德国，图特林根——笨重的灰色箱子正在南部城镇图特林根的一家工厂下线，准备在下一阶段运往前线德国美国与苏联的战争冠状病毒因为它成为周五达到100万确诊病例里程碑的最新国家。
像家族式企业宾德有限公司生产的这种人用大小的冰柜可能会成为德国政府准备推出的大规模免疫计划的一个关键部分疫苗下个月上市。
这是因为疫苗竞争的领先者之一是BioNTech，一家德国公司与美国制药巨头辉瑞公司一起开发了一种疫苗，据说在试验中有高达96%的效力，但有一个小问题:它需要冷却到零下70摄氏度(零下94华氏度)才能运输和储存。
确保这样的温度，甚至比南极的冬天还要冷，只是各国在试图让其人口接受免疫接种时面临的诸多挑战之一。
这一努力被比作军事行动。事实上，一些国家，包括德国，正依靠军事和民用专业知识来确保珍贵的剂量在分发前安全地从制造厂运输到秘密储存设施。
德国受益于作为欧盟成员所带来的市场力量。由德国前国防部长乌尔苏拉·冯·德·莱恩领导的27国集团执行委员会已率先与疫苗制造商进行谈判，迄今已订购超过10亿剂疫苗。
德国官员表示，该国希望从欧盟订单以及与德国三家制造商的双边协议中获得多达3亿剂疫苗，其中包括总部位于图宾根的生物技术公司(BioNTech)和加州疫苗公司(CureVac)，该公司表示，其疫苗可以在常规冰箱温度下储存长达三个月。然而，它的试验没有辉瑞/生物技术公司和其他公司走得远。
3亿这个数字取决于一切疫苗正在开发并推向市场。这足以让德国8300万人口接受免疫接种，即使需要注射两针，这似乎是可能的。
疫苗是如何准确地输送给病人的，因国家而异。在德国，联邦政府已经将这项任务委托给了16个州，这些州目前正在努力建设大型疫苗接种中心。
柏林这个城市国家在阿尔布雷特·布罗埃米(Albrecht Broemme)招募了一名灾害管理老手。这位前柏林消防局长后来领导了德国联邦民防组织THW，在那里他帮助组织了世界各地的洪水、风暴和地震救灾行动。
这位67岁的老人现在正在协调在柏林的一个会议中心、两个前机场、一个溜冰场、一个音乐厅和一个室内自行车跑道建立六个疫苗中心。
当局希望他们在12月中旬做好准备，开始每天在每个地点为3000多人接种疫苗。由于每次拍摄只需要几分钟时间，并且注意将每个中心的人数保持在最低水平，布罗埃米和他的同事们正在设计一个单向流动系统，类似于家具公司Ikea等大型商店的系统。
每个网站都将由一个医疗援助团体(如红十字会)管理，志愿者帮助注册并引导人们通过会场。
像其他地方一样，柏林疫苗接种的第一阶段可能将重点放在对卫生保健工作者和弱势群体(如老年人和慢性病患者)的免疫接种上。每天将有大约20，000人接种疫苗，三周后返回进行强化注射。
起初，需求可能会超过供应，但随着更多疫苗进入市场，这种情况将会改变。
德国总理安格拉·默克尔周四对议会表示:“我们希望疫苗领域的批准将很快发布。”。“那不会立即解决问题，但隧道尽头有光。”
布罗埃米说，他预计最初可用的疫苗中有五分之四需要超低冷却。这意味着每个中心都需要一个药房来处理疫苗的储存和解冻。
在该国的另一端图特林根，镇上数百家医疗器械制造商之一的宾德有限公司(Binder GmbH)，有些制造商的历史可以追溯到19世纪，现在对其冰箱的需求激增。
该公司的创新负责人彼得·维默(Peter Wimmer)说，每台设备的价格为13000-15000欧元(15500-17900美元)，可以在最佳温度下保存数万瓶疫苗。
“这是即插即用，”他告诉美联社。"你只需要一个电源插座，打开它，设备就准备好了。"
然而，让整个疫苗接种系统随时准备就绪是另一回事。
目前还不清楚谁将在柏林实际接种疫苗。与英国不同，英国有一个集中的国家卫生服务机构来组织免疫接种运动，德国依靠医生协会来提供必要的医务人员。
德国法定健康保险医生协会柏林分会的女发言人杜尔·阿诺德说，他们仍在等待州政府提供对医生要求的细节。
“尽管医生实践的积极反馈表明他们愿意提供更多的帮助，但为六个疫苗接种中心提供医务人员将是一项挑战，”她说。
医疗物流的局限性在春季受到了考验，当时全球对呼吸机、治疗药物、口罩和其他防护设备的巨大需求引发了竞购战、瓶颈和不合格产品的报告。
全球物流公司DHL估计，在未来两年内提供全球疫苗覆盖可能需要15，000次航班。
敦豪发言人萨宾·哈特曼告诉美联社:“挑战在于剂量的数量，以及不清楚哪种疫苗需要注射到哪里。”。“这不是一家公司能够独自完成的事情。所有物流公司都必须在这方面共同努力。”
Keep cool: Germany preps vaccine drive as COVID cases hit 1M
TUTTLINGEN, Germany -- Hulking gray boxes are rolling off the production line at a factory in the southern town of Tuttlingen, ready to be shipped to the front in the next phase of Germany's battle against the coronavirus as it became the latest country to hit the milestone of 1 million confirmed cases Friday.
