Delivering COVAX vaccines to the world

UNICEF’s role in a uniquely complex procurement and supply operation.

A shipment of COVID-19 vaccines from the COVAX Facility arrives in Bangladesh
24 June 2021

The journey that takes COVAX vaccines from the production lines of pharmaceutical factories to the arms of people thousands of miles away is the culmination of a much larger operation. The key steps described below involve UNICEF, COVAX partners and a range of other actors, and are critical to the rollout of the global vaccine delivery programme to over 130 countries and counting.  

Laying plans

As COVID-19 continued its spread around the world in the early months of 2020, the need for vaccines to help end the pandemic became apparent. UNICEF would eventually be called upon to coordinate the world’s largest vaccine procurement and supply operation on behalf of the COVAX Facility. The organization drew on its experience as the world’s largest single vaccine procurer, where in normal times, it supplies the vaccine needs of around 45 per cent of the world’s youngest children.

Even so, procuring and delivering COVID-19 vaccine doses meant doubling the volume of vaccines that UNICEF would normally handle annually and involve a mammoth logistics exercise with freight companies, governments, and partners.

Assessing the vaccine and syringe market

In June 2020, UNICEF Supply Division began discussions with major vaccine manufacturers to establish their capacity to produce COVID-19 vaccines in the quantities required to confront an unprecedented health emergency.

COVID-19 vaccines in production
UNICEF/UN0421711/COVAX/Dhiraj Singh

This market assessment, together with vaccine demand forecasts and studies on cold chain equipment and safe injection devices, enabled UNICEF to develop a procurement strategy to ensure that COVAX could count on supplies of vaccines and other essential health items, including up to 1 billion syringes.

It would also help address some of the risks that could arise given the daunting challenges facing international supply chains, with different production processes under way in different facilities in a variety of countries.

Issuing the world’s largest vaccine procurement tender

In November 2020, even as the first vaccines were completing clinical trials and receiving the necessary international approvals, UNICEF and the Pan American Health Organization (PAHO) issued a joint tender for a series of long-term vaccine supply agreements. UNICEF then got to work negotiating agreements and delivery schedules to make sure vaccines could be transported as quickly as possible once they came off production lines.

Next came the task of coordinating with countries and manufacturers to establish a steady supply of the vaccines throughout 2021 and beyond. Freight forwarders stood ready to deliver vaccines that UNICEF was contracting for delivery.

Enlisting the transport industry

A major air freight operation to handle vaccine deliveries was soon taking shape. UNICEF worked alongside key partners including the private sector in an effort to ensure global supply chains that had been severely disrupted by the pandemic could handle the vaccines, syringes and other supplies low- and lower middle-income countries needed. One boost to the plans came in February 2021, when 20 leading airlines and logistics firms joined a Humanitarian Airfreight Initiative set up by UNICEF to facilitate the delivery operation. This came on the heels of the first logistics industry consultation to prepare for the highly complex vaccine delivery operation.

All this took place against the backdrop of an ever-changing supply situation and growing worldwide need for vaccines.

Stockpiling half a billion syringes

UNICEF’s warehouses in Copenhagen and Dubai were already being filled with syringes and safety boxes to help countries in the vaccine rollout. The task of procuring 1 billion syringes, half of which would be stockpiled so they could be shipped in advance of the vaccines, began in the summer of 2020. In a usual year, UNICEF procures between 600-800 million syringes for children’s immunizations around the world, but this would double the volume of syringes UNICEF buys and delivers annually.

Beatrice Agasiru, a nurse at Nyaravur Health Centre III,  attends to patients at Out Patients department.

Preparations in receiving countries

Well in advance of the first vaccine deliveries, vital work was underway to make sure that recipient countries were ready to receive the vaccine doses allocated to them. Cold chain facilities were a critical issue. Some health facilities had benefitted from the provision of 84,000 solar and other cold-chain fridges as part of broader efforts, begun in 2017 with key partners Gavi, UNICEF, and WHO, to support numerous public immunization programmes.

Significant gaps remained, however, and teams from WHO and UNICEF were on hand to provide support. A further challenge was locating sufficient refrigerated vehicles and other equipment needed to protect fragile, heat-sensitive vaccines during the final stage of their journey to health facilities and clinics, sometimes in remote regions.

A nurse administers a COVID-19 vaccine in North Kivu, the Democratic Republic of the Congo

Delivering on the promise

Even as these practical issues were being addressed, health and other government officials were preparing for the final part of the operation – dispensing COVID-19 vaccines to the populations designated to receive them. With support from UNICEF, WHO and Gavi, national vaccine deployment plans were rapidly developed, and trainings organized to make sure frontline health workers were ready not only to deliver the injections, but also to safely store and dispose of the used syringes.  

The first COVAX vaccine consignment landed in Ghana on 24 February 2021. By mid-June 2021, in spite of severe restrictions in vaccine availability and other challenges, COVAX had delivered over 88 million vaccine doses to 131 countries and territories.

A uniquely challenging enterprise had taken a first major step to ensure equitable access to COVID-19 vaccines for all.


Find out the latest information on the COVID-19 vaccine market and COVAX vaccine deliveries at UNICEF’s COVID-19 Vaccine Market Dashboard.