Cold chain inefficiencies, fake vaccines, and poor healthtech and vaccine management are contributing to the slow journey back to normalcy.

Since the onset of the pandemic and the subsequent vaccination rollout, the initial concern was the scale and magnitude of ensuring global distribution of these vaccines safely without risk.

With the sheer number of vaccines being produced and delivered around the world, the back-end process of vaccine management became extremely important in ensuring that these drugs were delivered in a controlled manner, as well as the authenticity of the vaccines.

The Asia Pacific region is experiencing the same global vaccine paranoia surrounding counterfeit vaccines. This paranoia has been exacerbated by news reports purporting that certain private clinics and doctors around the world have been administering fake vaccines. China has been cracking down on crime rings making fake vaccines while India has reported that thousands were made to believe that they were given the vaccine shot but instead received a shot of saline solution.

Zuellig Pharma believes it has a blockchain-based solution to the issues contributing to this vaccine paranoia. DigiconAsia posed some questions concerning the issues and the eZVax solution to Daniel Laverick, VP, Head of Digital & Data Solutions:

Daniel Laverick, VP, Head of Digital & Data Solutions, Zuellig Pharma

What is eZVax and why was it developed?

Laverick: eZVax is a fully integrated end-to-end Vaccine Management Solution. Integrated with Zuellig Pharma’s blockchain solution, eZTracker, the vaccine management solution enables health authorities, pharmaceutical manufacturers, patients, and key health stakeholders to manage all aspects of vaccine distribution, administration​ and verification.

When COVID-19 first hit, the pandemic took a heavy toll on healthcare workers and overwhelmed the healthcare industry. In line with Zuellig Pharma’s mission to make safe healthcare more accessible, we developed a digital solution that would help governments and healthcare organizations streamline vaccine management processes while protecting patient safety. Here are some challenges eZVax addressed:

  1. Lack of vaccine traceability along the pharma supply chain
    The current supply chain is not governed by one single system. In addition, all stakeholders are working in silos, making it difficult to manage distribution and tracking down to the individual pack level. This could create further confusion for subsequent doses when vaccines are not tagged to each patient.
  2. Risk of vaccine wastage
    Covid-19 vaccines must be stored at low-temperature conditions, any exposure to the external environment might cause the vaccine to spoil and be thrown away. According to IATA, 1 in 4 vaccines are wasted due to cold chain inefficiencies. Without a vaccine management system to track and alert companies of cold chain operational gaps, degraded COVID-19 vaccines that are undetected might also be administered to patients.
  3. Limited availability of vaccination sites and staff
    Inefficient vaccine administration and poor inventory management could affect speed and efficiency of vaccine administration​. Without a system to track administration speed, vaccination facilities are unable to effectively plan the number of vaccines they really need. Over-ordering may occur, and this could incur waste, and deprive other facilities of vaccine stocks.
  4. Lack of patient management systems
    For vaccines to be effective, timely follow-ups need to be adhered to. Without a platform connecting vaccination facilities to patients, subsequent doses of vaccines may be missed, and this may compromise patient safety.
  5. Rise of counterfeit vaccines
    In 2018, the World Health Organization (WHO) revealed 1 in 10 medicines in developing countries are counterfeits. In March 2021, the WHO also stepped in to warn the public about growing trade on the dark web of counterfeit Covid-19 vaccines. Fake Covid-19 vaccine passports have also been a major threat to global health as travel starts to resume.

    As such, eZVax was deployed to simplify key processes in vaccine management and help provide a reliable source of truth using blockchain, verifying vaccines from an authorized distribution source and to better facilitate genuine Covid-19 vaccine passport management.

How is eZVax helping countries across Asia to put in place more secure vaccination programs?

Laverick: In 2021, eZVax was deployed in the Philippines to manage all aspects of vaccine distribution and administration. Through the eZVax platform, more than 1.7 million vaccinations have been administered and over 370 vaccination sites across the country have been registered.

The eZVax mobile application has more than 2.4 million users and allows patients to track their vaccination progress and book appointments. The solution has been a success in connecting government authorities, healthcare organizations, and patients to run effective vaccinations drives.