Man-sized freezers such as those manufactured by family-owned firm Binder GmbH could become a key part of the vast immunization program the German government is preparing to roll out when the first vaccinesbecome available next month.
That's because one of the front-runners in the race for a vaccine is BioNTech, a German company that together with U.S. pharmaceutical giant Pfizer has developed a shot it says is up to 96% effective in trials but comes with a small hitch: it needs to be cooled to minus 70 degrees Celsius (minus 94 degrees Fahrenheit) for shipping and storage.
Ensuring such temperatures, colder even than an Antarctic winter, is just one of the many challenges that countries face in trying to get their populations immunized.
The effort has been compared to a military operation. Indeed some countries, including Germany, are relying on military and civilian expertise to ensure the precious doses are safely transported from manufacturing plants to secret storage facilities, before being distributed.
Germany has benefited from the market power that comes with being a member of the European Union. The 27-nation bloc’s executive Commission — led by former German Defense Minister Ursula von der Leyen — has spearheaded negotiations with vaccine makers, ordering more than a billion doses so far.
German officials have said the country hopes to secure up to 300 million doses from the EU orders and bilateral deals with three manufacturers in Germany, including BioNTech and CureVac, a company based in Tuebingen that says its vaccine can be stored at regular refrigerator temperatures for up to three months. Its trials are not as far along, however, as Pfizer/BioNTech and others.
The figure of 300 million is contingent on all vaccines being developed making it to market. That would be more than enough to immunize Germany's population of 83 million, even if two shots are required, as seems likely.
How exactly the vaccine is delivered to patients differs from country to country. In Germany, the federal government has delegated the task to its 16 states, which are now working to build large vaccination centers.
The city-state of Berlin has drafted in Albrecht Broemme, a veteran of disaster management. The former Berlin fire chief later led Germany's federal civil protection organization THW, where he helped organize disaster relief operations for floods, storms and quakes around the world.
The 67-year-old is now coordinating the setting-up of six vaccine hubs in Berlin in a convention center, two former airports, an ice skating rink, a concert hall and an indoor cycle race track.
Authorities want them ready by mid-December to begin vaccinating more than 3,000 people per day at each location. With just a few minutes to deliver each shot and mindful of keeping the number of people in each center at a minimum, Broemme and his colleagues are devising a one-way flow system similar to that found in large stores like furniture company Ikea.
Each site will be run by a medical aid group, such as the Red Cross, with volunteers to help register and guide people through the venue.
Like elsewhere, the first phase of vaccination in Berlin will likely focus on immunizing health care workers and vulnerable groups such as the elderly and those with chronic illnesses. About 20,000 people will be vaccinated each day, returning after three weeks for a booster shot.
Demand is likely to outstrip supply at first, but that will change as more vaccines come onto the market.
“We're hopeful that approvals in the field of vaccination will be issued very quickly,” German Chancellor Angela Merkel told parliament on Thursday. “That won't solve the problem immediately, but there's a light at the end of the tunnel.”
Broemme has said he expects four-fifths of the vaccines initially available to need ultra-low cooling. That means every center will need a pharmacy that handles both the storage and thawing of vaccines.
At the other end of the country in Tuttlingen, Binder GmbH, one of hundreds of medical device manufacturers in the town, some with a history dating back to the 19th century, is seeing demand for its freezers surge.
Priced at 13,000-15,000 euros ($15,500-17,900), each device can keep tens of thousands of vials of vaccine at optimum temperature, says Peter Wimmer, the company's head of innovation.
“It’s plug and play," he told the AP. "All you need is an electrical socket, switch it on and the device is ready to go.”
Having the whole vaccination system ready to go at the touch of a button is a different matter, though.
It is still unclear who will actually administer the vaccines in Berlin. Unlike Britain, which has a centralized National Health Service organizing the immunization drive, Germany is relying on doctors associations to provide the necessary medical staff.
Doerthe Arnold, a spokeswoman for the Berlin branch of Germany's Association of Statutory Health Insurance Physicians, said they are still waiting for the state government to provide details on what will be required of doctors.
“Despite the positive feedback from doctors practices that they're willing to help out even more, providing medical personnel for the six vaccination centers will be a challenge,” she said.
The limits of medical logistics were tested in spring, when huge worldwide demand for ventilators, therapeutic drugs, face masks and other protective equipment prompted bidding wars, bottlenecks and reports of faulty products.
Global logistics company DHL estimates that to provide worldwide coverage of vaccines over the coming two years may require 15,000 flights.
“The challenge is the sheer number of doses and the fact that it’s not clear which vaccine needs to go where,” Sabine Hartmann, a DHL spokeswoman, told The AP. “It’s not something a single company can do on its own. All logistics companies have to work together on this.”
