.

To date, Indonesia has fully vaccinated 90 million people, or 43 per cent of the population, against COVID-19. One of the main pathways Indonesia uses to source vaccines is COVAX, the global initiative to ensure equitable distribution of COVID-19 vaccines worldwide, to help protect at-risk and vulnerable groups, such as frontline health care workers and people with underlying health conditions. 

But COVAX is about much more than providing fair access to vaccines. It is also providing ‘cold chain’ equipment such as vaccine refrigerators and freezers. This equipment is critical as vaccines need to be stored at the correct temperature if they are to work effectively, while it also supports countries to scale-up their vaccination programmes as quickly as possible. These cold chain units are an essential component of the global COVID-19 response and UNICEF has helped Indonesia to bulk up its storage capacity.

Delivering at speed

In August 2021, UNICEF delivered 17 ultra-cold chain (UCC) freezers to Indonesia on behalf of COVAX. The freezers, funded by Gavi, the Vaccine Alliance, can hold a combined 3.5 million COVID-19 vaccines that require storage at up to -70 degrees Celsius. This delivery was to meet the urgent need for UCC capacity brought about by the welcome donation of 500 million mRNA vaccines to COVAX by the Government of the United States in mid-June – a gamechanger when it came to planning for vaccine storage, as mRNA vaccines need to be kept an extremely cold temperature. 

“The scale of the vaccine campaign required Indonesia to rapidly improve its cold chain capacity,” said Kenny Peetosutan, UNICEF Indonesia Health Specialist. “If the vaccines were to roll out at speed, we needed more equipment and we needed it fast, especially with millions of vaccines needing ultra-cold storage being sent to the country.”

Putting the freezers to work

UNICEF’s procurement and delivery of UCC equipment is happening at extraordinary speed, and Indonesia was among the first countries to benefit from swift action. But there were installation challenges that had to be overcome after delivery. One of these was re-gassing the freezers, which had the refrigerant gas removed before air shipment could take place to meet airline safety protocols.

UNICEF worked with the facility where the freezers would be installed to ensure that all the necessary procedures were completed as quickly and safely as possible so they could be put to work immediately. Both the re-gassing and quality inspection took place within 72 hours of arrival in Jakarta – four times quicker than usual UCC installation. 

“In a short space of time, UNICEF collaborated with the Ministry of Health to prepare the facilities for the arrival of the ultra-cold chain freezers. This included ensuring that a stable electricity supply and backup generators were in place and that the installation was completed properly,” said Peetosutan. “We will continue to help monitor and ensure proper maintenance of the freezers throughout the pandemic and beyond.”

Immediate benefits

To date, Indonesia has received 5.4 million mRNA vaccines through COVAX, with more COVID-19 vaccine deliveries from COVAX expected by the end of 2021 and throughout 2022. The freezers, which will support vaccination efforts in 34 provinces, will help greatly expand access in cities, towns, and villages across the country, many of which are yet to receive sufficient vaccines to protect the most vulnerable.

Although there is some way to go in efforts to curb the spread of COVID-19 in Indonesia, the addition of extra vaccine storage capacity is a major boost for national vaccination efforts. UNICEF continues to support the Ministry of Health in delivering vital supplies, launching public awareness campaigns to prevent the spread of the virus, and rolling out COVID-19 vaccines to help protect children, families, and communities around the country.

UNICEF and partners are making COVID-19 vaccines available to countries across the world, including Indonesia, through COVAX - an international scheme to provide fair access to vaccines.

In Indonesia, the vaccine implementation is supported by partners, such as the Australian Embassy, Indonesia, the European Union, the Japanese Embassy, the New Zealand Embassy, the Canadian Embassy, the British Embassy, and USAID Indonesia through COVAX. UNICEF Indonesia is grateful for direct support received from key partners, including Gavi, the Vaccine Alliance, the Governments of Australia, Japan, New Zealand and United States of America as well as KOICA (Korea International Cooperation Agency).