COVID-19 Vaccine Roll-out by Local Authorities in Norway - Challenges to decision-making

Between January and September 2021, over 350 local authorities were charged with rolling out COVID-19 vaccine to their populations under demanding condi¬tions. This report identifies seven common challenges to decision-making based on the analysis of interviews with 14 people in key roles in nine different local authorities. Main challenges involved deciding how many doses to extract from vials, how to prioritize patients, and how to cope with changing recommendations on dose intervals. From analysis of the interviews, we also abstract 16 system functions that local authorities must control to roll out vaccine successfully. These functions can help in preparedness for future pandemics or act as the basis for improvements to future vaccine roll-out systems. Based on our collective findings, we present ideas on how central authorities and advisors might support local-level decision making and adaptation in future emergency roll-out situations. .