Developing an intuitive decision support system for equitable vaccine distribution during pandemics.

Effective organization of the vaccine supply chain is vital to achieve high vaccination rates in pandemics. This paper presents a novel approach for developing a decision support system (DSS) to support health officials and policymakers who must make timely and impactful decisions with limited information for distributing vaccines. We combine a stakeholder-informed systems approach for problem definition with a user-centered design approach for DSS development. The methodology has been tested during the COVID-19 pandemic. We used system modeling to capture stakeholders' knowledge, experience, and learnings from the H1N1 pandemic, leading us to focus on the central vaccine allocation problem (CVAP), which involves determining the number of vaccines allocated to each municipality in an equitable way. We designed a dashboard that embedded a mathematical model as a DSS for in-country CVAP during a pandemic. A Lightning Decision Jam workshop was conducted to define the DSS's characteristics, with the visualization of scenarios and decision-making transparency being key features during the development process. We validated the DSS with policymakers and built it for the Norwegian context, with flexibility for adaptation to other regions, particularly those still grappling with high vaccine supply deficits. Our approach offers a novel and practical way to develop DSSs to support policymakers making critical decisions during pandemics.