Challenges to COVID-19 Vaccine Delivery

The world has been living with COVID-19 for the past year, although for many it may feel like the virus has been plaguing the globe for much longer. Multiple vaccines are already being administered around the world, with more likely on the way later this year.

Yet, challenges remain concerning the vaccine distribution. Who will receive priority, how these vaccines reach local populations, and the issue of public skepticism are all significant concerns.

Funding for Distribution

One of the first problems for vaccine delivery is finding the funding for distribution. With distribution comes significant costs. Finding the money needed is difficult for most countries around the world because a pandemic of this scale was not for which most governments adequately budgeted.

There needs to be a solid plan in place that explains who will pay for the distribution. In the US, the bill will likely be footed by several different parts of the government at the federal, state, and local levels. Yet public health has long been underfunded, and the healthcare infrastructure is nearing a breaking point in some areas.

As of late September, the United States federal government had only allocated $200 million in federal emergency funds to state and local health departments to help with vaccine distribution. Considering that the United States has around 331 million people, it becomes easy to see that even doubling the $200 million would not be enough to ensure smooth distribution.

Chandrakant Lahariya, author of Till We Win: India’s Fight Against the COVID-19 Pandemic, writes “There are vaccines developed in India, and with our production capacity, I foresee that the price could come down very quickly and availability in low and middle-income countries will be high.” Although the cost of the vaccine could drop, this says little about the cost of distribution.

Supply of the Vaccine

In addition to the issues with funding the distribution of the vaccine, there could also be a problem with the supply of the vaccine. The United States is not the only country that needs to have a large supply of the COVID-19 vaccine. Every other country in the world needs doses of the vaccine, as well.

Some researchers have voiced concern over creating enough of the vaccine to provide to the entire world. Even with a workable vaccine, it still needs to be produced in mass quantities. The supply must meet the demand, and there’s never been a demand as high as there is for a COVID-19 vaccine.

Production facilities need to determine which of the vaccines they will make based on the workable vaccines ultimately created. Facilities may need to be expanded to meet the need. It’s certainly possible to create a large number of vaccines in a short period. It happens every year when manufacturing facilities around the world create influenza vaccines. However, shifting to the COVID-19 vaccine will take up a substantial amount of resources. Therefore, facilities need to determine whether they need to stop the production of other medicines or vaccines to make way for the new vaccine.

Logistics and Monitoring

Although funding and supply are two huge challenges, they can be surmounted. Yet, many other challenges remain. One of the biggest of those challenges is the logistics of getting the vaccine sent to the facilities where it can be used to vaccinate the populace.

Fortunately, other plans have been in place for years that can help to guide the United States and other countries in the matters of logistics and monitoring the virus distribution. For example, many countries already have vaccination programs in place for typical childhood inoculations. Not all countries have similar programs for adults. However, some plans can essentially be used as a blueprint when countries are developing their logistics plan for vaccine delivery.

It might have been easier to monitor peoples’ vaccinations in the United States if the efforts to create a national vaccine registry had succeeded in the 1990s. However, at the time many were worried that the government would have and maintain a database of their personal information.

Yet, it’s crucial that vaccine administration is monitored to ensure that as many people as possible are protected from disease. This can be difficult in many instances, of course. In the United States, for example, there is a large homeless population, as well as undocumented persons who may not know where to get the vaccine when it is available, or fear engagement with the government. Yet, if they aren’t vaccinated, it could result in the death toll continuing to rise.

In addition to ensuring that different locations have enough of the vaccine, the deliveries need to be monitored, along with the people who receive the vaccine. A big part of this is tracking vaccine safety by monitoring those who take the vaccine. Although the vaccines are going through testing when it is introduced to a large population, keeping track of its safety and potential side effects become essential.

The chief executive of the Public Health Association of Australia, Terry Slavin, has said, “It is mandatory to have this kind of information to protect the health of the population. In Australia, health officials will have healthcare providers report who gets a coronavirus vaccine to the country’s register.

In the UK, senior health officials say that coronavirus vaccinations need to be recorded by a person’s primary care doctor. In Japan, municipalities are required by law to keep vaccine administrative records for at least five years on a register. South Korea has a vaccine registry, as well.

Access, Cost and Trust

How will the vaccine be provided to the public after it’s in place and ready to be administered? Estimates of the percentage of the population that need to receive the vaccine in order to achieve herd immunity–and thus an end to the pandemic–vary. Both the CDC and WHO say that the number is currently unknown. As such, removing all barriers to vaccination is crucial. This includes access, cost, and trust in public health authorities. Many people may not have the financial means to buy doses of the vaccine, and some will not have insurance. Therefore, offering the vaccine free with insurance is not an effective solution.

Further, some people do not want to take the vaccine. They don’t trust the vaccine and/or the government, and they may refuse it. In the US, communities of color may have particular issues of access or trust. Governments across the globe must address these issues head-on, or else prepare to enforce a vaccine mandate. Of course, if there are mandates, how will they be enforced and what will happen to those who refuse?

Bottom line: Unless someone is subject to a vaccine mandate, getting the vaccine is voluntary.

Other Risks to Consider

Vaccines are not typically considered valuable or worthy of theft. However, the coronavirus vaccine is not like other vaccines. There will be a high demand for the vaccine, and some people will want to have access as fast as possible. Others may not want to go through the government to get the vaccine. Thieves may target the supply of the vaccine, which they can then sell to people. If there is not a proper regulatory system in place, this could cause problems with the supply and delivery.

Additionally, there may be some who attempt to weaponize vaccines. A country that has a large amount of the vaccine could then try to use it as a means to leverage its geopolitical influence. The Russians created a vaccine in August, for example, and many countries have expressed interest in the vaccine. It’s not inconceivable that countries who have developed their own vaccine could use it as leverage to gain political favors.

Getting Delivery Right is Essential

Many challenges, as noted above, will affect the delivery and ability of people to obtain the vaccine in the United States and around the world. The lives of potentially hundreds of millions of people depend on whether the vaccine can be delivered and distributed properly.
Most countries have already started to plan for the distribution of the vaccine, working to build a logistics strategy that will help them reach as many people as they can in as short a time as possible, but it is also certain that no country will have anticipated all the challenges ahead.

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