On Thursday, Italy blocked 250,000 doses of the AstraZeneca COVID-19 vaccine to Australia. Unfortunately, this latest vaccine nationalism episode is unlikely to be the last – Analysis of Italy’s blocking of an AstraZeneca vaccine shipment to Australia from Ho-Yin Mak, Associate Professor in Management Science at Saïd Business School, University of Oxford
How will the global vaccination effort cope with this development?
Facing limited manufacturing output globally, it seems natural for countries to scramble for vaccine supplies.
However, the supply of doses is hardly the only, or even the most important, bottleneck in the rollout process. In this particular case, Italy has reportedly received 1.5 million doses of the AstraZeneca vaccine and administered only 323,000 of them. Other bottlenecks exist in the system – without addressing these, securing extra supplies will not help the vaccine reach people’s arms quickly.
First, we must optimize the distribution process of vaccines. The logistics of vaccine distribution can be highly complex and involves coordination among many stakeholders.
Our recent research shows that vaccination outcomes depend much on rollout inventory policies.
Most countries follow the practice of holding back part of the vaccine supplies to ensure recipients are given the second doses on time, which partially explains why only a small fraction of the delivered doses have been used. Critically, the more volatility there is in vaccine supply, the more safety stock must be tied up for this purpose, creating a more significant inefficiency.
Thus, it is crucial to note that supply chains work best when demand and supply are predictable and transparent. The supply shocks created by last-minute re-routing or even interception of shipments will propagate down the distribution chain and can slow down rollouts in both countries substantially.
The second major bottleneck is vaccine acceptance when different vaccine brands are offered.
Some view the AstraZeneca vaccine as inferior to the Pfizer vaccine due to its lower reported efficacy figure in Phase 3 trials. Several countries (including Germany and France) to not offer the vaccine to the elderly have not helped boost public trust. Italy, in particular, initially advised the AstraZeneca vaccine to be used for under-55’s following the vaccine’s approval in late January (and later revised it to under-65’s).
While France and Germany have recently changed course after data from the UK showed that the AstraZeneca and Pfizer vaccines perform similarly in the real world for all age groups, public confidence in the vaccine will take time and effort to build up.
The US is starting to face a similar problem. The one-dose Johnson & Johnson vaccine, which has a lower reported efficacy figure than the Pfizer and Moderna vaccines, has been approved and deployed this week. Public hesitation must be addressed by offering transparency (about which vaccine is being delivered), choice (on which vaccine to take), and assurance (that each vaccine gives sufficient protection and that the top-line efficacy figures should not be interpreted literally). Likewise, Italy and the EU at large should not merely brush away hesitation against the AstraZeneca vaccine and must take concrete steps to tackle it.