Blockchain technology and vaccine supply chain: Exploration and analysis of the adoption barriers in the Indian context

The vaccine distribution system, being a bio-pharmaceutical cold chain, is a complicated and sensitive system that must be effectively managed and maintained due to its direct impact on public health. However, vaccine supply chains continue to be affected by concerns, including vaccine expiry, inclusion of counterfeit vaccines, and vaccine record fraud. The blockchain technology integrated with the Internet of Things (IoT) can create a solution for global vaccine distributions with improved trust, transparency, traceability, and data management, which will help monitor the cold chain, tackle counterfeit drugs, surveillance, and waste management. Several theoretical models for vaccine management with blockchain have recently been published, and a few pilot studies for COVID-19 vaccine management using blockchain have been started in India. Still, full-scale adoption of blockchain technology in vaccine distribution and management has yet to be achieved due to underlying barriers. This study explores the adoption barriers utilizing Technology-Organization-Environment (TOE) framework with the help of extant literature and inputs from administrators, academics, immunization, and blockchain experts and then analyzed using the Delphi and fuzzy Decision-Making Trial and Evaluation Labo-ratory (DEMATEL) techniques. The finding shows that the requirement of change in organizational structure and policies is the most prominent barrier, and the barrier related to requirement of large-scale IoT infrastructure and lack of technical expertise are the most impactful barriers. The theoretical contribution of this study lies in the identification and analysis of barriers that should be addressed to achieve blockchain technology adoption in the vaccine supply chain.