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It is interesting to learn about innovative solutions with the existing cold-chain infrastructure in India. I believe that the ingenuity and entrepreneurship of Indians could be instrumental in developing novel (make-shift or as said in Hindi "jugaad") solutions to transport the vaccine safely in rural areas. Some ideas could be developing passive cooling devices that can operate using solar and vehicle exhaust energy to provide cooling for a smaller batch of vaccines. I'd also like to add that even in the developed western countries, large hospitals do not have ultra-cold temperature storage that is required to keep the vaccine at -50C or lower. Almost everyone is currently thinking of using dry ice to maintain the low temperature during long-haul transport and then hoping the vaccine will be used within a few days and can be stored at relatively higher temperatures. The world might come to see a supply shortage of dry ice in this massive immunization mission. Building new infrastructure for ultra-cold storage will not be sustainable in the long-run. The energy consumption, cost, and carbon footprint of such facilities would be massive unless a disruptive new technology is developed which could take some time.

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