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Here’s a 4-step plan to rescue the US vaccination program

Boxes containing the Moderna COVID-19 vaccine are prepared to be shipped at the McKesson distribution center in Olive Branch, Miss., Sunday, Dec. 20, 2020. AP Photo by Paul Sancya, Pool

President Joe Biden has authorized the purchase of 200 million additional doses of COVID-19 vaccines, enough to inoculate every  adult in the United States by the end of summer.

Left, Rajmohan Rajaraman, professor of computer sciences. Northeastern file photo. Right, Nada Sanders, distinguished professor of supply chain management. Photo by Adam Glanzman/Northeastern University

But how will those vaccines be distributed? Can the treatment of so many people be organized so quickly?

To stave off COVID-19, says Nada Sanders, distinguished professor of supply chain management at Northeastern, the U.S. must create a national supply chain based on a centralized approach to delivering and administering vaccinations.

“It has got to be centralized,” says Sanders, who will be discussing her ideas Thursday at 10 a.m. on Facebook Live. “It’s ridiculous that each state is making the decisions of how to handle this on their own. The ultimate goal is to get the whole country back to normal by achieving herd immunity at the national level.”

Here, according to Sanders, are four steps that could help the U.S. gain control of national vaccination efforts:

  1. Put Bill Gates—or someone like him—in charge.

    The sprawling rollout requires a leader with a unique skill-set who can take responsibility for the success of this immense project.

    “People are operating in their own silos,” Sanders says. “You need an integrator—an orchestrator—to get the dialog going among the different experts so that they’re all working together.”

    Gates checks all of the boxes. The Bill & Melinda Gates Foundation works with partners on healthcare and other global issues, which has helped make Gates a stakeholder and expert on efforts to end the COVID-19 pandemic. As co-founder and former chairman of Microsoft, he knows all about complex supply chains, and he has the leadership skills and charisma to command an interdisciplinary team of experts across a wide variety of fields.

    “We are being mired in bureaucracy,” Sanders says. “They need to bring in Bill Gates, or somebody who can understand the big-picture pieces.”

  2. Develop a vaccine tracking system and complementary algorithm

    “If I order a pair of shoes, I can log onto FedEx and know exactly where they are in transit,” Sanders says. “So I don’t understand how it’s possible that you have elderly people in Florida who are waiting in line and then being sent home without being vaccinated.”

    The Centers for Disease Control and Prevention has a vaccine tracking system called VTrckS, but it appears to be failing to track COVID-19 vaccines. “I can’t tell you how much vaccine we have, and if I can’t tell it to you, then I can’t tell it to the governors and I can’t tell it to the state health officials,” Dr. Rochelle Walensky, director of the CDC, told Fox News Sunday.

    What if VTrckS can’t handle the job? The first step, says Rajmohan Rajaraman, a professor in the Khoury College of Computer Sciences, would be to fix VTrckS or create a vaccine tracking system—a software tool that maintains the network for monitoring the supply, demand, movement, and delivery of vaccines throughout the U.S.

    “Such a network will have suppliers, manufacturers, distributors, end-user sites that administer the vaccines, the delivery companies—a complex network of various nodes,” Rajaraman says. “It’s a massive enterprise that involves hundreds of thousands of people who are involved in the vaccine network. You can build an app of some kind where everybody is provided with a common interface, and there are a few methods and approaches to do it fairly well.”

    Then, says Rajaraman, an underlying algorithm could be created to help guide where and when the distributions should be made, based on surpluses and shortages, the shelf-life of vaccines, specific community needs, availability of personnel, varying infection and hospitalization rates, and other constantly changing variables.

    “A final, important piece of the puzzle is to have an effective public communication and scheduling system, in each state or local community, that informs individuals and enables them to receive vaccinations at the end-user sites in a timely and convenient manner,” adds Rajaraman.

    Sanders says the software tools would enable the stakeholders to make decisions based on a shared set of facts, empowering them to respond to bottlenecks in the system.

    “The nature of supply chains is that you’re going to have bottlenecks,” she says. “If we had tracking and communication in real time, which we have the technology to do, we wouldn’t be surprised by them.”

  3. Create a “war room”

    Key stakeholders of the national vaccination program should be stationed in a single place with full access to the algorithm and its real-time information.

    “In order to have everybody connected with everybody else, you would need the epidemiologists in the war room, along with someone who understands the biologics, and someone who knows the supply chain,” Sanders says. “You also need somebody who really understands the federal government and how the funding works for this program. Then you need somebody who will understand the analytics and computer science of the algorithm, and someone who understands healthcare policy.”

    The program leader should be wary of having too many experts on hand. The goal is to create dialog that is comprehensive as well as efficient.

    “Right now, each expert is looking at their own concerns, but they’re not pooling their knowledge,” Sanders says. “And the current federal administration has inherited a situation they don’t understand. Not only do they need to take stock of all of their inventory, but they need a place where the logistics experts and the epidemiologists and everyone else can be talking to each other.”

  4. Work backward

    Scientists continue to discover new mutations of COVID-19 that could eventually make current vaccines less effective. Such developments will continue to influence the success of the U.S. vaccination program.

    By adopting a supply chain that works backwards, Sanders says that the Biden administration will be able to set goals and reverse-engineer solutions that take new developments into account.

    “The end goal is being changed in real time,” Sanders says. “Think about if the virus mutations forces us to have a booster shot? How will that map out?”

    A centralized organization built on leadership, communication, and planning based in real-time information will be crucial to the success of the vaccination program.

    “As complicated as it is now, it’s going to keep getting more complicated because of the variants of the virus,” Sanders says. “As long as we stay disconnected, we’re going to keep fumbling the response—all while the virus is continuing to mutate.”

For media inquiries, please contact Jessica Hair at j.hair@northeastern.edu or 617-373-5718.

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