This Briefing Note was completed by the Research, Analysis, and Evaluation Branch (Ministry of Health) in collaboration with a member of the COVID-19 Evidence Synthesis Network. Please refer to the Methods section for further information.
Purpose
This note provides a summary of planning approaches for vaccinating populations for COVID-19.
*The full version of the Briefing Note including Supporting Evidence and the Appendix can be accessed in the PDF file at the top of the page*
Key Findings
- Supply: Many countries have secured agreements for COVID-19 vaccines through a variety of mechanisms, including international alliances (e.g., COVAX), local public-private partnerships, and country agreements with vaccine producers.
- Distribution: Centralized distribution approaches will be used in Europe (via advanced purchase agreements with vaccine producers) and the US (to ship vaccines to administration sites), and Germany will use a decentralized approach via 60 country-wide distribution centres.
- Ordering/Tracking: In the US, the Vaccine Tracking System is a secure, web-based IT system that integrates the entire publicly funded vaccine supply chain.
- Allocation: Guidelines and jurisdictions suggest phased vaccination approaches: first starting with health care workers and vulnerable populations (e.g., essential workers, older adults, people experiencing homelessness, Indigenous communities), followed by expanded coverage for remaining populations.
- Administration: Site options vary across jurisdictions (e.g., pharmacies, nursing homes, physician clinics, hospitals, mobile clinics), and logistical challenges (e.g., monitoring, staff training) need to be considered.
- Workforce Capacity: In Quebec, physicians, nurses, pharmacists, respiratory therapists, and midwives can administer vaccines, and other providers are being requested (e.g., social workers, psychologists). The scope of practice will be expanded for pharmacists to administer vaccines in the US. European countries are encouraged to foster new recruitments and training programs, potentially involving students or retired staff.
- Monitoring: Ontario and Manitoba participate in immunization surveillance systems. In the US and Europe, integrated IT systems will be developed and used to track purchasing, ordering, patient doses, and patient outcomes in compliance with data protection and privacy regulations.
- Communication: The US and Europe are enhancing partnerships and information campaigns to promote vaccine safety, efficacy, and acceptance. Reliable, frequent, and tailored information should be shared with communities through multiple media platforms (e.g., providers, social media).
- Performance Indicators: The WHO’s Vaccine Readiness Assessment Tool (VIRAT) provides a roadmap for countries to plan for COVID-19 vaccine introduction and a structured framework for countries to self-monitor their readiness progress against key milestones. The European Centre for Disease Prevention and Control’s guidance includes the development of performance indicators (e.g., coverage, safety).
Implementation Implications
Integrated vaccine responses are required within and across jurisdictions. Detailed scenarios should be planned for now based on prior vaccination campaigns and current COVID-19 research, but they may evolve as more information becomes available.
Supporting Evidence
*The entirety of the Supporting Evidence section can be accessed in the PDF file located at the top of the page*
This section summarizes the scientific evidence and jurisdictional experiences regarding plans for vaccinating populations against COVID-19 in terms of: supply, allocation, ordering, distribution, inventory management, administration, and performance indicators. Jurisdictions reviewed include: Canada, Australia, France, Germany, Japan, Mexico, New Zealand, South Africa, Spain, United Kingdom (UK), and United States (US), as well as the World Health Organization (WHO) and European Commission.
Methods
The COVID-19 Evidence Synthesis Network is comprised of groups specializing in evidence synthesis and knowledge translation. The group has committed to provide their expertise to provide high-quality, relevant, and timely synthesized research evidence about COVID-19 to inform decision-makers as the pandemic continues. The following member of the Network provided an evidence synthesis product that was used to develop this Evidence Synthesis Briefing Note:
- Bhuiya AR, Wilson MG, Moat KA, Gauvin FP, Wang Q, Whitelaw S, Alam S, Sharma K, Ahmad A, Drakos A, Dren N, Bain T, Lavis JN. COVID-19 rapid evidence profile #23: What is known about anticipated COVID-19 vaccine-delivery program elements, and whether and how federated states are harmonizing these elements across constituent units of federations. Hamilton: McMaster Health Forum, 5 November 2020.