COVID-19 ISO Insights

Can Distribution Disrupt Future COVID-19 Vaccine Supply Chains?

August 17, 2020

By: Christopher Sirota, CPCU

We recently posted about ongoing COVID-19 vaccine trials and some concerns that might arise regarding how it will affect the elderly population, distribution logistics, and possible public distrust. But there may be more immediate concerns relating to the supply chains that are necessary to manufacture the first successful COVID-19 vaccine. An article in Foreign Affairs Journal takes a look, revealing that—not surprisingly—most vaccine manufacturing processes are dependent on an international connection of stakeholders, and that a future COVID-19 vaccine would likely be no exception.

Vaccine Manufacturing is Complex

Researchers around the world are in hot pursuit for a COVID-19 vaccine. Foreign Affairs Journal points out that, although scientists are often working independently in separate countries, the manufacturing of a viable vaccine most likely will depend on stakeholders outside of the country that it was developed in.

The article provides the following background about manufacturing vaccines in general:

  • manufacturing vaccines is complex; to ensure a final product is safe and effective, regulators "license not just the finished vaccine but each stage of production and each facility where it occurs."
  • "Making a vaccine involves purifying raw ingredients; formulating and adding stabilizers, preservatives, and adjuvants (substances that increase the immune response)."
  • Only a few dozen companies can complete the process by adding doses into syringes or glass vials.
  • Only four global companies (based in the U.S., U.K. and E.U.) can "handle the quality-controlled manufacture of active ingredients."
  • About a dozen companies can manufacture at scale, the largest being in India; most could not make billions of doses.

The Future COVID-19 Vaccine: How Distribution Might Interfere with Manufacturing

With that said, the article further focuses on the global interdependency that will likely be inherent in the manufacturing of a COVID-19 vaccine. As an example of how some current COVID-19 vaccine trials might be dependent on stakeholders in multiple countries, and how such dependency might influence vaccine distribution, the article explains as follows:

For example, a number of [COVID-19] vaccine candidates use the same adjuvant, a substance produced from a natural compound extracted from the Chilean soapbark tree. This compound comes mostly from Chile and is processed in Sweden. Although Chile and Sweden do not manufacture vaccines, they would be able to rely on their control of the limited supply of this input to ensure access to the eventual output. Vaccine supply chains abound with such situations.

The article suggests that such a situation may make countries think twice about limiting the initial distribution of the first successful vaccine solely to its own citizens. The first successful vaccine is typically not the best, per the article, so if a country restricts distribution, the country may face the same restrictions from other countries that develop improved versions of the vaccine; improvements could include different means of storage (e.g. no need for refrigeration), and greater efficacy for targeted demographics (e.g. for children).

Is there Global Awareness for Vaccine Supply Chains?

The article also notes the obvious: countries dependent on exporting goods may lose business if their customer countries have locked-down and stricken populations. Business interruption risk may continue for industries that depend on importing parts or ingredients from a stricken country. One industry that has suffered tremendously during the COVID-19 crisis may serve as a great example of global dependence: the travel industry. CNN has reported on how much the following countries depend on tourism:

GDP chart.PNG

If global awareness of the global economy does not prevent countries from potentially hording a future COVID-19 vaccine, perhaps research might help provide convincing evidence. Per the article, more research on how COVID-19 spreads may help provide direction on how to best vaccinate a population. For example, with respect to influenza, it is reportedly well known that the elderly are more protected if children, who are frequent spreaders of influenza, are vaccinated, rather than the elderly themselves. Such insight may guide countries to understand that their entire population may not actually require immunization; instead, per the Foreign Affairs(?)Journal, perhaps only "protecting health-care workers, military personnel, and nursing home staffs; reducing the spread to the elderly and other vulnerable populations; and breaking transmission chains" would be just as effective, thus encouraging countries to share their inventory of vaccines.