The Centers for Disease Control and Prevention (CDC) is in the process of determining prioritization criteria and allocations per jurisdiction for the initial limited vaccine doses once they are approved under emergency use authorization.³ Working with the Department of Defense, the CDC will then activate a national framework for distribution and safe administration, the outline of which has already been released.⁴ Jurisdictions are already enrolling vaccine providers, determining administration sites and establishing protocols that maximize throughput while maintaining social distancing and safety protocols.⁵ Each administration site (including temporary, off-site and mobile clinics) will need a dedicated administration protocol. At the core, states are being asked to establish highly complex vaccine command centers (with some support from the federal government), with deep program management needs, that will manage all aspects of vaccine distribution, administration and tracking.⁶
In order for each point in this journey to run smoothly, public sector command centers will need to deploy advanced analytics to coordinate the outflow of information to providers and local administration sites, as well as the inflow of data from vaccination programs – including wasted vaccine data, any adverse reaction data and patient tracking. The data will be essential in adjusting the program and adapting plans as the rollout develops.
In parallel, epidemiological data and pandemic analytics can be reported back to the command center to inform decision-making and demand forecasting. Without accurate demand forecasting, all stakeholders will be forging ahead without the key information needed to make informed decisions about access and aligned supply. In addition, because several of the vaccines rely on complex cold-chain systems,⁷ accurate demand forecasting down to the county level will avoid significant wastage, especially in the critical first six months of vaccine availability.
The command center and demand forecasting tools will be at the heart of the immunization program as a whole and leveraged to communicate to supply chain partners where shifts and changes need to be made. Scenario planning will be an essential tool as uptake within and across communities evolves, new vaccine-related policies emerge and public sentiment continues to shift. Additionally, managing the multi-dose requirements creates capture/recapture challenges that are inherent in any vaccine program, but exacerbated by the scale and politicization of the COVID-19 response. The command center and underlying data platform provide the decision-support tools for leaders to plan for key scenarios and communicate implications for the whole multilayer ecosystem.
While the need for a strong digital platform that serves to coordinate multiple stakeholders is critical, in many cases existing structures can be utilized. Jurisdictions that are already suffering from change fatigue can integrate these tools and capabilities within their systems, decreasing the scale and complexity of the task.
The command center approach, and the data layer underpinning it, creates a responsive feedback loop among jurisdictions and federal agencies, multiple providers, distribution partners and individual administration sites that is essential to successful execution.