Same author: Dr. Brad Crammond, Team Leader – Research & Insight, RMIT-Cisco Health Transformation Lab
At the beginning of 2020, when the world only knew of the existence of COVID-19, there was no vaccine for anything that looked like the coronavirus. However, such a vaccine became known to close humanity during the 2001 SARS outbreak, efforts were shelved when traditional infectious disease control measures were sufficient to prevent the disease from spreading. orchid. Just 12 months later, there are seven approved vaccines and six restricted supplements. Most notably, there are 82 other candidates in human trials. As amazing as it is, developing a vaccine is not enough. Collaboration is needed in vaccine administration to ensure those gains are not in vain.
The central role of the vaccine(s)
There was a time, globally, that policymakers, individuals, families and companies hoped that vaccine development and deployment would deliver on the promise of ‘return to normal’. While these hopes may be overly optimistic, events even in the past few weeks have shown just how important vaccines are in the response to COVID-19.
The UK’s vaccine program appears to be successfully intervening in the link between COVID-19 cases and deaths. Symptomatic cases have fallen by 60% and hospital admissions by about 80%. The British Prime Minister is starting to tell a story of optimism – of the ability to open up society and everyday life in ways hitherto unthinkable in that country – with the majority of credit being given to him. give the vaccine program and its robustness.
Meanwhile, in Australia – where the curve is famously ‘torn’ by a wide range of interventions in the economy and society – a vaccine program has dragged on since this crisis. Another crisis has now been met with the latest concerns about blood clotting and adverse side effects associated with the preferred AstraZeneca vaccine. And while the government has sought to reassure people that alternative vaccines are being made available and that deficiencies in the program can be remedied, what is perhaps starting to be a logistical policy issue. is rapidly becoming a political issue centered on the trust and capacity of government. Public opinion is currently swirling around the vaccine program causing panic – with accusations starting to surface that its weaknesses are leading to the risk of slower economic and social opening, the re-opening of international borders. closures, and the lingering specter of local outbreaks and shutdowns – and all the disruptions that come with them.
Mare’s nest: complications and vaccines
It can be tempting to treat vaccine deployment as a simple management matter – create a strong plan and execute it effectively.
But behind the seemingly logistical problems lies a highly complex set of problems that further complicate cooperation in vaccine management – problems involving multiple departments, players, and interests in the industry. society. The basis of the conundrum is a delicate dance of public trust and collective action, which can happen in many – sometimes unexpected – ways.
A group of issues related to strategy and sourcing. Securing the ‘right’ vaccine supply confused countries: the question of contracts for the supply of vaccines at the time did not exist. Deciding between different vaccine technologies. The dilemma involves the optimal combination of different vaccines. The choices between domestic production and reliance on internationally sourced supplies in a geopolitical context have distinct national interests. Each of these has presented itself with a series of complex issues that need to be navigated by governments and states.
The sum of these are matters of priority and necessity. Within countries, questions have been raised regarding the prioritization of different groups for vaccination – whether they are frontline workers, immunocompromised persons, particularly vulnerable people. But of course, many of these issues are complex, political, and controversial. Trade-offs are hard 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 consensus can be hindered by differing views and values.
Logistics of all
And of course, logistics We center, too. In Australia, doses of the vaccine have been delivered by the government since February, while deployment has so far not been rapid, with quantities rapidly falling behind government schedules. Whatever the exact cause of the delay, they highlight the crucial role logistics play in turning vaccines into vaccines. Public health experts have long discussed logistical barriers to vaccine delivery in contexts of inaccessibility or populations marked by a general lack of government trust. In Australia, where 20 million flu shots are administered three months each year, the leisurely schedule is surprising. Here, digital technology can help a lot: from patient access and access to field hospitals and mobile clinic setups, from supply chain management to data security, rights 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 for these seemingly strategic, logistical or policy decisions is that – as we’ve seen in recent weeks in Australia – missteps can dramatically erode trust. into not only vaccine programs but also the desire for vaccination. The worst fears of those who question the safety of vaccines have been confirmed, and the flaws in the implementation bring submission to those who trust government funds. . And while rational thoughts may differ on the questions of whether to vaccinate and when, to achieve herd immunity, two-thirds of the population needs to be vaccinated. In the United States, about 25% of the population reported that they would refuse vaccination. In Australia, the figure is only slightly lower at 19.4%. No vaccine is 100% effective, reaching the threshold of herd immunity becomes complex, and poor vaccine program management risks increasing that complexity.
Conclusion: Call for cooperation in vaccine management
Perhaps the central lesson to be drawn from all of this is the need for collaboration between parties – governments, technologists, industry players, clinicians and service organizations – if the vaccine is converted to vaccination and if the COVID-19 response is indeed successful.
One intriguing aspect of the COVID-19 vaccine space is that the most successful vaccines have been developed by private pharmaceutical companies, addressing long-standing complaints that most of the innovation occurs. in publicly funded universities with Big Pharma get a free ride, trading patent rights for the capital needed to get a new drug through Phase 3 trials. But as we have seen, pharmaceutical companies cannot – alone – solve the conundrum of vaccines. So are governments. So are the doctors. Nor is it personal.
Collaboration in vaccine administration is key: if we are to successfully implement the vaccination dimension of the COVID-19 response, we will do so together – or not at all.
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