Enabling effective, population-centric COVID-19 vaccination programs

It has been a long nine months since the World Health Organization declared the coronavirus pandemic. Globally, individuals and communities have experienced devastating loss of life and livelihoods and significant economic hardship. But also during these challenging months, we’ve witnessed herculean efforts by health professionals to save lives and care for those who are ill.  

At the same time, scientists worldwide have collaborated diligently on the critical quest to find effective vaccines. 

With today’s promising news on those efforts comes the next set of big challenges. As leaders move to vaccinate populations successfully, they must not only educate their populations, but also ensure that local infrastructure is in place to facilitate rapid and timely vaccine administration as doses become available. This critical part of the pandemic journey could continue well into 2022 as countries begin receiving shipments of vaccines and implementing their respective vaccine programs.

The health and life sciences ecosystem is highly complex, encompassing pharmaceutical firms, governments at all levels and areas of responsibility, distributors, medical providers, pharmacy benefit managers, payers (insurance plans) and consumers. Government health jurisdictions and other members of this ecosystem need highly effective ways to forecast, allocate and distribute the vaccines to achieve the desired 70% coverage level needed for herd immunity. 

Moving from approval to sufficient immunization

How will jurisdictions confidently and efficiently predict demand, order vaccines, and inoculate populations to meet their goals?

These topics took centre stage at the HIMSS webinar I moderated last month on “Factors for a Successful COVID-19 Vaccination Program,” along with Lois Privor-Dumm, Director of Adult Vaccines at the Johns Hopkins Bloomberg School of Public Health. More than 150 representatives from across the health ecosystem joined in our discussion. (Watch the recording.) 

A key issue was how to gain consumer acceptance of these vaccines when there is a high level of distrust among significant segments of the population. For example, in the U.S., according to a Gallup poll last month, 42% of the population said they would not vaccinate, while 58% said they would.  

Addressing the behavioural, logistical and technical challenges of COVID-19 vaccinations requires a common healthcare success factor: population centricity. Improving vaccine uptake means engaging consumers to understand more about these vaccines to increase their confidence in them. A population-centric model is also needed to support vaccine administration and tracking to ensure individuals receive the same vaccine at second dosing, and that percentage of vaccinated populations can be tracked to understand the gap or achievement of the ideal 70% coverage level. Fortunately, there are proven practices, tools and technologies that can help organizations improve their effectiveness in these endeavours.

Focusing on the criticality of consumer education

What information do consumers need to feel confident about their vaccine decision? Where can they find answers to their questions? How will they know when and where to get vaccines or their eligibility? How can authorities provide transparency about their vaccine programs? Can the consumer make a choice of a preferred vaccine when there is more than one choice available? 

Answers to these questions are a critical component of the communications plan. 

Consumers need to know more about how the vaccines work, their side effects, and their efficacy. Government digital channels such as mobile apps and portals are effective sources of consumer information and in facilitating eligibility determination, enrollments and appointment scheduling. At the same time, such apps can provide critical information for jurisdictions in monitoring the progress of their programs. Manufacturers should also provide information on their digital channels, such as on portals and via chatbots, to address consumers’ and healthcare practitioners’ questions and general concerns. Of course, any information must be collected in accordance with privacy laws and consumers must feel confident about sharing their data. 

Additionally, effective communications and outreach plans are needed to ensure trusted sources convey accurate information that can help consumers overcome hesitancy and mistrust. (On this topic, I invite you to read my earlier blog on applying human centred design to drive a successful coronavirus vaccine mindset.) A key success factor is also using trusted local leaders such as faith and community leaders in the outreach process. This is a critical programmatic strategy used in the developing world for decades with much success.

Planning for vaccine management

There are additional challenges in distributing and administering vaccines during a pandemic versus vaccinating for seasonal viruses like the flu. While annual flu vaccines require a single dose, the majority of vaccines for COVID-19 require 2 doses, 3 weeks apart. So, if overcoming vaccine hesitancy is the first hurdle, the second is achieving dose compliance, ensuring each individual returns for the booster dose at the required time. The next hurdle is the ability to carefully forecast and plan for populations, percentage uptake, timeframes, jurisdiction allocation and optimal scheduling for second dose availability at the required time.

In addition to new investments to provide the appropriate cold storage for Pfizer’s mRNA vaccine, there will be significant logistics hurdles with a phased distribution model and periods of limited supply. In terms of allocation, some countries will start with health workers, the elderly and/or first responders, for example. Jurisdictions will need to manage and track orders and inventories to ensure accountability, and to prevent or identify any temperature excursion and product diversion. 

The COVID-19 vaccine is needed globally, and one should not discount the possibility of product diversion given the value these vaccines carry at this critical time. Having the ability to track a vaccine from its point of origin to the arm of an individual is of absolute necessity. In addition, these vaccines have been tested during a short time duration. In this case, population immunization serves as the “Phase 4” study. To drive greater success in getting vaccine doses to individuals, 2D barcoding is the ultimate solution. Not only would it streamline practices, but it also would improve inventory management and increase data accuracy. 

Jurisdictions will also need population-centric solutions to schedule vaccine administration (including equitable allocation determination), confirm doses, and provide post-vaccine surveillance with real-world evidence for adverse events. Every vaccine manufacturer should consider adding the 2D barcode to product packaging if they are not already doing so.

Digitizing processes to provide for interoperability and integration

In countries like the U.S., health ecosystems are complex and fragmented. Coordination is needed at all levels of government (federal, state and local) and with other healthcare ecosystem members to ensure success. But there’s no central way to track key information for all phases of a vaccination program. 

Members of the healthcare ecosystem can use this opportunity to work together to enhance existing and build upon digital strategies that promote more standardization, centralization and tracking. Greater interoperability can facilitate integration of vaccine tracking and administration systems with immunization registries and other relevant systems, just as an example.

Advancing data management, reporting and analytics

Data is needed for this effort on many levels, such as to determine if vaccination plans are working and identify which parts of the community are not achieving desired coverage levels and require more outreach. Health jurisdictions will need real-time data to understand population interest and commitment to obtain the vaccine and to report required information to oversight entities. They also will need reporting and analytics to measure and know if their programs are successful, such as whether they are meeting herd immunity goals.

At CGI, we are committed to helping our clients in the healthcare ecosystem to respond to unprecedented challenges, rebound at the right pace, and reinvent ways of working. As new vaccines work their way through approval processes, we have a vaccine tracking and administration solution (CGI AdminVax) to assist jurisdictions in solving these challenges, in accordance with recommendations of infectious disease regulators. Please contact me to learn more about this solution or visit our CGI AdminVax web page.