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. 2012 Jun 22;30(30):4517-23.
doi: 10.1016/j.vaccine.2012.04.041. Epub 2012 Apr 24.

How influenza vaccination policy may affect vaccine logistics

Tina-Marie Assi  1 , Korngamon Rookkapan, Jayant Rajgopal, Vorasith Sornsrivichai, Shawn T Brown, Joel S Welling, Bryan A Norman, Diana L Connor, Sheng-I Chen, Rachel B Slayton, Yongjua Laosiritaworn, Angela R Wateska, Stephen R Wisniewski, Bruce Y Lee
Affiliations

How influenza vaccination policy may affect vaccine logistics

Tina-Marie Assi et al. Vaccine. .

Abstract

Background: When policymakers make decision about the target populations and timing of influenza vaccination, they may not consider the impact on the vaccine supply chains, which may in turn affect vaccine availability.

Purpose: Our goal is to explore the effects on the Thailand vaccine supply chain of introducing influenza vaccines and varying the target populations and immunization time-frames.

Methods: We Utilized our custom-designed software HERMES (Highly Extensible Resource for Modeling Supply Chains), we developed a detailed, computational discrete-event simulation model of the Thailand's National Immunization Program (NIP) supply chain in Trang Province, Thailand. A suite of experiments simulated introducing influenza vaccines for different target populations and over different time-frames prior to and during the annual influenza season.

Results: Introducing influenza vaccines creates bottlenecks that reduce the availability of both influenza vaccines as well as the other NIP vaccines, with provincial to district transport capacity being the primary constraint. Even covering only 25% of the Advisory Committee on Immunization Practice-recommended population while administering the vaccine over six months hinders overall vaccine availability so that only 62% of arriving patients can receive vaccines. Increasing the target population from 25% to 100% progressively worsens these bottlenecks, while increasing influenza vaccination time-frame from 1 to 6 months decreases these bottlenecks.

Conclusion: Since the choice of target populations for influenza vaccination and the time-frame to deliver this vaccine can substantially affect the flow of all vaccines, policy-makers may want to consider supply chain effects when choosing target populations for a vaccine.

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Figures

Figure 1
Figure 1
Trang Province Vaccine Supply Chain Network *Districts-level stores serve approximately 60% of patients seeking vaccination in Trang Province, which vaccinate 1 to 4 days per month **Sub-district-level stores serve approximately 40% of patients seeking vaccination in Trang Province, which vaccinate 1 day per month ***Patients arrive at these locations for vaccine administration. Other locations are only involved in vaccine storage. The number of vaccines ordered by vaccine administering sites is governed by their previous month’s vaccine demand without ordering additional buffer stock.
Figure 2
Figure 2
Average Transport Capacity Utilization across Varying Influenza Vaccination time-frames and Target Population Sizes
Figure 3
Figure 3
Average Storage Capacity Utilization across Varying Influenza Vaccination time-frames and Target Population Sizes
Figure 4
Figure 4
Average Influenza Vaccine Availability across Varying Vaccination Campaign time-frames and Target Population Sizes
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