The world watches and waits as more than 100 scientific teams across the globe race to develop a COVID-19 vaccine. There is much talk about a vaccine being delivered this fall or winter. It is important that realism reigns.
As a supply chain professor, I, along with my students, have engaged in projects with biotech companies that have mapped the vaccine supply chain. There are colossal complexities in ramping up and distributing vaccines, especially during a pandemic.
A COVID-19 vaccination campaign with full national coverage will require one of the largest public/private, federal/state/local partnerships in history. This means that the federal government will have to pivot from its venture capital role in seeding vaccine development efforts to an intense managerial and supply chain leadership role.
Here is a look at the major operational challenges:
Picking Early and Middle Stage Population Targets
There are 7.8 billion humans — 328 million of them are Americans. Obviously, not everyone will get the vaccine simultaneously. Presumably, national governments will determine the allocation priorities for vaccines that come onstream. Which population segments will be targeted first: Frontline health workers; school-aged children (whose return to school is a foundation for workforce recovery); seniors (who die en masse in nursing homes and whose staff become community super-spreaders)? Which will be priority geographies for vaccine distribution? How will other population segments be prioritized? And what will the reaction be among the groups who receive the vaccine long after others? These all have the potential to spark civil unrest and homeland security challenges.
Candidate Vaccines’ Supply Chain Characteristics Will Be Critical
The stability profiles of the vaccines selected will drive the design of their supply chain and distribution networks. For example, Inovio Pharmaceuticals claims that its DNA vaccine can be stored at room temperature for a year. It does not seem to require a difficult-to-scale cold chain that an Oxford vaccine might need. These stability characteristics determine the storage and shipping modes and methods for administering the vaccine to whole populations.
Vaccine Production Will Be Complicated and Might Be Disrupted by Shortages
Companies’ biotech units scale up vaccine production in bioreactor vats. Bottling (fill and finish) operations are done in-house or are outsourced to contract manufacturing organizations (CMOs). It is at this stage that shortages of glass, stoppers or needles and syringes could severely disrupt the vaccine supply chain.
According to a recent survey of 1,800 medical suppliers conducted by Premier, a group purchasing organization for health care networks, more than 10,500 items, including 360 types of needles, have “caps on orders” — in other words, they already are experiencing shortages. Normally, there would be 300-500 items capped per year.
An estimated 850 million needles and syringes will be required to deliver the vaccine. “Our current inventory of these supplies is limited and under current capabilities, it would take up to two years to produce this amount of specialized safety needles,” Peter Navarro, White House director of trade and manufacturing policy, wrote in a Feb. 14 memo to the White House Coronavirus Task Force.
Vaccine Distribution Will Need to Scale Up Multiple Logistics Partnerships
When ready for distribution and delivery, finished vaccine products are turned over to an array of specialized third-party logistics companies (3PLs). These 3PLs expedite cross-border movement and customs approvals, and maintain necessary cold chain environments from product pickup to its last-mile delivery to customers. This means equipping warehouses, ocean containers, trucks, railroad cars and last-mile fleets with cold chain refrigeration and temperature measurement capabilities.
For one vaccine maker we studied, it would have taken eight different 3PL partnerships in the United States and 10 partnerships in Europe to fill and finish, warehouse and transport a vaccine. Finally, vaccine distribution channels reaching deep into the community will need to be established. Hospitals under tight security could be primary hubs, with public schools, local social service and senior center locations, as well as large workplaces serving as secondary distribution sites.
In our rush to hope, we need to remember that the development of an effective vaccine is just the start of the campaign.
Sandor Boyson is a research professor and founding co-director of the Supply Chain Management Center at the University of Maryland’s Robert H. Smith School of Business. He also has served as a principal investigator and adviser in supply chain risk management for NIST and as a U.S. Secretary of Commerce-appointed member of the Advisory Committee on Supply Chain Competitiveness.