Public Health
Optimizing support for the COVID-19 vaccine rollout
By Maria Antonieta Alva Luperdi & Jonny Barty
After more than a year fighting the COVID-19 pandemic, government officials are now turning their attention to the challenge of vaccinating their populations.

The rollout of the COVID vaccine is unlike any other. For most public officials involved, it will be the most complex challenge they will ever face in government. At the global level, it is estimated that the world will need to vaccinate ten times more people per year than it does normally to achieve the required coverage levels. The scale of this challenge can already be seen across some of the world’s richest and ‘highest-capacity’ countries. For developing countries, which often lack the funding, resources, capacity, data systems, and political stability of rich countries, the challenge will be many times greater. Given the scale of the challenge, it is critical that support to countries reflects the scale of the challenge.


A ‘business as usual’ approach will not be enough. Four principles should guide that support:

1. Provide managers with best-practices they can use to inform interventions and improve decision making


Countries face many challenges in rolling out the vaccine. However, best practices for many of these are already emerging. Managers can be supported, both to plan their rollouts and to build support for their strategies, by good access to emerging best practices.

For instance, vaccine hesitancy during Ramadan was an issue faced by many countries with Muslim populations. Sharing examples of how leading countries have worked across government, religious scholars, and civil society actors to promote vaccine uptake during this period, allowed leaders to identify approaches they could adopt in their own countries.


Reviewing best practices from other countries helps make for interventions required to ensure an effective rollout:



“Getting a Covid-19 vaccine is acceptable during Ramadan and the shot does not invalidate the fast because it is injected into the muscle and has no nutritional value.” Supreme Council for Islamic affairs, Bahrain.



“There is no nutritious vitamin or food substance in any vaccine, including the Covid-19 vaccine. Injecting such a thing into the body does not break the fast.” Idris Bozkurt, a top official of the Turkish Religious Affairs Directorate (Diyanet)



“The vaccine should not be considered as a ‘nutritional product’ and has nothing to do neither with digestion nor with the fact of drinking or eating". Grand Mufti of Tunisia Othman Battikh



“ not considered as food and drink. The vaccine is administered intramuscularly, so it does not invalidate the fast.” Sheikh Abdul Aziz Al-Asheikh, Grand Mufti of Saudi Arabia



“The vaccine is administered intramuscularly, therefore it does not invalidate the fast. If someone experiences side effects after receiving the COVID-19 vaccine, then it is allowed to break the fast in order to take the required medicine.” General Iftaa Department for the Hashemite Kingdom of Jordan


2. Support governments to use data to crack the delivery model


With vaccines arriving in batches, it is important that Governments focus on getting the first shipments into the right arms quickly to maximize impact.

Data allows governments to know in real time what is happening at service delivery points, track whether key priority groups are being vaccinated and take rapid, targeted action as soon as there is a need. Given the limited shelf-life of COVID-19 vaccines, this is particularly important to avoid mass expiry scenarios.

Data also enables leaders to set and track weekly goals, celebrate successes, and drive momentum across different rollout phases. It also helps to set standards and expectations across managers, and identify areas of high performance, which others can then learn from.


3. Be flexible - help put out fires and keep the focus on the main goals


While being in charge of the vaccine rollout, public officials still face many challenges related to the broader COVID-19 pandemic, as well as their day-to-day activities.

Sometimes their agenda and energy needs to be completely dedicated to another issue with larger consequences.

In these situations, it is important to be flexible and to provide ‘out-of-scope’ support when required to help address urgent issues. This helps to build political capital and trust, and ensures the continued focus and attention of officials when they can return focus to the  COVID-19 vaccine rollout.


4. Continue to innovate and adapt as new challenges and objectives emerge


In late 2020, countries dedicated efforts to develop National Deployment and Vaccination Plans (NDVPs).

This was essential to align the system towards mass immunisation programs, and to gain access to the COVAX facility.

However, in many instances the on-the-ground reality has changed considerably since this time, with some plans no longer as relevant or targeted as they could be.

As such, it is critical to support managers to continually review and update their approach, based on new data, constraints, new vaccines, priorities and learning about what works.

This flexibility is critical - countries must not stick to plans that no longer provide the roadmap to achieve a successful vaccine rollout.

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