With the rapid developments in COVID-19 vaccines, attention is turning to the brutally complicated supply chain and logistics needed to roll them out as part of an immunisation campaign.

If the task of procuring and transporting the vaccine – ensuring it stays at the perfect condition all the way from ‘lab to jab’ – wasn’t challenging enough, governments across the world are faced with vaccinating an already fatigued global population at the right time and, for some vaccines, doing it twice in a matter of weeks. The vaccines are also already being met with significant suspicion and mistrust. With the highly visible nature of the campaign and this inevitable scrutiny, it is imperative to plan and prepare the intricate details of a national immunisation campaign ahead of deployment.

To successfully immunize a large proportion of a population, governments need to address institutional and cultural barriers in their specific contexts, as well capacity gaps in their systems and human resources. Crown Agents has a long history of partnering with governments to support them build long-term capability in management of their health systems. We also provide systems designs and help develop standard operating procedures for health interventions and distribution systems, taking into consideration risk management and community sensitisation. From our experience we’ve distilled four key points to consider when planning a mass vaccine campaign:

1. Map clinical need: For a Covid-19 vaccination campaign to be successful, high coverage needs to be achieved in the target population. This means reaching millions of adults across immense areas of land, many of which are not easy to reach. Detailed information gathering is therefore needed to map out accurate data about communities and to quantify need per age group. This includes research on even the most remote settlements and hard to reach groups, such as the internally displaced or migrant workers. Communities must be accurately plotted, along with distances, population spread and movements in order to inform the logistics, the amount of vaccine needed per region and the number of health workers needed to carry out immunisations. This intensive research requires close collaboration with the communities, government and ministries of health, to make sure no one is left behind.
2. Prepare the population: Education and outreach about the vaccine is key in order to counter misinformation. This requires an appropriate media campaign, developed with the support of local, religious and political leaders, in order to generate materials that are sensitive to both national and local contexts. This campaign can be used to not only communicate awareness of the vaccine, but also for educational means, in response to the ascertained beliefs of the target population. Accompanying the media campaign with data collection to identify where there is ongoing resistance will help enable it to be flexible enough to respond to new and arising challenges.
3. Build the capacity of health workers: Mass immunisation campaigns pose significant challenges compared to the routine immunisations that health workers are so accustomed to. In particular, staff are not familiar with the vaccine and will be under pressure to vaccinate as many people as possible in a short time frame. National managers, decision-makers and health workers across the board must be mobilised and upskilled so as to minimise risks and negative impacts of the campaign. Where vaccines requiring ultra-cold storage conditions are being used, special handling training is required to ensure the safety of the health worker when dealing with vaccines at such extreme temperatures.
4. Consider the delivery strategy: The Covid-19 vaccine will require large populations to be immunised over a short period of time, which may be beyond the capacity of existing health infrastructures. Governments need to think about how they can best utilise the resources they have and where populations can easily be reached. With widespread lockdowns across the globe and a vast proportion of adults in their households, mobile and transit point teams and door-to-door immunisations may need to be considered as opposed to fixed sites.

When it comes to navigating the complexities of deploying a national Covid-19 immunisation campaign, Crown Agents can offer specialist capabilities and experience. Recently for example, as part of the Foreign, Commonwealth and Development Office’s global programme to end neglected tropical diseases (NTD), Crown Agents has provided extensive technical assistance to 11 governments at national and sub-national level. This support has helped them plan critical NTD health interventions and map clinical needs. In South Sudan, we’ve also developed Covid-19 education communication materials in over 20 local languages as part of our Health Pooled Fund programme. To date, 19,000 copies have been placed in our supported health facilities, which reach 80% of the population.

You can discover more about our holistic vaccine capability offering here.