Analysis shows: Procurement and delivery must be coordinated - new omicron vaccines bring new challenges

With the approval of the new, adapted to the Omikron variant, vaccines and the National Immunization Panel’s (NIG) recommendation for the fourth Corona vaccine for everyone 12 years and older, it is also interesting to look at vaccine supply.

As reported in March, dwh GmbH, in cooperation with the Vienna University of Technology and DEXHELPP, has developed a corresponding calculation model for vaccine supply in Austria. For the client, the Federal Ministry of Social Affairs, Health, Care and Consumer Protection, this model was used to investigate the vaccine requirements for Austria.

The aim of this model was and is, on the one hand, to determine the possible need for vaccines and thus always to support safe supply and, on the other hand, to compare this need with the available vaccine. In this way, a possible oversupply can be determined and thus also a decision can be made as to whether and how many doses can be passed on to other countries. Clearly, the shelf life of the vaccines was also taken into account, i.e. when vaccines have to be passed on so that they can be used by the recipients. The parameters were agreed with the Ministry of Health and are based on the currently valid vaccination recommendations.

Based on this, various scenarios were run through. These ranged from very low vaccination readiness to an unrealistic, extremely positive scenario in order to be able to estimate an absolute upper limit of demand. In this upper limit scenario, a large proportion of Austria’s population takes up all 4 vaccinations in 2022. These calculations were performed at the end of the first quarter of 2022. At the end of the second quarter, a status update was performed based on the updated data on vaccinated and ordered doses.

In doing so, the initial analysis of this scenario in March 2022 showed that in the scenario used to calculate a cap, assuming 16.7 million vaccinations still to be administered during the year, 3.3 million doses of vaccine will expire by the end of the year - if they are not donated in time. Updating the numbers at the midpoint of the year, under the same conditions, approximately 7.5 million vaccine doses would have passed the year-end expiration date.

In addition, the analyses have shown two aspects. The above figures represent a scenario - albeit an important one for decision-makers - namely the scenario that there is security of supply in any case. Realistic assumptions about vaccination readiness, however, lead to much lower demand and therefore much higher numbers of expiring doses. On the other hand, full supply would then no longer exist if the worst came to the worst. How to deal with this should be part of a transparent societal discussion. By the way, not only for Covid-19 but for all supply-relevant issues.

And: Vaccines that are specifically adapted to new omicron variants increase the willingness to be vaccinated, according to current studies. This happens independently (or only indirectly dependent) on the medical evidence whether they are really better. People’s motivation to get vaccinated (for fall 2022) is probably directly related to their personal perception of “better” vaccine protection - we humans sort of think to ourselves, “new brooms sweep better.” This is very important, because in an informed society, medical evidence and personal, free decision come as close as possible together. The Austria Corona Panel Project has studied these areas very successfully, and a recent paper by the University of Vienna and the Medical University of Vienna is currently under review (Update 4.10.2022: preprint of paper is available; Update 27.3.2023: The paper has now been published in Nature Medicine). But still we are far away from the “best case scenario” in which 95% of the people are vaccinated. And the increase is then likely to be due to the fact (even though there is no evidence here) that the new vaccines will simply “crowd out” the older vaccines in future demand. So that leaves more vaccines rather than fewer. These analyses of behavior and their impact on therapies (and on scenarios and forecasts) are important to support optimal alignment between supply and resource planning.

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Note on assumptions:

For the optimistic “upper bound” scenarios, it was assumed that 95% of all people who received a second (third/fourth) vaccination would also receive a third (fourth/fifth) vaccination.