The success of the eZVax solution relies on four key pillars:

  1. Data aggregation platform
    With a secure system for management and analysis of data across the vaccine supply chain, governments can now monitor vaccination progress, track vaccine movements across sites, simulate changes in demand and supply and use real-time data to make decisions on opening additional mass vaccination sites to maximize efficiency and ensure adequate and timely vaccine supply.
  2. Product traceability solution
    Tapping on Zuellig Pharma’s blockchain-based solution, eZTracker, that enables end-to-end product traceability, pharmaceutical companies and health authorities can have full visibility of pack-level vaccine movements across the entire supply chain. This provides greater assurance of quality and integrity of supply by allowing users to instantly verify the provenance, authenticity and storage conditions of vaccines by scanning the data matrix on the vaccine package.
  3. Citizen services app
    The citizen services app supports patients’ end-to-end vaccination process to improve their experience, adherence, and safety. Through the app, patients can keep track of their vaccination journey from registration to completion. They can view scheduled vaccination sessions, complete their eligibility checks and health declarations, receive automated SMS and email vaccination reminders, access proof of vaccination and even report adverse events.
  4. Vaccine management platform
    eZVax is an integrated platform which facilitates efficient and timely management of citizen vaccinations. It helps healthcare professionals and vaccination teams track vaccine administration progress, manage vaccination site schedules, and organize schedules based on the availability of healthcare workers, automate citizen appointments, verify patient identities, and track vaccine records.

How does the platform leverage blockchain technology, and what are the benefits of blockchain in healthtech?

Laverick: First, blockchain can be leveraged to create better checks and balances. For eZVax, healthcare practitioners at vaccination facilities are now empowered to verify product provenance and storage conditions on their own before administering the vaccines. Integrated with eZTracker, Zuellig Pharma’s end-to-end solution powered by blockchain, pharma manufacturers, patients and healthcare professionals are now all able to access real-time product verification.

Unlike centralized databases where data can be easily tampered with, erased, or destroyed, blockchain architecture provides immutable data. With a consortium blockchain model, health tech like eZVax can provide stakeholders access to a single source of truth they can trust.

Next, health tech can benefit from secure sharing of information across the supply chain. With blockchain’s highly secure and compliant infrastructure, patients can be assured that all personal data from vaccination facilities are securely encrypted and stored in accordance with local data regulations. Authorities and healthcare organizations can also trust that important business information is protected. The ability to use blockchain to build multi-tenanted and cloud agnostic platforms, also allows pharmaceutical principals, hospitals, clinics and pharmacies to easily integrate solutions like eZVax with their existing systems and foster greater collaboration between and within the healthcare and pharmaceutical industries.

Another benefit is data aggregation. With real-time reporting dashboards and a control tower, governments and private institutions using blockchain solutions like eZVax can now have a clear and easy way to view day-to-day operations, citizen vaccination progress, and vaccine stock movements. With this information, governments and healthcare institutions can ensure vaccinations are carried out at optimal capacity and make changes where needed to improve operational efficiency and prevent wastage.

Good management of vaccines requires collaboration between governments and private organizations. How effectively has this been done in various parts of Asia, and what more can be done?

Laverick: For vaccines to be rolled out to the population expeditiously and in an orderly manner, it is crucial for 3P partnerships between governments, private organizations, and the public to work together and take a united front towards vaccine management.

In Asia, we see how digital technologies are used for planning and management of mass vaccination programs. The success of digital tools is highly dependent on government support for the rollout and high adoption rates by private organizations and members of the public.

In line with Zuellig Pharma’s mission to make healthcare more accessible, eZVax has enabled private organizations (including those beyond the health industry) to leverage the platform to facilitate efficient and convenient private sector vaccination drives among companies. The proactive drives in turn help ease pressure on government vaccination drives and helps hasten vaccination progress among all citizens.

However, more can be done to improve vaccine management in Asia.

First, serialization of products is still not widely mandated by governments in Asia, which in turn affects adoption of blockchain to better manage vaccines. Current verification processes are still highly manual in private organizations, which creates a ceiling as to how many products can be brought onto the blockchain for more efficient and safer distribution processes.

While there’s a strong case for using serialization, another challenge the pharmaceutical industry faces is the limited focus on aggregating vast amounts of serialization data to enable business intelligence. Much of this data is now stored or extracted in silo so becomes difficult to use data in a way that’s meaningful and relevant.

In addition, blockchain use in enterprise processes is still quite nascent in Asia, and not everyone knows how to work and build using the technology. In the long run, there needs to be better education and collaboration between governments and private organizations, so that blockchain can be more widely adopted in the market.