A review of leading COVID-19 vaccines, the quest for immune protection, and its key challenges. Part 4: Global Covid-19 vaccination campaign – supply and distribution logistical requirements and challenges.
Date
2021-05-06
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Abstract
Rationale
• Rapid manufacturing and effective distribution of sufficient quantities of vaccines is paramount to launch a successful vaccination campaign that will successfully achieve herd immunity to interrupt the pandemic crisis.
• The fundamental objective driving COVID-19 vaccine deployment is to ensure that all people have fair access to safe and effective COVID-19 vaccines.
• The purpose of Part 4 of this series is to highlight the logistical and ethical challenges of the supply and distribution chain of COVID-19 vaccines.
Key points
• All phases of the COVID-19 vaccination campaign merits strong consideration from an ethical and logistical perspective.
• Vaccines must be authorised by regulatory authorities before use.
• Governmental implementation bottlenecks are the cause of the inability to vaccinate at-risk populations rapidly.
• Productivity and manufacturing of mRNA-based vaccines remain low, and ultra-cold chain requirements impose significant storage and distribution challenges.
• Viral vector-based vaccines are based on proven technology and expected to yield significantly higher annual volumes.
• Recombinant protein subunit vaccines can be easily scaled up, are reasonably stable and easier to manage, but development is currently running months behind schedule.
• Live attenuated and whole inactivated virus vaccines require regulatory-approved biosafety level 3 (BSL-3) facilities for development and manufacturing, thus have more safety hurdles, are more complicated and slower to develop, and therefore unpredictable to manufacture.
• An effective vaccination campaign requires adequate procurement of vaccines and political will.
• Health care workers and elderly adults are the highest priorities for vaccination.
• Exposing vaccine distribution and implementation plans to scrutiny is critical.
• Allocation of limited vaccines should be prioritised and based on the ethical principles of maximising benefits, minimising harms, fair and equal access, transparency, informed consent and trust.
• Public trust can only be ensured through transparent communications and consistently applied allocation of safe, effective, and fair vaccines to everyone.
• Safety and public trust are critical considerations in vaccine acceptance.
• Health care professionals are the most trusted source of information.
Public health implications
• Access to vaccines for global distribution before the end of 2021 will be a task of unprecedented proportions.
• Experts recommend that governments invest in a more expansive and diversified portfolio of vaccines.
• Many countries are under-resourced with vulnerable high-risk communities.
• Multiple stakeholders are driving a global approach to equitable access.
• Public distrust, anti-vaccine messaging, and vaccine hesitancy are a significant concern to vaccine campaign efficacy to contain the pandemic.
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Keywords
acceptance, accessibility, allocation, availability, COVID-19 vaccines, distribution, equitable distribution, ethicals, logistics, manufacturing, procurement, storage, supply chain, tracking, vaccination campaign, vaccine hesitation, verification