Vaccines are widely viewed as the way out of the COVID-19 pandemic nightmare, but developing them was only one part of the challenge. Distributing them into the arms of the approximately 1.8 billion people who live in Southeast Asia is quite another.
Vaccination programs are complicated at the best of times, and this is far from the best of times. As things stand, all vaccine options require extra cold storage and have a short shelf life after they are opened, plus there's immense pressure to carry out vaccinations swiftly and keep vaccine waste to an absolute minimum.
The countries that make up Southeast Asia vary greatly, ranging from wealthy, developed Singapore to countries already facing multiple crises, like Bangladesh and Maynmar. But their fates are intertwined and it's in everyone's best interests to ensure high vaccine coverage worldwide.
The question is, what can be done?
Improve Access To Vaccines
Many have criticized the world's wealthier countries for buying up all of the vaccines and failing to share fairly with low to middle income countries (LMIC). Nepal's reliance on India for vaccines left the country close to panic, for example, as India shut off vaccine exports to deal with its own crisis.
The COVAX nonprofit group is addressing vaccine inequity by coordinating donations from other countries. In the U.S., President Biden pledged to share 60 million doses of the AstraZeneca vaccine with poorer countries, on top of the 4 million already promised to Mexico and Canada. He also just announced the purchase of 200 million doses of the Pfizer vaccine in 2021, and 300 million in 2022, to donate to 100 LMICs, and has already donated 2.5 million Pfizer doses to Taiwan.
One side effect of Western vaccine jealousy is that much of Southeast Asia is forced to rely on Sinopharm and Sinovac vaccines from China. Widespread regional distrust of the CCP means that much of the area's population are nervous about a Chinese vaccine, fueling vaccine hesitancy.
Streamline Vaccine Management
Public health organizations need to prioritize individuals with comorbidities, check who has allergies that make the vaccine dangerous, ensure each person knows when to return for their second dose, and protect vaccine certificates so they can't be forged or tampered with. This information needs to connect with vaccine supply chains to send the right number of doses to each place at the right time.
DKSH offers a health care management platform that enables patients to find a local vaccination station, register for vaccine updates, schedule a vaccine, and track their second dose appointment. But many countries lack connected digital health records, many areas have no internet connectivity, and some still have large mobile populations and people who aren't on the records at all.
These places need more manpower as well as new tech. Health care workers need to be trained to go door to door to register the number of people who need vaccination in every village, town and province, as well as the number who can't make it to a vaccination site.
Ensure Vaccines Are Safe
Today's COVID vaccines are the prima donnas of the vaccine world, demanding special conditions - primarily low temperatures - to perform as expected. All current vaccines need to be kept refrigerated at 2-8℃, while the Pfizer/Biontech vaccine requires -80.
For Asian countries in tropical climates, ultracold storage is a challenge, especially areas with inconsistent electricity supplies. Few have the deep freezers needed for Pfizer and Moderna vaccines; many lack fridges; and while most vaccines can last some time at higher temperatures, the warmer they are, the sooner they expire. It's crucial for health care workers to know exactly how long they have to administer vaccines, so they can do their best to avoid wasting doses.
With unscrupulous individuals selling fake vaccines, medical supply chains need to prove that they're sending genuine vials. Logmore's condition data logging system can track every step of the vaccine journey, from manufacture to central distribution hub to the vaccine site, reassuring health officials that the vials they receive are the same that left the plant. If any thaw too soon, are switched or tampered with, this would be recorded on the data tags.
Unlike other systems, Logmore's loggers are suitable for air freight to locations that are inaccessible by road, rail or sea.
While it's almost impossible to arrange enough deep-freezers at vaccination sites, better logging can help mitigate that by speeding the vaccines on their way, so there'll be more time for them to remain safe at ambient temperatures.
QR data tags can be easily read with any smartphone and don't need expensive RFID computing systems, so they're viable even in rural areas with less connectivity, providing full and constant information about temperature, humidity and light exposure of shipments, so health care workers know when they'll expire.
Address Vaccine Hesitancy
Southeast Asia has extremely high levels of vaccine hesitancy, with the notable exception of Vietnam. Many don't trust Western medicine and believe that vaccines are a Western plot to sterilize girls.
Indonesians receiving Sinopharm fear that China included pork products in the vaccine, while Filipinos remember 2016, when the vaccine against dengue fever was withdrawn after two children died. Japan, meanwhile, has the lowest vaccine rates in the world.
A number of countries, like Pakistan, the Philippines and Indonesia, are extending combinations of incentives for people who get vaccinated, but experienced aid workers say education is more effective.
Health organizations need to educate local community and religious leaders and enlist the help of local health care workers, identifying the salient fears in each area and addressing them clearly.
Improve Vaccine Administration Logistics
Even in developed countries, enabling each person to get to a vaccine site is a challenge, and that only rises in Southeast Asia. While some parts are densely populated with plenty of health care hubs, in others the population is scattered widely across inhospitable terrain, transport links are poor, and there are few health care workers.
Governments need to set up popup vaccination sites in remote areas, but that means training enough health care workers and arranging a site with all the sterile vials, needles, alcohol pads, and PPE that they need to do the work. The World Health Organization and the International Monetary Fund are discussing ways to open up funding for local logistics.
In Bangladesh and Nepal, governments have reached out to NGOs like the Red Crescent for help staffing vaccination centers, while Malaysia deployed vaccine trucks for people who would struggle to reach a vaccination center, and Cambodia mobilized its army to inoculate its citizens.
Digital solutions also play a role. Zuellig Pharma just launched eZVax, a digital solution that monitors vaccination progress and simulates fluctuations in supply and demand to enable better decisions about vaccine supply, health care worker deployment, and the opening of more vaccination sites.
Southeast Asia Can Reach Vaccine Nirvana
Plenty of hurdles are holding Southeast Asia back from reaching widespread vaccine coverage, but by increasing supply and using a combination of new tech, targeted education and increased manpower, public health organizations in the region can increase vaccine uptake, smooth the way for vaccine management and administration, and guarantee the safety of vaccines for all its residents.
