COVID-19 Vaccine Rollout in Denmark - Administration
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Comprehensive details for some aspects of Denmark’s vaccine rollout plan were not fully available. Based on available data, the vaccines will be given based on the planned priority order due to limited supply. The groups who will be given first priority include nursing home inhabitants, healthcare and elderly care workers, and older people who are prone to COVID-19 complications. The rest of the available findings on Denmark’s vaccine rollout plan were presented below.

COVID-19 Vaccines in Denmark : Information and Facts

  • Comirnaty® and Moderna® are the first two vaccine brands that have been given the go-signal to be used in Denmark.
  • Comirnaty® is the first approved vaccine brand against the coronavirus. BioNTech, a company in Germany, partnered with Pfizer to develop the vaccine. The supplies of this vaccine that are being sent to Denmark are being produced in Germany and Belgium.
  • Meanwhile, the Moderna® vaccine brand is being produced in Switzerland and Spain.
  • These two vaccine brands were developed using the same technology. Their safety and efficacy levels were also comparable.
  • Comirnaty® has been “tested on and approved” for those who are more than 16 years old.
  • As for Moderna®, testing and approval were done for those who are more than 18 years old. Both vaccines are not approved for those who are pregnant or breastfeeding.
  • Comirnaty® has an efficacy of around 95%, while Moderna® has around 94%. This means that 95% of those who will receive the Comirnaty® vaccine and 94% of those who will get the Moderna® vaccine, respectively, will be protected from the coronavirus.
  • The Danish Health Authority is responsible for choosing the vaccine brand that will be used on the target segments. The citizens will not be able to select the vaccine brand that they will receive. This is due to the scarce supply of the vaccine. The vaccines also need to be kept under specific environmental conditions.
  • Health professionals from the Danish Medicines Agency collaborate with their peers from the other EU members under the auspices of the European Medicines Agency (EMA). If the EMA then concludes there is sufficient scientific evidence of the vaccine’s efficacy and safety from large-scale clinical trials, it is approved for distribution throughout the EU countries.
  • Denmark started vaccinating its citizens on December 27 and is viewed as the fastest country in the European Union to do so in terms of vaccinations per capita.
  • Around 3% of Denmark’s citizens have already been vaccinated with the COVID-19 vaccine. Around 0.5% have already received the second dose.
  • Part of the country’s vaccine rollout strategy is to divide the country’s population into 12 priority segments. Vaccines are already being offered to the first five priority groups. However, this is also dependent on their area of residence.
  • Those who are homeless and socially marginalized are considered at risk so they are part of category 5 vaccinations.
  • The country has around 6,500 homeless citizens. Charitable groups and elected politicians lobbied for them to be included in the priority group due to the observed heightened transmission among them.
  • Around 70% of Denmark citizens are open to being vaccinated with the coronavirus vaccine as their level of trust in their health authorities was one of the highest in the continent. This has given Denmark’s government a solid starting ground for the vaccination program.
  • Denmark has centralized its vaccine rollout process. This way, the government is confident that they can allocate vaccines more efficiently. Furthermore, this central process has made reporting vaccination data faster.
  • Denmark is also in the process of developing a “digital vaccine passport” for those who have already been given the shot. This can enable them to travel to other international locations where some form of vaccine documentation is required.

Priority Populations : Vaccination Against COVID-19

  • The Danish authorities plan to inoculate all its citizens who are eligible to receive the vaccine. Those who are not approved to receive the vaccine as it has not been tested on them include children below 16 years old, pregnant, or breastfeeding mothers.
  • However, there might be rare cases where the vaccine needs to be administered to these vulnerable groups such as in the case of severe illness.
  • Women within the reproductive age need to be aware if they are in the family way before receiving the vaccine.
  • For those experiencing symptoms such as high fever (at least 38 degrees) or acute infection such as pneumonia, the vaccination plan should be rescheduled.
  • Vaccines should only be given to those with mild symptoms.
  • For those taking other medicines such as blood thinner or if they have other blood-related diseases, caution should be practiced.
  • Due to the limited supply, the vaccines will be given based on the planned priority order. The prioritization was based on an evidence-backed evaluation by the Danish Health Authority.
  • The groups who will be given first priority include nursing home inhabitants, healthcare and elderly care workers, and older people who are prone to COVID-19 complications.
  • Once Denmark obtains more vaccine supplies and the priority groups have already received their shots, those who are next in line are the people who are 16 to 64 years old.
  • The Danish Health Authority has identified the following target segments to be given priority in the following sequence for its COVID-19 vaccine program:
    • “Selected persons with conditions and diseases that result in a significantly increased risk of severe illness from COVID-19.”
  • This prioritized order is based on a professional assessment of how best to protect vulnerable citizens and frontline staff.

