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The COVID-19 vaccines are here: What comes next?

Coronavirus vaccines have started becoming available in some countries1 and are expected to be critical tools in ending the pandemic. Several vaccines in development have reported promising initial data, with some receiving authorization for use.

Now the focus is likely to shift to how quickly and successfully vaccines can be distributed, an effort that will be the largest simultaneous global public-health initiative ever undertaken. The scale of the challenge is immense: from the sheer volume of doses needed to planning for uncertainties around the vaccines’ safety, efficacy, and durability—and from logistical and storage challenges to the service-delivery model. Governments will likely be expected to mount communication and education campaigns to address the concerns that consumers have about vaccine safety. In particular, without proactive planning, underserved populations disproportionately affected by COVID-19—including ethnic, minority, and socioeconomically deprived groups, as well as rural populations—may face disparities in vaccine adoption.

Citizens will look to national and regional governments for a delivery plan. As vaccine availability nears, communities and consumers will want answers to many questions, including:

  • Is the vaccine effective and safe?
  • Who will get vaccinated first?
  • Which vaccine will we receive, especially if multiple vaccines are available?
  • Where and when can we get vaccinated?
  • Will we have to pay?
  • Above all, what do we need to worry about?

Unfortunately, many countries are not yet ready to respond to these questions and are underprepared for the scale of the delivery challenge. In response, they could pursue a structured program that we call the 6A framework, an approach that accelerates end-to-end planning to ensure vaccines are available, administrable, accessible, acceptable, affordable, and accountable. Countries can take near-term actions to speed their efforts, such as setting up or strengthening vaccine task forces; developing a delivery road map and agreed-upon governance; and starting no-regrets activities such as supply-chain logistics planning, administration-site selection, and service-delivery model planning. Done correctly, vaccine delivery efforts can save lives and restore livelihoods, strengthen public trust in governments, and allow us to start the next normal.