The Immunization Supply Chain and How COVID-19 Presents New Challenges

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As the world races to develop a vaccine to combat the COVID-19 pandemic, many look towards a future of inoculation. To reach this goal, there are challenges that come with the research and creation of a vaccine that must be overcome. However, the creation of a vaccine is only the first step. The manufacturing, distribution, and packaging of vaccines are also extremely important. Vaccine supply chains are what society leans on for vaccination distribution that is safe, efficient, and fair. This is part of the process that isn’t particularly visible to the public and many people may not consider or know much about.

The goal of supply chains is to maintain the availability of quality vaccines from the manufacturer level to the service delivery level. Vaccine management and logistics support are crucial to the success of a supply chain at every level of distribution. Vaccine management and logistics support focuses on vaccine monitoring, cold chain management, immunization safety, and global shipping.

Cold chain management is especially important in the vaccine supply chain. Scientists have identified that 2°C to 8°C is the optimal temperature for vaccine storage and that these conditions must be maintained from manufacturing through the immunization of a patient. WHO estimates that typically around half of produced vaccines are wasted each year due to inadequate temperature control in supply chains.

Vaccine waste is a combination of discarded, lost, damaged, and destroyed vaccines. Vaccine waste accounts for a significant portion of the costs in the supply chain, so minimization of waste is a priority, particularly now with such vast quantities needed. Calculating the waste rate is important for preventing under or over-stock and allows the adjustment of supply chain infrastructure at a national level. On a global scale, waste helps forecast vaccine access.

In addition to the existing challenges of the supply chain, the current COVID-19 pandemic presents new barriers to overcome. One such barrier lies with the production of medical products like vials and syringes necessary for inoculation at such a scale. In the United States alone, there is a demand for at least as many vials and syringes as the 300 million people that may need to be inoculated. To adjust for this scale of demand, production companies will have to ramp up manufacturing or find alternatives. The pandemic has resulted in industry-wide delays in inventory replenishment for many products, which may hinder the capacity of production companies to meet such a large demand for the products necessary to manufacture and distribute a vaccine.

Another challenge that the pandemic presents is global distribution through ships, planes, and trucks. Freight companies have already been stretched thin by the pandemic and face shrinking capacity on their cargo ships and planes. The stopage of commercial flights has added to the supply shortage since they usually carry cargo below the passenger cabin. Distributing the vaccine to rural and remote communities also presents challenges, and logistical services will be stretched to reach these communities.

The accelerated production of a COVID-19 vaccine may also lead to changes, hopefully improvements that can be applied elsewhere, in vaccine production and distribution. The surge in investment in vaccine development due to COVID-19 may bring new players to the market or put additional pressure on competition and profit margins.

The challenges of the manufacture and distribution of vaccines as well as the supply chain will be the next hurdle to overcome after the development of a successful vaccine, or maybe more than one. Being able to exit the current pandemic will also rest on manufacture and distribution and on the world’s preparedness and willingness to combat these challenges head-on.

Resources:
WHO: https://www.who.int/immunization/programmes_systems/supply_chain/en/
Forbes: https://www.forbes.com/sites/sap/2020/08/27/the-next-supply-chain-challenge-how-to-vaccinate-the-world/#73b91f727c4f
https://www.forbes.com/sites/willhorton1/2020/04/01/7-unusual-ways-aircraft-now-fly-cargo-during-coronavirus-outbreak/#5f844fa635b1
NY Times: https://www.nytimes.com/2020/05/01/health/coronavirus-vaccine-supplies.html
S&P Global: https://www.spglobal.com/ratings/en/research/articles/200803-covid-19-may-accelerate-disruption-in-the-global-vaccine-market-11568238