Table 5.

Estimated energy consumption for RNA-type vaccines – Example scenarios of the Czech Republic.

Stages	Conversion factor (as summarised in Fig. 8)	Estimated energy consumption (for 709,750 doses)
Type of Vaccine (RNA) 1st batch = 9,750 doses [111] 2nd batch = 700,000 doses [112]
Production and manufacturing
Material production and extraction •Glass Vials •Syringe	•0.014 kWh/vials or power and 0.243 MJ/vials of natural gas [90] (1 vial equivalent to 5 doses [113]) Other Assumptions: ❖Glass vials only, low dead volume syringes etc. not accounted ❖Fuel consumption in transporting the materials is not accounted ❖Based on Belboom et al. [90] where the improvement in energy efficiency is not accounted •2.98 × 10−5 kWh/pcs syringe Other Assumptions: ❖Electricity consumption = 1,785.7 kWh (Estimated based on [114] for 60 M pcs, conversion = 5.6 R/kWh [115])	•1.99 × 103 kWh of power (~7.1 × 103 MJ) for vials •3.45 × 104 MJ natural gas for vials •21.2 kWh of power (76.1 MJ) for the syringe •Sum = ~4.2 × 104 MJ
Vaccine manufacturing	•3.34 kWh of power/g of vaccine [92]) (1 dose = 100 μg of mRNA [93]) Other Assumptions: ❖Based on the study by Kis [92]	•2.37 × 102 kWh of power (~8.53 × 102 MJ)
Cold Supply Chain (energy consumption embedded by packaging is excluded) Sum for “from Kalamazoo” = ~6.0 × 106 MJ Sum for “from Karlsruhe (air cargo)” = 4.9 × 105 MJ Sum for “from Karlsruhe (road transport)” = 1.5 × 104 MJ Sum for “from Puurs (air cargo)” = 7.6 × 105 MJ Sum for “from Puurs (road transport)” = 2.5 × 104 MJ
Dry ice during transportation	•0.14 kWh/kg dry ice [102] (1 dose required 0.00466 kg dried ice [107])	•4.62 × 102 kWh of power (~1.6 × 103 MJ)
Fuel consumption (Air Cargo)	•11.96 L/km (see Fig. 8, and in-text discussion) Other Assumptions (Kalamazoo Scenario): •Distribute from Kalamazoo sites [116] to Prague and Brno •Kalamazoo to Prague = 7,123 km •Prague to Brno = 203 km •Energy density 34.2 MJ/L •Deliver in two batches Other Assumptions (Kalamazoo Scenario): •Karlsruhe site [116] to Prague and Brno •Karlsruhe to Prague = 398 km •Prague to Brno = 203 km •Energy density 34.2 MJ/L •Deliver in two batches Other Assumptions (Puurs Scenario): •Puurs site [116] to Prague and Brno •Puurs to Prague = 724 km •Prague to Brno = 203 km •Energy density 34.2 MJ/L •Deliver in two batches	•~6 × 106 MJ (from Kalamazoo) •~4.9 × 105 MJ (from Karlsruhe) •~7.58 × 105 MJ (from Puurs)
Fuel consumption (Refrigerated Lorry)	•5 L/h for refrigeration (see Fig. 8) •0.3 L/km engine consumption (see Fig. 8) Other Assumptions [111]: •From Prague airport to The Military University Hospital Prague, General University Hospital Prague and Na Bulovce Hospital (26 km) – 1.45 h (include 15 min unloading) •From Brno airport to University Hospital Brno and FNUSA Hospital Brno (21 km) – 1 h including unloading •Distribute among hospitals •Energy density 34.2 MJ/L •Deliver in two batches Karlsruhe Scenarios (without air cargo) •Karlsruhe to Prague = 520 km (by road transport without air cargo, 5 h) •Deliver in two batches Puurs Scenarios (without air cargo) •Puurs to Prague = 900 km (by road transport without air cargo, 9 h) •Deliver in two batches	•Distribute in Prague = ~1136 MJ •Distribute in Brnõ 785 MJ •Additional ~1.2 × 104 MJ (if from Karlsruhe to Prague without air cargo) •Additional ~2.15 × 104 MJ (if from Puurs to Prague without air cargo)
End of the life cycle
Waste management	•Incineration is among the standard method. •Considerate energy is consumed if autoclaving, chemical disinfection, microwave/radio-wave treatment and crushing/shredding are implemented	•The energy consumption of transporting depends on the distance and frequency •~41.3 MJ/kg can be recovered from plastic medical waste. See Fig. 8 for more information