Breaking Down Bottlenecks in Vaccine Distribution

The past year has been a long series of supply chain disruptions occurring within the greater context of the COVID-19 pandemic. While it goes without saying that the pandemic has not yet passed, signs of normalcy have begun to emerge within the global supply chain ecosystem, and the ongoing vaccine rollout has given the world hope that things may soon return to normal. As the world holds its breath, we’re beginning to see a clearer picture of what it will take to actually get there.

Much of what we’ve written in the past has focused on the likely challenges that the COVID vaccine rollout — certainly the largest-scale distribution campaign in human history — will present. Now that we find ourselves in the midst of that campaign, it’s becoming more and more apparent where those predictions are holding true. In a recent webinar, I had the chance to sit down with Dave Malenfant and Eric Tichy, two individuals who truly have one foot in both medicine and supply chain.

Dave is the Director of Outreach and Partnership for Texas Christian University. He has close to four decades of experience in supply chain, specifically within the medical and pharmaceutical device industry. Eric, Vice Chair of Supply Chain Management at Mayo Clinic, is a pharmacist by training, an infectious disease expert, as well as a career logistics professional. It’s hard to think of two people more qualified to speak on this important topic, and our recent discussion shined a light on some of the things standing between the world population and total COVID-19 vaccination.

The Trouble With Bottlenecks

One of the first questions on everyone’s mind right now is  “Why aren’t there enough vaccines to go around?” This then prompts the follow-up question: “Where in the supply chain are bottlenecks preventing product from getting to the consumer?” This was one of the first topics we tackled in our talk.

During the webinar, Eric identified four major areas where bottlenecks are most likely to occur during a vaccine distribution campaign, as well as the primary sector where delays are occurring.

Four Potential Bottlenecks to Vaccine Distribution

  • Distribution: All transportation-related aspects, such as trucking capacity, cold storage, etc, fall under the Distribution category. Thus far in the COVID vaccine rollout, this sector has performed admirably.
  • Administration: These are the resource constraints that exist at the site level, where vaccines are being actively administered to the population. They range from simply having enough people to properly administer the vaccine, to obtaining adequate facilities and PPE to equip those personnel. This sector has also performed well so far.
  • Demand: As with any product or material, demand is an important piece of the overall supply chain picture. There’s been a lot of vaccine hesitancy over the course of this distribution campaign, and yet many, many more are choosing to get vaccinated as soon as possible, meaning that demand is not the factor slowing down the process.
  • Supply: Supply is the classic counterpoint to demand in any economic equation, and it all comes down to a seemingly simple question: Do we have enough vaccines available to meet demand? This is where the majority of slowdowns are occurring at this time.

Supply-Side Slowdowns

It’s in the supply sector that has been the origin of the delays we’ve been seeing in getting enough doses of vaccine to meet demand. In a way, this is very similar to the situation we’ve seen over the past 12-plus months: Vaccine providers are racing to create product while the rest of the world stands by, holding its breath.

Eric noted that demand on the patient side has been very high since long before vaccines became available, and while it’s true that some people have displayed a hesitancy to get the injection, many more are anxious to get their dosages as soon as they possibly can. Similarly, professionals on the distribution and administration side have had quite a while to prepare and source the needed capacity, facilities and personnel to ensure the smooth transfer of vaccine from manufacturer to final consumer.

Eric himself estimates that his organization would be physically capable of vaccinating about ten times the number of people they’re currently seeing, if only they had more doses to administer. Especially with the turmoil surrounding the Johnson & Johnson vaccine over the past few weeks, the available supply simply hasn’t been forthcoming. Because of all this, it’s become clear that the bottlenecks we’re seeing have been more to do with the available supply of the product itself than with any of the other three sectors Eric described.

“In my organization, we could be administering ten times more vaccines than we currently are.”

– Eric Tichy, Mayo Clinic

Do No Harm

The good news is that while we’re still playing something of a waiting game, at least vaccines are moving now, after so many months of lockdown and R&D. Once we get a critical mass of product in hand, then the burden will shift away from supply and into the distribution and administration sectors.

On the distribution side, things like temperature tracking and smooth border transits will be critical to ensure that vaccines remain stable throughout their journey to the vaccination sites and facilities. All along the way, you’ve got a host of different challenges, ranging from courier shipments, last mile deliveries, and hyper-specialized packaging to worry about.

It’s deeply ingrained into the DNA of every supply chain professional that the products we transport need to be safe. A lot of things go into ensuring that. Consumers may take the safety of the medical and pharmaceutical products they buy for granted, but that’s a privilege that supply chain professionals simply can’t afford. All in all, if a product as sensitive as a vaccine takes a little while longer to make its way to me as the consumer, but I know that it’s safe, that’s a delay I’m willing to accept.

You can catch the full webinar here.

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