Managing two-dose COVID-19 vaccine rollouts with limited supply: Operations strategies for distributing time-sensitive resources.

Distributing scarce resources such as COVID-19 vaccines is often a highly time-sensitive and mission-critical operation. Our research was prompted by a significant obstacle that the United States and other nations encountered during the early months of the COVID-19 vaccination campaign: Most COVID-19 vaccines require two doses given 3 or 4 weeks apart. Given the severely limited supply and mounting pressure on many countries to reduce hospitalizations and mortality, how to effectively roll out two-dose vaccines was a critical policy decision. In this paper, we first model and analyze inventory dynamics of the rollout process under three rollout strategies: (1) holding back second doses, (2) releasing second doses, and (3) stretching the lead time between doses. Then we develop an SEIR (susceptible, exposed, infectious, recovered) model that incorporates COVID-19 asymptomatic and symptomatic infections to evaluate these strategies in terms of infections, hospitalizations, and mortality. Among our findings, we show releasing second doses reduces infections but creates uneven vaccination patterns. In addition, to ensure second doses are given on time without holding back inventory, strictly less than half of the supply can be allocated to first-dose appointments. Stretching the between-dose lead time flattens the infection curve and reduces both hospitalizations and mortality compared with the strategy of releasing second doses. We also consider an alternative single-dose vaccine with lower efficacy and show that the vaccine can be more effective than its two-dose counterparts in reducing infections and mortality. We conduct extensive sensitivity analyses related to age composition, risk-based prioritization, supply disruptions, and disease transmissibility. Our paper provides important implications for policymakers to develop effective vaccine rollout strategies in developed and developing countries alike. More broadly, our paper sheds light on how to develop effective operations strategies for distributing time-sensitive resources in times of crisis.