The Australian government and the health system is looking to run two mass vaccination programs at the same time next year but its COVID-19 advisory group still includes no expertise on logistics and distribution.
The federal government recently formed a COVID-19 Vaccines and Treatments for Australia - Science and Industry Technical Advisory Group.
It is chaired by Department of Health secretary Professor Brendan Murphy and includes a range of the government's most senior advisers on medicines and vaccines. It also includes people with extensive industry experience.
Its terms of reference are to support the government in making decisions on the range of issues related to the purchase and manufacture of COVID-19 vaccines and treatments.
The terms of reference also include "distribution and logistics associated with COVID-19 vaccine candidates".
Yet the group does not currently include anyone with extensive experience of distribution and logistics.
The government recently announced purchase and manufacturing agreements with AstraZeneca and CSL. The agreements, for over 80 million doses of two investigative candidates, include the importation of 3.8 million doses of the candidate AstraZeneca is developing with The University of Oxford.
The government has said it is in discussions with other companies regarding the procurement of additional vaccine candidates. All the investigative COVID-19 vaccines require cold storage, ranging from around -4 degrees to -70.
The government has indicated a phased COVID-19 national vaccination program starting in early 2021.
The implication is that Australia's medicine and vaccine supply chain will be asked to start the distribution of a COVID-19 vaccine, if one is approved, at the same time it is preparing for the national seasonal flu vaccination program.
The 2020 flu vaccine program was launched in March. Around 18 million doses of flu vaccination were distributed this year - through private organisations or the National Immunisation Program.
The 2021 flu vaccination program could coincide with the rapid upscaling of a national COVID-19 vaccination program - the supply chain would have to accommodate and distribute over 60 million doses of vaccine in just a few months.
It is unclear whether Australia's current cold storage capacity - across the medicine and vaccine supply chain - can manage two mass vaccination programs at the same time along with all the other immunisation programs.
The government might need to consider committing resources ahead of next year to support the supply chain to upscale its capacity, including for cold storage.
At the same time, it will need to consider who will be prioritised to receive any approved vaccine, as well as who will do the administration.
The federal government's technical advisory group does not yet include anyone with experience or extensive knowledge of Australia's medicine and vaccine supply chain.
The US government's 'operation warp speed' initiative engaged distributor McKesson in August as the first under a COVID-19 agreement.
It said, "Detailed planning is underway to ensure rapid distribution as soon as the FDA authorizes one or more vaccines. Once these decisions are made, McKesson will work under CDC’s guidance to ship COVID-19 vaccines to administration sites."
In a recent white paper, well-known logistics provider and pharmaceutical wholesaler DHL said the mass distribution of any COVID-19 vaccine - globally and within countries - presents "novel logistics challenges" that need to be addressed as a matter of urgency.
