Optimization of Distribution Network Configuration for Pediatric Vaccines using Chance Constraint Programming

Abstract: Millions of young people are not immunized in low- and middle-income (LMI) countries because of low vaccine availability resulting from inefficiencies in cold supply chains. We create supply chain network design and distribution models to address the unique characteristics and challenges facing vaccine supply chains in LMI countries. The models capture the uncertainties of demand for vaccinations and the resulting impacts on immunization, the unique challenges of vaccine administration (such as open vial wastage), the interactions between technological improvements of vaccines and immunizations, and the trade-offs between immunization coverage rates and available resources. The objective is to maximize both the percentage of fully immunized children and the vaccine availability in clinics. Our research examines how these two metrics are affected by three factors: number of tiers in the supply chain, vaccine vial size, and new vaccine technologies. We tested the model using Niger's Expanded Program on Immunization, which is sponsored by the World Health Organization. We make many observations and recommendations to help LMI countries increase their immunization coverage.