Co-author: Dr. Brad Crammond, Lead – Research & Insight, RMIT-Cisco Health Transformation Lab
In early 2020, as the world was only learning about the existence of COVID-19, there was no vaccine for anything that looked like a coronavirus. As much as humanity had approached this vaccine during the SARS outbreak in 2001, efforts had stopped when traditional infectious disease control measures were sufficient to stop the spread of the disease. Just 12 months later, there are 7 vaccines approved for use and an additional 6 with limited approval. Most notably, there are 82 more candidates in human trials. While surprising, vaccine development is not enough. Collaboration will be needed in the administration of vaccines to ensure that these successes are not in vain.
The central role of vaccines
For a time, it seems that around the world, policymakers, individuals, families, and businesses hoped that the development and deployment of a vaccine promised a “return to normalcy.” While these hopes may have been overly optimistic, events in recent weeks have shown how central the vaccine dimension is to the response to COVID-19.
The UK vaccine program appears to be successfully intervening in the link between COVID-19 cases and deaths. Symptomatic cases have dropped by 60% and hospital admissions by 80%. The British Prime Minister is beginning to tell a story of optimism, of a possible opening of society and daily life in ways hitherto unimaginable in this country, with much of the credit given to the vaccine program and the its robustness.
Meanwhile, in Australia, where the curve was famously “crushed” by a series of far-reaching interventions across the economy and society, a vaccine program that has gone from crisis to crisis has now stuck with the latest set of concerns about blood clotting and adverse side effects regarding AstraZeneca’s preferred vaccine. And while the government has tried to reassure the population that alternative vaccines are being obtained and that program deficiencies can be addressed, what perhaps began as a policy and logistics problem is quickly becoming a problem. politician focused on government confidence and competence. Opinion on the failed vaccine program is now being rounded off, with accusations beginning to sound that its weaknesses run the risk of a slower opening of the economy and society, the continued closure of international borders and the persistent spectrum of local outbreaks and blockages, and all the interruptions that accompany them.
The mare’s nest: complexity and vaccines
It can be tempting to consider vaccine deployment as a matter of simple administration: generate a solid plan and execute it efficiently.
But behind seemingly logistical issues is a set of deeply tangled issues that hinder collaboration in vaccine administration: issues that affect multiple parties, actors, and societal interests. At the heart of the enigma is a delicate dance of public trust and collective action, which can be detached in many ways, sometimes unexpected.
A set of issues concerns strategy and procurement. Achieving a “proper” supply of vaccines has confused nations: issues of vaccine supply contracts that did not exist at the time. Decisions between different vaccine technologies. Dilemmas about the optimal combination of different vaccines. Choices between local manufacturing and dependence on supply of international origin in a context of sharpened geopolitical context of national interest. Each of them has proven to be a complicated set of issues that governments and states need to address.
To this have been added issues of prioritization and necessity. Within countries, questions have been raised about sequencing the prioritization of different cohorts for vaccination, whether front-line workers, immunocompromised, or especially vulnerable. But, of course, many of these issues are complicated, political, and controversial. Commitments are difficult and different logics compete. Addressing vulnerability (real or perceived) may not always go in the same direction as addressing epidemiological risk factors. Transparency can be difficult to achieve and the agreement can be frustrated by divergent perspectives and values.
The logistics of it all
And of course, logistics they are central, too. In Australia, doses of the vaccine have been in the hands of the government since February, while so far the launch has not been rushed, with a number that quickly lagged behind the government’s own schedule. Whatever the precise causes of the delay, they highlight the fundamental role of logistics in the transformation of a vaccine into vaccines. Public health experts have long discussed logistical barriers to vaccine supply, either in the context of physical inaccessibility or populations marked by widespread government distrust. In Australia, where 20 million flu vaccines are given in 3 months each year, the peace program is amazing. Here, digital technology can help a lot: from patient access and outreach to field hospital and mobile clinic setup, from supply chain management to data security , privacy and compliance. Facing a very new logistical challenge requires us to take advantage of new tools that can help us do so.
Part of the challenge with these seemingly strategic, logistical, or political decisions is that, as we have seen in recent weeks in Australia, mistakes can lead to a significant erosion of confidence not only in vaccination programs but also in the desirability of vaccination. The worst fears of those questioning the safety of vaccines are confirmed and implementation defects provide relief to those who have confidence in the government. And although reasonable minds may differ on questions about whether and when to vaccinate, to achieve herd immunity, two-thirds of the population must be vaccinated. In the United States, approximately 25% of the population report refusing to get vaccinated. In Australia, the figure is only slightly below 19.4%. Because none of the vaccines are 100% effective, reaching vaccination thresholds for herd immunity becomes complicated and mismanagement of the vaccine program runs the risk of unnecessarily increasing this complexity.
The conclusion: a call for collaboration in the administration of vaccines
Perhaps the central lesson to be learned from all this is the need for some kind of collaboration between actors (governments, technologists, industry actors, doctors and service organizations) if vaccines are to become vaccines. and whether the response to COVID-19 is truly successful.
An intriguing aspect of the COVID-19 vaccine space is that the most successful vaccines have been developed by private pharmaceutical companies, addressing the long-standing complaints that most innovation occurs in universities funded with COVID-19. public funds with Big Pharma obtaining a free trip, marketing patent rights for the capital needed to obtain a new drug through phase 3 trials. But, as we can see, pharmaceutical companies alone cannot solve the riddle of the vaccine. Neither do governments. Not doctors. We are individuals.
Collaboration in vaccine administration is key: if we want to successfully execute the vaccination dimension of the response to COVID-19, we will do it together, or we will not do it at all.
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-  https://www.bbc.com/news/health-56663969
-  https://www.theage.com.au/world/europe/barnstorming-vaccine-effort-key-to-dramatic-reversal-of-uk-s-covid-crisis-20210406-p57gpp.html
-  https://grattan.edu.au/news/four-ways-australias-covid-vaccine-rollout-has-been-bungled/
-  Attaullah Ahmadi, Mohammad Yasir Essar, Xu Lin, Yusuff Adebayo Adebisi and Don Eliseo Lucero-Prisno III. Poliomyelitis in Afghanistan: The current situation amid COVID-19. The American Journal of Tropical Medicine and Hygiene, 103 (4): 1367–1369, 2020.
-  Infectious Diseases Research and Policy Center, “Survey: 1 in 4 Americans will reject the COVID-19 vaccine” https://www.cidrap.umn.edu/news-perspective/2021/03/poll- 1-4-Americans- will-reject-the-covid-19-vaccine
-  Anthony Scott, “More Australians are wary of COVID-19 vaccines”, https://pursuit.unimelb.edu.au/articles/more-australians-becoming-wary-of-covid-19-vaccines
-  Amitava Banerjee, Aidan Hollis and Thomas Pogge. “The Health Impact Fund: Incentives to Improve Access to Medicines.” The Lancet 375.9709 (2010): 166-169