To the naked eye, there’s no discernible difference between the potentially life-saving liquid inside a COVID-19 vaccine vial and any other clear liquid.

In fact, not even trained personnel tasked with administering the vaccine will be able to test on the spot if the liquid contains the authentic mRNA vaccine. The technology needed to make these observations in the field simply doesn’t exist, says Nikos Passas, professor of criminology and criminal justice at Northeastern.

As public health officials begin widespread distribution of the long-awaited vaccines, ensuring that vaccines are authentic could emerge as an important issue. If the first round of doses are scarce—and desperation for a quick COVID-19 solution is strong—counterfeiters could attempt to capitalize on the opportunity, Passas says.

“The problem we have is a clear mismatch in supply and demand,” he says. “Whenever you have this kind of asymmetry, you can expect illicit markets to pop up.”

To fight the trade of counterfeit vaccines and other medicines and supplies, Passas and a team of researchers are analyzing global trade networks and collaborating with pharmaceutical companies, banks, and law enforcement worldwide on how to ensure quality control and stop the illicit flow of potentially ineffective—or even fatal—fakes.

Initially, the U.S. military is overseeing the vaccine’s supply chain and facilitate shipping across the country.

“Where the military is involved, there’s an assurance that the vaccines will be authentic,” says Amiji, university distinguished professor of pharmaceutical sciences and chemical engineering. “But once the product gets beyond that scale, once the military becomes less involved, the concern for counterfeits becomes more pronounced.”

As of right now, the U.S. military is only expected to help distribute vaccines in the early phases. Afterwards, healthcare providers, pharmaceutical companies, and shipping companies will have a greater role in overseeing distribution and administration of the vaccines.

A less coordinated effort could expose breaches in the supply chain for counterfeit peddlers to capitalize on, Amiji explains. “People are going to be looking for cheaper alternatives.”

In the worst-case scenario, a counterfeit vaccine could directly harm a person. For example, the water used in the fake vaccine liquid could be contaminated with something unsafe for humans, Amiji says.

But even if the counterfeit vaccine doesn’t cause direct complications, it still won’t prevent COVID-19, and that could provide people with a false sense of security, Amiji says. People might engage in unsafe behaviors under the assumption that they’re protected from COVID-19.

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