The Vaccine Supply Chain: A Call for Resilience Analytics to Support COVID-19 Vaccine Production and Distribution

Pharmaceutical companies, upstream suppliers, associated logistics providers, health workers, regulatory agencies, public health experts and ultimately the medical practitioners and general public have been navigating an increasingly globalized vaccine supply chainVaccine supply chain; any disruption to the supply chain may cause cascading failure and have devastating consequences. The COVID-19 pandemic has already highlighted the lack of resilience in supply chains, as global networks fail from disruptions at single nodes and connections. As the race for a COVID-19 vaccine continues, the importance of not only an efficient supply chain but a resilient vaccine supply chainVaccine supply chain capable of reliable production and reaching target populations despite likely but currently unknown disruptions is imperative. Proactively applying resilience analytics to vaccine supply chainVaccine supply chain models will increase the probability that vaccination programs meet their goals. Without such a network in place for manufacture and distribution of the COVID-19 vaccine, even the most efficacious and safe vaccine will not prove viable. Through an overview of the existing vaccine and pharmaceutical supply chainPharmaceutical supply chain publications focusing on resilience, as well as recent papers reporting modeling of resilience in supply chains across multiple fields, we find that models for supply chain resilienceSupply chain resilience are few and most of them are focused on individual dimensions of resilience rather than on comprehensive strategy necessary for scaling up vaccine production and distribution in emergency settings. We find that COVID-19 resulted in a wave of interest to supply chain resilienceSupply chain resilience, but publications from 2020 are narrow in focus and largely qualitative in nature; evidence-based models and measures are rare. Further, publications often focus exclusively on specific portions of the specific supply chain of interest, excluding associated supporting networks, such as transportation, social and command and control (C2) necessary for vaccine production and equitable distribution. This lack of network analysis is a major gap in the literature that needs to be bridged in order to create methods of real-time analysis and decision tools for the COVID-19 vaccine supply chainVaccine supply chain. We conclude that a comprehensive, quantitative approach to network resilience that encompasses the supply chain in the context of other social and physical networks is needed in order to address the emerging challenges of a large-scale COVID-19 vaccination program. We further find that the COVID-19 pandemic underscores the necessity of positioning supply chain resilienceSupply chain resilience within a multi-network context and formally incorporating temporal dimensions into analysis through the NAS definition of resilience—plan, absorb, recover, adapt—to ensure essential needs are met across all dimensions of society. Modeling and analyzing vaccine supply chainVaccine supply chain resilienceVaccine supply chain resilience ensures that value is maintained should disruptions occur.