The vaccine risk you’re probably not considering

Chanticleer

Chanticleer

Developing a COVID-19 vaccine is one thing, but actually vaccinating the population is another. A complex and potentially fraught logistics challenge lies ahead. 

Whether or not you believe Donald Trump’s declaration that a COVID-19 vaccine could be possible as soon as October, it seems clear the world is marching inexorably towards a breakthrough.

But it’s equally clear that simply discovering a safe vaccine is only the start of a very complex and potentially fraught process of actually getting Australia vaccinated.

The government is already considering several vaccine challenges.  David Rowe

The government has started tackling some of these problems, as shown by the deal it has struck with healthcare giant CSL to manufacture doses in Melbourne, should two candidates from the University of Queensland and Oxford University prove successful.

But EY partner and supply chain expert Nathan Roost says the level of complexity involved in distributing the vaccine will hinge at least in part in a simple but unlikely question.

Will the virus have to be chilled or frozen as it is distributed around the country?

Chilled products (which must be kept between 2 degrees and 8 degrees) are one thing. But if the vaccine needs to be frozen, that’s an entirely different logistics challenge.

Consider the manufacturing process. Demand will be strong, and the objective will be to get Australians vaccinated as quickly as possible. Roost can see a scenario where up to 2 million doses are produced by CSL in Melbourne.

Those doses will first need to be stored before being transported in bulk around to the various states. Then, just as in the retail sector, there will be a “last mile” challenge of getting it into the hands of the medical professionals who will administer the vaccine.

Will that be done through the state hospital system, through GPs or through drive-through clinics? How that question is answered will trigger another set of challenges, particularly if the vaccine needs to be frozen.

There’s also the question of prioritisation. Which states will get the vaccine first? Which members of the community are then first in line? Is it front line workers or the elderly, or another group?

The allocation of the vaccine, the sequencing of its distribution and the prioritisation of recipients needs to be carefully planned for, Roost argues, to ensure logistics capacity can cope.

“There might be a surge in logistics capacity that’s required,” Roost says. “There’s a fair bit to think about and it’s good to get in front of this because it’s going to take months to prepare.”

Roost says the capacity of Australia’s logistics network is pretty good and while he doesn’t expect the vaccine will need to be frozen, he believes we can still cope if careful planning is in place.

Existing pharmaceutical supply chains for something like the annual flu jab will be helpful, although demand is likely to be higher and the stability of the new vaccine compared to well-established flu shots could be very different.

“If we can understand the demand, that will drive the logistics requirements. Then we can smooth things out – any surge causes a bit of variability.”

Supply constraints

While few of us would have given much thought to the logistics challenge before COVID-19 stuck, the farcical run on toilet paper seen in March, and the on-going problems retailers have had in keeping the shelves full have reminded us how important the plumbing of the economy is.

And not being able to get the vaccine in a timely way could cause a few more problems than struggling to get dunny paper.

“There’s probably a whole different level of emotion involved here,” Roost says in his understated way.

He expects retailers’ stock problems to continue for a while yet, due to a combination of reduced global manufacturing capacity due to the virus and a reduction in inbound freight options, mainly due to the deep cuts to air travel.

But those same factors could also make the vaccine rollout more difficult. Even leaving aside the raw materials for the vaccine itself, Australia will likely need packaging, syringes, protective gear and other equipment.

And we’ll need all this stuff at exactly the same time every other country in the world is clamouring for it.

“I think that’s an on-going risk that we’ll need to watch.” Roost says of the ancillary items required to vaccinate the population. “Most of those materials are produced in north Asia so there’s an on-going watch there.”

Roost is confident that between existing pharmaceutical suppliers, state and federal health networks and Australia’s private logistics players, the country can rise to the challenge. There may even be a role for the defence force in surge capacity.

But he stresses that we must have a good plan and even better coordination.

“There’s a part for everyone to play, it’s just a matter of figuring out the plan. We’ve got some time to solve for this – which is very different to six months ago.”

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