New tool developed to distribute vaccines fairly and avoid waste

No one knows exactly how many doses of coronavirus vaccines were discarded during the pandemic. But the numbers are high. Media reported that 125,000 doses went unused in Norway during 2021 alone.

"We started planning quite late in Norway. There wasn't enough information about what kind of vaccines we'd get and when they'd arrive. There were also no systems to effectively gather and use data."

This is what Hossein Baharmand says. He is a researcher at the University of Agder (UiA) and has led the development of a new system to assist authorities in distributing vaccines.

Many considerations to be made

The system uses data accessible to decision-makers. This can include the number of vaccines and the population count in each municipality.

"Let's say we have 10,000 vaccines to be distributed among the 50,000 residents in Grimstad. The system calculates how we can allocate these equitably," says Baharmand.

The model takes into consideration prioritized groups, distances between storage and vaccination sites, available transport, and the capacities of health centres.

The result is a plan for vaccine distribution that is both fair and feasible.

During the Covid pandemic, Norwegian authorities struggled to organise all this information effectively.

"It was difficult for authorities to know how many vaccines to send where. Data on people's preferred vaccine manufacturer, for instance, wasn't stored properly. The result was that many vaccines had to be thrown away," says Baharmand.

Equitable planning

There will always be different views on what constitutes a fair distribution of vaccines. But the reality is there won't be enough for everyone initially.

The system developed by the researchers requires authorities to first decide who should be first in line for vaccines. This could be the elderly, sick or other groups.

"Let's say groups A, B and C get vaccinated first. Other groups have to wait a bit. The system uses the number of people in these groups to create a plan," explains Baharmand.

The goal is to maintain a smooth pace for vaccination. For instance, ensuring 60 per cent of each group is vaccinated within four weeks.

"Some won't make it to the vaccination site for various reasons. We can expect at least 50 per cent to get the first dose and 50 per cent to come for the second round," he says.

Once the first groups are done, the same process begins for the next group. The system ensures everyone gets a chance to take the vaccine.

"It's fair for all and provides an opportunity for everyone. Whether the vaccination rate in each group should be 60, 70 or 80 per cent, that's for the authorities to decide," says Baharmand.

International use

The system developed by the researchers is particularly useful for countries with poor infrastructure. For instance, Uganda only has one international airport and limited means to keep vaccines refrigerated during transport.

"When Uganda receives vaccines, they must be dispatched quickly. But authorities also need to know that health centres have the capacity to administer all the vaccines. Otherwise, vaccines might be discarded due to insufficient storage capacity," says Baharmand.

The researchers have provided the vaccination system to health authorities in several African countries through the Africa Centres for Disease Control and Prevention. Baharmand hopes the system will be further developed by them and implemented in African countries.

"In poorer countries, the margin for error is much higher. We can't risk people going without vaccines because poor decisions are made in Europe."

Further research

Baharmand emphasises the importance of supporting vaccination efforts worldwide for global health.

"We live in a world where everything is interconnected. If those in poorer countries don't receive enough vaccines, new variants of diseases may emerge which will also affect us," he says.

Researchers are now seeking funding to study vaccine distribution in Senegal, where many live in remote areas.

"In many African countries, fewer want vaccines now compared to during Covid. This could relate to trust in authorities but also misinformation and other factors. We need to understand why and find solutions," he says.

The system developed by the researchers is ready for use when a new pandemic arises. It can be adjusted for any country and situation.

The CONTRA project

• Funded by the Research Council of Norway
• Led by Hossein Baharmand at UiA
• Participants from Belgium, Turkey and Norway
• Developed a tool for planning vaccine distribution in a smart and equitable manner
• The system is available as open source and can be adapted to different countries and contexts.