Since 2021, MOMENTUM Routine Immunization Transformation and Equity has focused on identifying and minimizing barriers faced by marginalized and vulnerable populations to accessing COVID-19 vaccination. It provided technical assistance to the national and 18 state governments to accelerate vaccination campaigns, fight misinformation, minimize the wasting of vaccines, and deploy human resources to increase vaccination capacity. The project worked with the Government of India to employ data-driven planning methods aimed at facilitating rational and equitable vaccine allocation, distribution, and transfer to help overcome supply and demand imbalances.

A vaccine management strategy was employed in the states of Jharkhand and Rajasthan using weekly vaccine consumption data to inform orders for the following week. Through this data-driven approach, vaccines were ordered accordingly, and their use tracked in real time. This real-time data visibility allowed state supply chain managers to ensure vaccine availability by directing districts with a surplus stock to transfer vaccines to those that had insufficient vaccine stocks. Together, MOMENTUM helped these state governments distribute nearly 6,600 vaccination doses in Jharkhand and 10,000 doses in Rajasthan.

Integrating COVID-19 Logistics into Routine Immunization

Supply chain managers must be able to visualize vaccine logistics data to make supply chain management decisions. Before the pandemic, India used the Electronic Vaccine Intelligence Network (eVIN) to manage vaccine logistics. As part of its systems strengthening support, MOMENTUM collaborated with government and other development partners to incorporate COVID-19 vaccine logistics into the eVIN. This integration gave health care staff — especially cold chain handlers and program managers — real-time information on stock levels and logistics to track vaccines from regional government medical stores depots (GMSDs) to the last cold chain point. As a result, the government and its partners were able to reduce supply and demand disparities and distribute vaccines to areas where they were needed most. The project teams ​​facilitated interstate transfers across 18 states in India of about 3.9 million COVID-19 doses and use of approximately 1.7 million doses of near-expiry vaccine.

Additionally, MOMENTUM strengthened frontline health care workers’ capacity to use locally available data to plan, implement, and monitor vaccination efforts. This helped program managers review progress through data triangulation and identify gaps and propose solutions. State teams visited district facilities to monitor vaccine storage and shared feedback with supply chain partners and the government, emphasizing the importance of regular updates of vaccine stock on digital platforms to improve real time vaccine availability.

“With the ability to continuously monitor the supply of vaccines from manufacturer to districts, the project expanded end-to-end traceability, creating a more resilient system that allows supply chain managers to step in before vaccines are expired,” said G.K.Soni, the Momentum director in India.

Optimizing Supply Chain Processes

Vaccine manufacturers dispatch vaccines to GMSDs, which then transport them to state-level vaccine stores.  From there, the vaccines are shipped to districts and sub-districts while maintaining optimum temperature conditions throughout the process. The project team bolstered the supply chain management systems within the GMSDs by developing inventory plans, closely tracking vaccines and cold chain space, and consistently monitoring temperature levels. Additionally, they conducted routine physical checks of vaccine stocks at GMSDs, and monitored the state- and district-level stock information via digital platforms. These proactive measures played a crucial role in optimizing supply chain processes, ensuring the seamless flow of vaccines and enhancing overall efficiency within the distribution network.

Partnering with Local Organizations for Access

In a concerted effort to ensure equity and widespread access to the COVID-19 vaccine, MOMENTUM collaborated with 26 non-governmental organizations (NGOs) with established local networks in hard-to-reach communities across various states. The NGOs deployed community mobilizers to drive demand by disseminating COVID-19 messaging during community events and festivities. Furthermore, the NGOs bolstered government efforts to vaccinate vulnerable groups such as older individuals, people with disabilities, members of the transgender community, and marginalized ethnic communities. Addressing the unique needs of these diverse and often overlooked populations necessitated specialized efforts in vaccine and supply chain management, employing a range of innovative service delivery strategies.

Learning from COVID-19 Vaccination

MOMENTUM’s comprehensive approach not only ensures the efficient distribution of vaccines but also lays the foundation for a resilient and adaptable immunization system. Learnings from COVID-19 vaccination are being applied to strengthen routine immunization services. The project’s success can be attributed to its data-driven methodology, optimization of supply chain processes, and integration of COVID-19 logistics into routine immunization systems.

The insights gained from managing the COVID-19 vaccination initiative have not only strengthened India’s preparedness for future pandemics, but have also enhanced local capacity to administer vaccinations across all stages of life. The project has contributed to developing a broader and more robust health care framework that is better equipped to meet people’s evolving health needs.