(348g) Strategic Planning of Joint COVID-19 Booster and Influenza Vaccination Campaign: The UK COVID-19 Pandemic Study

The emergence of Severe Acute Respiratory Syndrome Corona Virus 2 (aka corona virus disease 2019 or COVID-19) in Wuhan, China and its rapid spread across the world have led the World Health Organisation (WHO) to declare COVID-19 a pandemic on 11 March 2020. To date, globally, COVID-19 have claimed the lives of around 6.2 million individuals and around 58.1 million individuals are still infected with the highly contagious virus, raising concerns on public health. Supported by governments and non-governmental organisations, pharmaceutical companies and academic institutions have deployed a range of platform technologies to produce COVID-19 vaccines in record time in order to mitigate the impact of the virus. The vaccines developed include: (i) viral vectors such as AZD1222 (ChAdOx1 nCoV2) developed by University of Oxford and AstraZeneca, Ad26.COV2.S developed by Johnson and Johnson, Sputnik V (rAd26 and rAd5) developed by Gamaleya Research Institute; (ii) nucleic acid-based vaccines such as BNT162b2 developed by Pfizer and BioNTech, mRNA-1273 developed by Moderna, CVnCoV developed by CureVac; (iii) inactivated pathogens such as BBIBP-CorV developed by Sinopharm; and (iv) protein subunits such as NVX-CoV2373 developed by Novavax.

Despite the successes recorded in vaccination of individuals against COVID-19 (especially in high-income countries), the disease is still prevalent around the globe. This is partly due to the emergence of new variants that render the current vaccines less effective. Booster jabs have been developed and administered to high-risk and vulnerable individuals to avoid developing complications that could lead to hospitalisation or even death. Similarly, influenza virus has been around for some time, and high-risk and vulnerable individuals are required to take annual flu jab to boost immunity and to reduce the impact of the disease within the society. The simultaneous distribution and administration of COVID-19 booster and influenza vaccines poses a significant logistical challenge. For example, COVID-19 and flu vaccines require different type of storage technologies, especially RNA-based vaccines that need to be stored and transported at ultra-low temperature conditions. Consequently, an effective and efficient planning would be required for the vaccination campaigns to be successful.

This work develops a novel multi-product MILP vaccine supply chain model that can be used to plan and optimise the distribution and administration of both COVID-19 booster and influenza vaccines. In addition to planning of vaccine administration, the supply chain model optimises the transport of vaccines from manufacturing plants to administration points. The structure of the supply chain considered here includes manufacturing plants or import locations, fill-finish plants, central stores, regional stores, and administration points. A manufacturing plant, aka primary manufacturing, consists of several unit operations used in the production of drug substance, which is the main ingredient in vaccines, while a fill-finish plant, also known as secondary manufacturing, inserts formulated vaccines (drug substances and excipients) into sterile glass vials or bags that are further packaged into cartons. The multi-product MILP model minimises total cost incurred over the entire vaccination period, while setting targets for total vaccine doses needed, storage capacity required at central store, regional stores and administration points, and identifies cost-effective transportation routes.

The capability of the proposed model is demonstrated using a real-world case study concerned with COVID-19 booster and influenza vaccination campaigns in the UK. Outcomes from this work can be used by government and policy-makers to (i) set out an effective vaccination strategy focusing on the most vulnerable individuals, (ii) assess workforce requirements and financial planning, (iii) monitor the progress of a vaccination and identify resources needed throughout the vaccination period, including storage equipment (fridge, freezer, and ultra-low temperature freezer), transport modes (plane, trucks, and van), vaccine doses (COVID-19 and influenza vaccines), thermal shippers and dry ice, and healthcare personnel.