COVID-19 vaccine delivery in LMICs: How to think about concentration vs dispersion in delivery?

COVID-19 vaccine delivery has begun in many low- and middle- income countries (LMICs) and many countries will be looking to scale as more vaccines arrive. The distribution of COVID-19 vaccines is distinct due to limited vaccine availability, different target populations compared to routine immunizations, and the importance of speed in reaching the maximum number of people, driving the need to explore alternative delivery and supply chain designs. This report investigates the question: How concentrated or dispersed should COVID vaccination delivery be in different geographic areas and with varying available vaccine supply? Should COVID-19 vaccines be delivered through a few large, centralized vaccination locations (concentrated) or through many small vaccination locations closer to target populations (dispersed)? The report also explores how delivery strategy changes with vaccine allocation and throughput to reach full population coverage, target vulnerable populations, and minimize cost.