Vaccination Locations

  • The majority of citizens will receive their shots in regional vaccination centers. The location of these centers can be found on the region’s websites.
  • For some employees in the healthcare, elderly care, and social sectors, they can receive their doses at their workplaces.
  • Mobile vaccination units will also be deployed to nursing homes to enable those who cannot proceed to stationary centers to receive their shots.
  • As for those who are in hospitals, they will be receiving their vaccine doses in the hospital if they are offered a shot. This will be based on an individual evaluation of an extremely high risk of severe symptoms from COVID-19.

Administering Staff

  • Danish authorities boasted that they have a “good and well-functioning collaboration with the regions, the municipalities, and the general practitioners” to enable the development of a workable vaccine rollout plan.
  • All crucial branches of the government such as the police and the army were also part of the vaccination rollout team. This way, everyone is aware of the details of the plan and how to put them into action.
  • Health professionals from the Danish Medicines Agency partner with other professionals from the other EU countries under the guidance of the European Medicines Agency (EMA). If the EMA then decides that there is enough scientific proof on the effectiveness and safety of the vaccine from extensive clinical trials, the vaccine is then approved for use in EU countries.
  • The Danish Health Authority is tasked with leading Denmark’s COVID-19 vaccination plan. The Authority is already managing other national vaccination initiatives such as the yearly influenza vaccines and the “Danish Childhood Vaccination Programme.”
  • After the vaccines have been approved and shipped to the country, they are given to the target groups as soon as possible.
  • All the parties involved need to work closely together to handle the complex logistics involved in getting the vaccine to the target groups. The Danish Health Authority’s plan is key to making this process happen smoothly.
  • It is also responsible for planning the national vaccination program. The scarcity of the initial vaccine supply will require recommendations on which groups should be at the forefront of those who need to receive the vaccine. Based on sound scientific principles, the priority groups were segregated based on “age, occupation, vulnerability, outbreaks, geographical boundaries, vital societal functions, and others.”
  • The division will also handle the communications to the public and to the various health professionals. They will also need to further involve the required stakeholders to nail down the names of those who will vaccinate the people.

Booking

  • Denmark has one of the most digitally-advanced infrastructure in the world. This helped in facilitating the government’s vaccination program. CPR, the identification number of every Dane connects each citizen to a “centralized national register.” Meanwhile, an email app makes it easy for the authorities and the civilians to communicate with each other. These digital network components and a centralized database work together to enable the country’s health officials to determine where each of its citizens belong in the vaccine prioritization segments.
  • People who are next in line for their shots are informed through their e-boks. For those who are exempted from getting messages through Digital Post, they will get a notification letter in the mail.
  • Those who have received notifications need to proceed to the vacciner.dk website to book for their vaccination slot.
  • They should then proceed to the vaccination center during their appointment time. They should follow the instructions in the center and practice health protocols such as wearing face masks. The yellow health insurance card will need to be presented in the center.
  • Vaccines will then be administered under the watchful eye of medical experts. Several healthcare professionals are also present in the center for support.
  • After receiving the vaccine, the patient needs to stay within the area for at least 15 minutes to determine if there is any allergic reaction to the vaccine.
  • Any side effects will need to be reported by the physician to the Danish Medicines Agency.

Vaccine Quality Assurance

  • In Denmark, the DSV Panalpina logistics company is one of the logistics companies that will help with the vaccine transport.
  • Logistics firms that are involved in the transport of the vaccine need to coordinate deliveries to navigate hallways that are full of refrigerated containers. These refrigerated containers are expected to maintain a temperature of -70 degrees celsius to preserve the integrity of the vaccine doses.
  • Denmark stretched its capacity to prepare for the deliveries of the Pfizer vaccine.
  • It has purchased special freezer storage units to preserve the quality of the vaccine.
  • These vaccine doses are stored in these freezer storage systems. Once needed, vaccines are shipped to the country’s public vaccine institute. The institute then divides them and ships them to Denmark’s five regional health authorities. The allocation is based on the number of residents in these areas.

