Last Friday (26) was a stressful day in Denmark, but for good reason. The country which used the most doses of vaccine per 100 inhabitants and which made the best use of the doses it received (more than 93% of the 638,240), it is now preparing to increase tenfold: by 10,000 daily injections to 100,000 daily injections.
On Friday, the stress was part of a controlled trial, in which applications, overnight, dropped from 10,000 to 35,000. The idea was to check the structure, equipment and bottlenecks, so that the final climb goes smoothly.
This advance preparation is one of the factors explaining the Danish leadership so far, says public health expert Jens Lundgren, professor at the University of Copenhagen.
A few months before the arrival of the vaccines (end of December), teams from different zones at the federal, regional and municipal levels drew up a vaccination plan.
It was established who would receive the vaccines first, how many doses would be needed in each city and what were the shortest routes to get the ampoules to the vaccination sites.
The details were especially important because the first immunizer to arrive was the one from Pfizer, which is more difficult to handle: it must be stored and transported at minus 70 degrees Celsius, and lasts a few hours after being handled.
To avoid losses, each of the five Danish regions built hospitals with freezers and mapped out vaccination routes from there to vaccination stations, in the exact quantities planned.
The establishment of these volumes and deadlines was not trivial with three different products used, each with different intervals between the first and the second dose. In this step, another Danish tool made the difference: a centralized register by which the government knows how many people of each age live in each place and a digital vaccination control in operation since 2013, explains the director general of the services of data from the Danish Health Authority, Lisbeth Nielsen.
The system allows direct contact with each inhabitant – by SMS or e-mail, for example – informing when and where the vaccination will take place and providing the link for the calendar. In the beginning, however, there was one difficulty: one of the highest priority groups – that of people over the age of 80 – was less comfortable with electronic means.
It was necessary to adapt the system to also send letters and offer a telephone scheduling service, which delayed the process a bit, says Lundgren, also a government adviser to fight Covid-19. In some 1,000 nursing homes in the country, one of the priority areas, vaccination has been linked directly to the directors.
Essential for dealing with the most perishable vaccines, such as those from Pfizer and Moderna, detailed logistics planning and control are important not only for the efficiency of the process, says the director of the data department: “In the event of a pandemic, you do not want dozens of people piling up in the queues ”.
The latest figures from the Ministry of Health show that the goal of avoiding waste has even been exceeded. In 2 of the 5 regions —Nordjylland and Sjaelland – more than 100% of the doses received were applied (this is possible with specific needles which can take six doses instead of five from the vaccination vials).
Lundgren and Lisbeth say the ‘Danish model’ will be even more relevant in the coming months, not only because the number of vaccines per day will increase rapidly, but because vaccines from other manufacturers – with different time frames and needs – will start to arrive. .
In addition, believes the public health specialist, new rounds of vaccinations should be necessary later this year, either because of variants or because it is not yet known how long the vaccine will last.
To take the final step, it remains to ensure a solid supply of vaccines. Like all countries in the European Union, Denmark has also received fewer doses than expected, which has caused one of the main problems so far, according to Lisbeth: “Receiving the invitation to plan vaccination creates a huge expectation, and you have to be prepared to meet it ”.
Some technical adjustments will also be necessary, the test showed on Friday: in the early hours, a drop in the system caused queues at stations. “When the process is fully digital, you need to make sure it’s easy to use and reliable,” Lisbeth says.