# A System View to the Risks of COVID-19 Vaccination Projects
## 3 Results
### Process Concerns
* Failure to calculate the program costs is a risk, as the program objective is to reduce both the costs of infections and the expenses of the control plan [8]. Feasible plans for rapid distribution and administration of vaccines are essential [25; 26].
* In logistics, when selecting where to locate vaccine stocks, inventory control considerations must be made, and they include issues concerning the location, required personnel, and structure of distribution stations. When movable facilities are deployed, routing and scheduling issues arise [2; 8; 20; 27; 28].
* Vaccine dosages can sometimes be insufficient to vaccinate the entire population, particularly during rapid outbreaks such as COVID-19. This raises the question of vaccine priority and necessitates that we discriminate between high-risk and low-risk groups within a community, as well as high-transmission and low-transmissiongroups. A thorough examination is required to identify which group(s) should be vaccinated first [2; 8; 18; 25; 27; 29; 30].
* COVID vaccines should be kept at a regulated temperature. Thus, risk-free technologies for inventory and transportation stages are another concern [29]. When vaccine distribution venues do not have the necessary infrastructure to keep vaccines at a safe temperature, they will have little time to distribute the stock once it arrives [2; 18; 29].
* Logistics disruptions can occur as a result of a variety of infrastructure flaws [2]. Some of these are a lack of dependable power supply in remote regions, geographical barriers, lack of spare components for maintaining cold storage, a severe shortage of skilled personnel, and an insufficient number of delivery vehicles. In addition to frequent interruptions, these infrastructure problems are also likely to reduce the effective shelf life of the vaccines [2; 17]. Supply lead time interruptions, combined with the sensitivity of shelf life, are causing massive problems manifesting in vaccine waste due to expiry and reduction in customer service [2].
* Existing local health facilities, mobile facilities, and field hospitals are all potential vaccine administration sites. Thus decisions must be made regarding sites' location [8], the number of clinics per area, proper layout of the facilities [8], and the necessary number of professional personnel [2; 8]. For mobile clinics, proper project management for moving the facility to different serving nodes in an area is another challenging task [8].
* Security and safety of the developing vaccines are crucial. Fake COVID-19 vaccines exist [20; 31], and failure to control the black markets risks the vaccination program's success. The potential of any bioterror attack is another concern [8].
* Unpredictable natural or human-caused disasters create many obstacles throughout the supply chain, which may result in a loss of a large number of vaccines. Thus, authorities should make an effort to try to prevent or mitigate the fallout of these circumstances [32].
* Developing and implementing nascent modern technology such as Blockchain-based systems or data-driven methodologies can provide a golden chance to trace and monitor the products throughout the supply chain [28; 33; 34]. However, high dependence on such technologies can also bring about irreversible outcomes, for instance, in countries with corrupt or authoritarian political systems.
* Socioeconomic status directly impacts the supply chain and vaccination of a population. Therefore, stratifying the population in vaccination administration helps keep the risk of vaccine waste and disposal at a lower level [21].
* The flow of information between different parties in the vaccine supply chain plays a key role in diminishing ambiguity and creating knowledge necessary to optimize the system operation [22]. In the conventional supply chain, the lack of proper communications between all involved parties leads to disruptions in the flow of relevant information to the consumers.