Avoiding Wastage

Data Collection

  • After receiving the vaccine, the patient needs to stay within the area for at least 15 minutes to determine if there is any allergic reaction to the vaccine.
  • Any side effects will need to be reported by the physician to the Danish Medicines Agency.

Performance Management

  • The Danish Medicines Agency takes on a central role in the “approval and tracking of clinical trials.” Together with experts from other “medicines regulatory agencies in the EU,” the Danish Medicines Agency collaborates with the European Medicines Agency’s (EMA) with regard to giving to companies who apply for approval of vaccines for distribution within the whole of EU. After a vaccine has been authorized, the Danish Medicines Agency will be tasked with tracking all Danish reports of “possible side effects of the vaccine, and for tracking the safety of the vaccines at the European level.” This work is being done together with various medicines regulatory agencies from the other EU members and the European Medicines Agency.
  • The Danish Medicines Agency is tasked with communicating to the public the reasons for the “approval of the vaccines, their efficacy, and how safe they are.”
  • Statens Serum Institut is tasked with the purchase and distribution of the vaccines. The Institut will also track the number of vaccinations as well as the “frequency of vaccine-preventable diseases in Denmark.”
  • Statens Serum Institut will also provide advice to the country’s doctors and other healthcare workers on “vaccines and the prevention of infectious diseases.”
  • The Danish health authorities provide advice to the Danish Ministry of Health, which will eventually decide on “who should be offered free vaccination in a publicly funded vaccination program.”

What Can the Other Countries Learn From Denmark (Lessons Learned)

What Went Well

  • Compared to other countries, Denmark was able to administer COVID-19 vaccines at a much faster rate. The country was able to deplete its first batch of vaccine supplies due to the efficiency of its process. Its highly digital system also helped in the speed of its vaccine delivery.
  • The country is also spacing out the required double doses of the vaccine by around six weeks. This is expected to let more people get vaccinated with a first jab.
  • Denmark was able to stretch the content of a Pfizer vaccine vial from five to six shots when a smaller syringe is used. This practice has gotten the approval of the European Medicines Agency.

What Went Poorly`

  • Denmark may be fast in administering the Pfizer vaccines but this speed was partly attributed to the fact that the supply of the Pfizer-BioNTech vaccine is relatively plentiful as some countries turned down part of their EU share of the vaccine. The vaccine was developed based on never-before-tried technology, is more expensive, and is difficult to store. Other EU countries opted to wait for the less expensive and low maintenance Astra-Zeneca vaccine.
  • The vaccination rollout program of Denmark is heavily impacted by delays from the manufacturer’s side. In this case, Pfizer’s factory upgrade in Belgium caused some supply delay in the delivery of the doses to Denmark.
  • There were some concerns from various groups on who should be included in the vaccine priority list given the nature of their jobs or lifestyles.
  • In one case, a Danish road transport group clamored for lorry drivers to be included next in the priority list after the frontliners. The group mentioned that those who help keep society functional should be considered as well. The lorry drivers’ crucial effort to deliver products and medical equipment during the pandemic was highlighted by the group.
  • In another case, several charitable institutions and officials were able to win their case to include homeless people in the priority groups. This is to address the greater risk that they are facing to catch the disease given their living condition.

What is Important to Consider

  • It is important to focus on ensuring that the vaccines are kept in the required environmental condition while in transit to prevent the doses from losing their efficacy. Currently, transporting the vaccine is a challenge as doses need to be shipped and kept in special freezers at a temperature of -70 degrees Celsius.
  • It is also important to ensure that all the at-risk segments are identified and included in the priority groups to prevent the spread of the virus among them.
  • Denmark has one of the most digitally-advanced infrastructure in the world. This helped in facilitating the government’s vaccination program.
  • It is also important to consider diligent tracking of symptoms after the vaccine shot was received to ensure that feedback can be given to the manufacturers to correct any concerns.
GLENN TREVOR
Glenn is the Lead Operations Research Analyst at The Digital Momentum with experience in research, statistical data analysis and interview techniques. A holder of degree in Economics. A true specialist in quantitative and qualitative research.

COVID-19 Vaccine Rollout in Denmark – Distribution and Logistics

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