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Summary:
A vaccine is only as effective as the healthcare system that gets it to people. A newly published rapid systematic review from Duke GHIC and co-authors builds on prior collaboration with the World Health Organization’s Department of Immunization, Vaccines and Biologicals, and the International Vaccine Access Center at Johns Hopkins Bloomberg School of Public Health to examine lessons from the global COVID-19 vaccine rollout, from accelerating vaccine access to understanding the systems and strategies needed for effective delivery. The findings reinforce a critical lesson: developing an effective health product is only part of the challenge. Infrastructure, real-time data, trained personnel, and regulatory agility all influence whether health innovations reach people efficiently and equitably. For health innovators and decision-makers, the takeaway is clear: plan for the delivery system alongside the product, from the beginning.
Authors:
Sarah Nabiaa,*, Alba Vilajeliub, Victor Vegab, Ni Made Adnya Suastib, Affiong Simeon Ebongc, Chinelo Cynthia Ndukad, Katharine Olsone, Wenhui Maoe, Krishna Udayakumare, Ann Lindstrandb, Chizoba Barbara Wonodia
aInternational Vaccine Access Center, Department of International Health, Johns Hopkins University, 415 N. Washington St, Baltimore, MD, 21231, USAbDepartment of Immunization, Vaccines and Biologicals (IVB), World Health Organisation, Geneva, 1211, SwitzerlandcDirect Consulting and Logistics, 15 Amazon St, Maitama, Abuja, Federal Capital Territory, 904101, NigeriadDepartment of Community Medicine, Nnamdi Azikiwe University Teaching Hospital, College of Health Science, 2WG7+4VC, Nnewi, Anambra, 435101, NigeriaeDuke Global Health Innovation Center, Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27705, USA
Abstract:
COVID-19 vaccines substantially reduced the risk of severe disease, hospitalization and death, and are estimated to have saved 2.5 million lives between 2020 and 2024. Together with the rapid pace of vaccine development, the efficiency of supplying and distributing vaccine doses was critical in ensuring the true potential of the vaccines is realized. We conducted a rapid systematic review to synthesize peer-reviewed accounts of imple-mented COVID-19 vaccine supply and logistics and the outcomes reported. We searched PubMed, Scopus, and WHO’s Global Index Medicus (GIM) text and numeric databases in four waves between February 2022 and July 2024. Nine papers reporting implementation experience between December 2020 and mid-2023 were included in the final analysis. The results were summarized as per the WHO supply and logistics framework. The papers described nine of the fifteen functions of the WHO framework. Five papers were from high-income countries, and four were from low- and middle-income countries. Key learnings included the need to invest in long-term supply chain capacity and improving digital visibility to increase supply chain efficiency. One study indicated that stronger in-country regulatory agility during health emergencies improves vaccine distribution. One study documented the benefit of public-private partnerships cultivated during COVID-19 pandemic, which can be continued to be nurtured for improvement of routine immunization programs. Two studies indicated that training and upskilling healthcare workers to fill multiple roles can reduce hiring pressures when a gap exists between health personnel availability and need. These learnings can potentially benefit routine immunization programs and future pandemic preparedness.