A New Hope: Vaccine Supply Chains Get More Attention

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To reach their destination, vaccines have to travel through a series of locations, storage equipment, vehicles, personnel, and processes, while protected from the heat and freezing. Photographer: Robin Nelson/Bloomberg

In the last episode (“Are Vaccines Getting To Where They Need To Go?“), you learned that vaccine supply chains are the Chewbacca of the vaccine world: not because they are hairy (although they can get hairy) but because they are very important yet very underappreciated. And like the Star Wars character Chewbacca, vaccine supply chains are much more complex than they may seem. Now, with a just-published special issue of the journal Vaccine entitled “Building Next Generation Immunization Supply Chains“, vaccine supply chains are finally getting more deserved time in the limelight. As Han Solo once told Chewbacca, “laugh it up fuzzball.”

Two international experts on vaccine delivery, Benjamin Schreiber, Senior Health Advisor at UNICEF and Raja Rao, Senior Program Officer at the Bill and Melinda Gates Foundation, served as Guest Editors for the special issue along with me (a self-declared Chewbacca expert.) Heidi Lasher, Emma Stewart, and Erin Fry Sosne of PATH and Amy Wales formerly of PATH and now of Weber Shandwick helped pull the issue together. The issue features over 30 publications (actually 31, which is over 30) authored by an all-star lineup of vaccine and vaccine supply chain experts. Here are some examples.

In an editorial entitled “No product, no program: The critical role of supply chains in closing the immunization gap“, five key vaccine decision makers (Matshidiso Moeti, Regional Director for Africa, World Health Organization (WHO), Robin Nandy, Principal Advisor and Chief of Immunization, UNICEF, Seth Berkley, CEO, Gavi, The Vaccine Alliance, Steve Davis, President and CEO, PATH, and Orin Levine, Director, Vaccine Delivery, Bill & Melinda Gates Foundation) frame the issue: there are too many places in the world where vaccines are still not reaching the people who need them most. Compounding the problem, as explained by Celina Hanson, Anupa George, Adama Sawadogo, and Schreiber in their literature review, “Is freezing in the vaccine cold chain on ongoing issue?” vaccines are too often damaged by exposure to frozen ice packs before they reach local health clinics or other points of use, hindering efforts to boost coverage. A renewed focus on next-generation supply chains that can safely and reliably manage, store, transport, and deliver vaccines to the point of use is vital to closing the immunization gap.

In “The origins of the vaccine cold chain and a glimpse of the future“, John Lloyd and James Cheyne, pioneers (two “Jedi Masters”) who transformed immunization programs by setting up many of the world’s first vaccine supply chains in the 1970’s and 1980’s, provide a brief history of vaccine supply chains and their perspective on the future. And here’s Ewan McGregor, who played a Jedi Master in the Star Wars series showing how challenging vaccine delivery can be:

Felix Kabange, Mukwapa Numbi, and Blanchard Mukengeshayi Kupa from the Ministry of Public Health for The Democratic Republic of the Congo outline the urgent need to improve vaccine supply chains and the potential far-reaching benefits in “The potential of next-generation supply chains to ease DRC’s “Casse-tête.”

Some of the publications in the special issue examine how the characteristics of refrigeration technologies and vaccines interact with supply chains in complex ways. As fellow guest editor, Raja Rao explains, “the design of all the equipment and technology within a supply chain needs to match the structure and operations of the supply chain.” For example, a review paper by authors from JSI (Alexis Heaton, Kirstin Krudwig, Craig Burgess, Andrew Cunningham, and Robert Steinglass) and the Gates Foundation (Tina Lorenson) entitled “Doses per vaccine vial container: An understated and underestimated driver of performance that needs more evidence” explains how the number of vaccine doses per vial can affect delivery schedules and vaccine wastage.

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