Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
World Bank Group, Washington, DC, USA.
BMJ Glob Health. 2024 Nov 8;9(11):e015136. doi: 10.1136/bmjgh-2024-015136.
The COVID-19 pandemic focused attention on the importance of vaccine security to national security. Demand for vaccines far exceeded supply when the first COVID-19 vaccines were released. Growing data suggest a non-perfect correlation among vaccine development, production, purchases, deliveries and vaccination rates. As such, the best approach to strengthening vaccine security remains unclear. In this study, we use an operations research/operations management framework to characterise the relationship between vaccine security and key supply chain predictor variables in high-income countries (HICs) and low-income and middle-income countries (LMICs).
We performed a comparative analysis of vaccine security against eight supply chain variables in a purposive sample of five HICs and five LMICs during the early phase of the pandemic (31 March 2021 and 30 April 2021). All data were obtained from publicly available databases. We used descriptive statistics to characterise our data, basic statistics to compare data and scatter plots to visualise relationships.
Our data show greater vaccine security in HICs compared with LMICs (32.2% difference in April 2021; 95% CI 4.2% to 60.3%, p=0.03). We report a significant difference between HICs and LMICs in only two of the eight predictor variables studied. Interestingly, we observed large variation in vaccine security HICs, with Canada, Israel and Japan being frequent outliers, and within LMICs, with India standing out.
Our data suggest a stronger relationship between vaccine security and 'downstream' supply chain variables compared with 'upstream' variables. However, multiple outliers and the lack of an even stronger relationship suggests that there is no magic bullet for vaccine security. To boost vaccine resilience, countries must be well governed and strategically reinforce deficient aspects of their supply chains. Modest strength in multiple domains may be the best approach to counteracting the effect of an unfamiliar, novel pathogen.
新冠疫情大流行使人们关注到疫苗安全对于国家安全的重要性。首批新冠疫苗问世时，疫苗的需求远远超过了供应。越来越多的数据表明，疫苗研发、生产、采购、交付和接种率之间并非完美相关。因此，加强疫苗安全的最佳方法仍不清楚。在这项研究中，我们使用运筹学/运营管理框架来描述高收入国家（HIC）和低收入和中等收入国家（LMIC）的疫苗安全与关键供应链预测变量之间的关系。
我们在疫情早期（2021 年 3 月 31 日至 2021 年 4 月 30 日）对五个 HIC 和五个 LMIC 的疫苗安全进行了比较分析，共纳入了 8 个供应链变量。所有数据均来自公开数据库。我们使用描述性统计来描述数据，使用基本统计来比较数据，使用散点图来可视化关系。
我们的数据显示，HIC 的疫苗安全性高于 LMIC（2021 年 4 月差异为 32.2%；95%CI 4.2%至 60.3%，p=0.03）。我们报告了在研究的八个预测变量中只有两个变量在 HIC 和 LMIC 之间存在显著差异。有趣的是，我们观察到 HIC 之间的疫苗安全性存在很大差异，加拿大、以色列和日本是经常出现的异常值，而在 LMIC 中，印度则很突出。
我们的数据表明，疫苗安全与“下游”供应链变量之间的关系强于“上游”变量。然而，多个异常值和缺乏更强的关系表明，疫苗安全没有灵丹妙药。为了提高疫苗的弹性，各国必须治理良好，并从战略上加强其供应链中薄弱的环节。在多个领域保持适度的优势可能是对抗陌生、新型病原体影响的最佳方法。
