Vaccine distribution and the complex Supply chain

I have 30 years of experience in logistics and supply chains, and the government’s vaccine rollout strategy is the most demanding logistical challenge I’ve ever seen. Why? Let me explain. We have a sought-after commodity (in this case, the vaccine), and we know we have a market for it (a population in need of immunity to COVID-19). All we have to do is to get this commodity out to the end-user.

That’s easily said, but it’s hard to overstate just how challenging it will be to achieve. We have an incredibly complex target audience with people all over the country needing their doses at different times. Then there’s the vaccine itself, which comes with its own strict storage, handling, and delivery requirements.

The goal has to be to vaccinate everyone as quickly as possible so that society can re-emerge from its current state of stasis – so that people can go back to work and life can return to some semblance of normal. ‘Time is money’ has always been a central maxim of any supply chain. But in this case, time also means an extension of the personal and financial suffering so many people are having to endure at the moment.

The government here in Norway has set out a hugely ambitious vaccination strategy, but that strategy is also rigid. It’s based on an overarching plan for who will receive the vaccine and when. For practical reasons, healthcare professionals and other key workers are being given priority, as are the elderly and those with pre-existing medical conditions - but political agendas and other factors have also influenced rollout decisions. And each of these strategic choices has a knock-on effect on the supporting logistics process, which requires “just in time” precision to ensure the vaccine is in the right place at the right time for the end-user.

If vaccine distribution had been based on geography - per municipality or region, say - everyone with an affiliation to a particular medical center could have received the vaccine at the same time, which would have meant all available vaccine doses could have been sent to the same place, making delivery faster and more efficient. We could even have gone so far as to provide vaccines only based on geography, without further prioritization beyond that, which would have made it easier to get more people vaccinated more quickly.

There’s no right or wrong way to do things here, and every approach comes with its own pros and cons. But whichever approach we take, the supporting logistics solution that’s so vital to the rollout won’t work by magic and the goodwill of healthcare professionals who are under more than enough pressure as it is.

A complex Supply chain

The supply chain in this case will see vaccine doses sent from manufacturers to central storage warehouses for distribution around the world. Manufactures will pack individual doses into smaller vials, and then into large freezer containers, where the temperature chain must remain unbroken until final delivery.

Norway’s central warehouse is located in Sweden, and from there vaccine doses will be sent on to distribution centers around the country by road. While the location of distribution centers is a closely guarded secret for security reasons, one would hope locations have been chosen to ensure driving distances are manageable, as once the vaccine exits a distribution center the temperature chain is broken, and the doses must be used within 5 days.

This creates a time-critical bottleneck within the supply chain, and it’s crucial that everything comes together perfectly at this point to ensure all the vaccines are delivered and used while they’re still viable: the carrier must arrive to pick up the doses at the right time, the roads must be relatively clear to avoid significant delays due to traffic, accidents must be avoided, and a robust contingency plan has to be in place in the event that unforeseen problems are encountered along the way.

Bottlenecks will always occur in a supply chain. Today, production is the bottleneck, but when production volume increases, these bottlenecks will begin to move down the supply chain, putting more pressure on carriers and so on. It’s vital we monitor these bottlenecks as they arise to ensure we avoid major delays further down the line.

Once delivery is completed, the thermo-containers and freezer containers used to keep the vaccines at the right temperature during transportation must be returned to the relevant distribution centers or central warehouses for reuse.

We can think of the injection of a vaccine dose as the point of sale in this scenario, and it requires that both the customer (the person being vaccinated) and the goods (the vaccine dose) are in the right place at exactly the right time. And a lot of work goes into making that happen. Each municipality will be given an indication of how many doses they can expect to receive, usually around 2 weeks in advance of delivery. From there, the doses are distributed to local medical centers and other relevant vaccination sites.

GPs are required to determine which of their patients should be vaccinated first based on the current criteria defined by the government. Patients are then contacted by phone, and some must be called several times to successfully arrange an appointment. Even once the appointments have been made, there are plenty of potential hurdles to overcome – family members may need to be involved with transport arrangements, and last-minute illness among any of the people involved in the process - healthcare professionals, customers, relatives, and carriers - could mean vaccine doses are wasted, as could unfavorable weather conditions or other unforeseen circumstances.

IT systems that aren’t fit for purpose

Today, the IT systems supporting this fragile supply chain are able to do so only to a limited extent, because they were designed to support far simpler processes. A typical healthcare industry supply chain might consist of orders based on usage forecasts, or even a simple push strategy based on past usage volumes. These kinds of repetitive deliveries to stable markets - and the IT systems that support them - were never built to cope with the kind of complex, dynamic supply chain that’s required to successfully vaccinate a nation in a short space of time.

What’s really needed is a holistic view of the various information flows involved, but that means integrating a wide range of solutions and data streams. For now, support staff are having to plug the gaps with manual interventions and an incredible amount of hard work.

What I’ve tried to describe here is, first and foremost, how complicated the logistics solution underpinning vaccine delivery really is. How and when you and I personally receive our vaccines depends on a whole host of different factors and bottlenecks that need to be monitored if we want to avoid unnecessary delays.

I think it’s time to discuss how we can carry out this whole process more efficiently and with a simpler logistics strategy—because if we fail to find the best solution now, we all pay the price.

If you’re interested in monitoring your own supply chain, don’t hesitate to get in touch and we can continue the discussion.

Øistein Reppe

Managing Director, Vince AS