Indemnification, reimbursement, supplies and other issues in private participation in vaccinations

Though private hospitals are ready to support vaccination programmes, a host of issues still need to be sorted out.

More than a year after COVID-19 first emerged, the world is looking at effective vaccination as the light at the end of the tunnel. Countries in Asia are working feverishly on rolling out their vaccination drives, which have begun, or are set to begin across the region in the coming months.

However, the pace of vaccination has been generally sluggish. Governments are facing different challenges in the roll-out, from the sheer population size to be vaccinated, to a lack of resources. In boosting the speed and coverage of the vaccination programme, many governments have roped in private hospitals into the exercise.

However, in such a public-private partnership, a range of details, from indemnification, supplies/supply-chain and reimbursement, need to be understood and addressed before any roll-out.


When adverse events (from mild to serious side effects, or even death) occur after a private vaccine shot, which party should take responsibility – the government, the vaccine manufacturer, or the private hospitals who procured the shots?

Some countries, such as the Philippines, have made it clear that for private sector purchases, the national government will shoulder the responsibility, based on the tripartite agreement that the private entity will enter into with the government and vaccine manufacturers. Some states have already set up national funds which will compensate those who suffer adverse effects from vaccines.

But for other countries, the responsibility of such compensations is not yet clear. With the urgency to obtain vaccine supplies as fast as possible to save lives, policymakers may not have been able to sort out indemnification-related legal issues, which are typically long, drawn-out processes. This could lead to legal tussles down the road.

Supplies and supply chain management

Vaccines may be the most in-demand goods in the world right now. Private hospitals will have to compete with countless other players in the market to place their vaccine orders, and also consider the risk of vaccine supply delays.

Vaccine manufacturers worldwide are working at top speed, but supply delays have been reported in recent days. In mid-April, Moderna announced that it was cutting back its scheduled deliveries to countries such as the UK and Canada, due to a shortfall in doses in its European supply chain. India has also delayed its vaccine exports, due to the sharp rise in cases in the country.

To ensure a smooth supply chain, private hospitals may have to invest in track-and-trace systems, to keep track of when the vaccines will be available for use, when they will expire, and so on. In addition, vaccine vials require careful cold storage management. Private hospitals storing the vaccines at their premises need to look at their existing cold chain infrastructure, and ensure real-time monitoring and reporting of temperature, shock and moisture, amongst other requirements.


In the US, healthcare providers (hospitals, physicians, pharmacies and others) are reimbursed by the federal health insurance programme Medicare, at the rate of $40 for administering each vaccine dose. This amount was to cover the costs involved in administering, and the additional resources necessary to ensure the vaccine is administered safely and appropriately.

Information on such reimbursements in other countries is scarce. Some countries may not have finalised these rates for private hospitals, or they may not use such a reimbursement method at all. The question might be – is a reimbursement process necessary, or the most appropriate in the public-private partnership?

Deep dive into these issues at HMA webinar on 28 April

Besides the above, other issues that private hospitals have to consider include ensuring enough resources (staffing, consumables etc) to run the exercise, sufficient storage, preventing wastage of vaccines, and so on.

On 28 April, join heads of private hospital association in Asia at the “Efficient COVID vaccination rollout in ASEAN” webinar organised by HMA, as they deep dive into issues surrounding private participation in vaccination programmes. The second part of the webinar will feature an interview with infectious diseases specialist Dr Leong Hoe Nam on the why and when of serology testing, which ensures vaccines are effective.

Registration is free for all participants from healthcare organisations. Don’t miss this opportunity – click here now to register.