Vaccination Update

On January 6, according to data available that morning, the national Vaccine Utilization Rate (VUR) was 30.7 percent. As of January 30, the national VUR was 59.2 percent. The US rate of vaccine consumption has basically doubled in three weeks time. As February begins the number of vaccine doses distributed in the United States will cross the 50 million threshold.

Recent outbound flows of the two currently available covid-19 vaccines have been averaging 1.2 million-plus doses per day. Given availability of upstream inputs and throughput at the finishing plants, current upper-end North American production capacity for these two vaccines is estimated to be about 2 million doses per day. (The highest credible estimate of current capacity that I have seen is 2.5 million doses per day.) To consistently achieve maximum capacity for a never-before-produced vaccine is unlikely this early in production, but flows are projected to more consistently achieve full capacity by the end of March.

Improved Vaccine Utilization Rates are due to several factors including, moving beyond holiday-related friction, accumulated vaccination experience, reformed procedures and processes, more person-hours spent jabbing, expanding the size of priority populations, enhanced flexibility serving priority populations, and increasing the number of access points. Larger-scale drive-through vaccination venues have received significant media attention. Here is a report on the quick standup of a “Vaccination Superstation” in San Diego County.  Data are not yet available to assess which method or combination of methods have been most helpful to doubling the consumption rate.

As higher velocity vaccinations are achieved, it will be even more important that planning and execution reflect effective demand management. (The linked WSJ report is consistent with Supply Chain Resilience TA principles.). Late Friday, January 29, the editors of the Journal of the American Medical Association published an editorial on demand management  very similar to the approach the TA program has outlined since October.  For this virus, better risk prioritizing also advances greater equity. 

The Kaiser Family Foundation reports that the American public is demonstrating increasing confidence in — and demand for — vaccinations.   As demand signals — population pull — increases, it will be even more challenging to effectively target available push. Most outbound flows are not yet structured to support variable demand. Over the weekend a colleague also commented, “The most obvious concern to me is burning out human resources as we poorly manage supply and demand of product. We will continue to need so much from [medical staff and volunteers] in the coming months. That is why making their time as productive as possible now, not slowing them down with paperwork delays [and other distractions], is important.” 

Despite current supply limitations, up to twenty-million doses (about 40 percent of flows) are reported to be “deployed” but not yet administered. The improved VUR is encouraging, but there are also increasing concerns to vaccinate as many risk-prioritized populations as possible before more contagious variants of the virus become dominant. The authors of a variant study released last week conclude, “this virus is traveling in a direction that could ultimately lead to escape from our current therapeutic and prophylactic interventions directed to the viral spike. If the rampant spread of the virus continues and more critical mutations accumulate, then we may be condemned to chasing after the evolving SARS-CoV-2 continually, as we have long done for influenza virus. Such considerations require that we stop virus transmission as quickly as is feasible, by redoubling our mitigation measures and by expediting vaccine rollout.” The more quickly risk-prioritized vaccinations are administered, the more this threat is mitigated.

Potential expansion of production capacity for current vaccines is being explored. But realistic options are unlikely to produce more flow before late Spring if at all. The distribution-friendly Johnson & Johnson single dose vaccine seems likely to receive an Emergency Use Authorization in coming weeks.  J&J anticipates having the ability to produce 100 million doses by the end of June.  Some virologists expect one or more variants to be dominant by the end of March.