Trust Formation with Blockchain Audit Trails in Vaccine Supply Chains: Implementation Study

Abstract

The distribution of temperature-sensitive pharmaceuticals, particularly vaccines, demands a highly coordinated and transparent supply chain to ensure efficacy and public safety. Traditional vaccine supply chains suffer from information asymmetry, fragmented data silos, and opaque accountability mechanisms, which collectively erode trust among stakeholders and end-users. This paper investigates the formation and transformation of inter-organizational trust through the implementation of blockchain-based audit trails in vaccine supply chains. Drawing upon empirical evidence from an extensive implementation study, this research assesses how immutable, decentralized ledger technologies shift the paradigm from relational trust to system-based cryptographic trust. By tracking physical vaccine vials integrated with Internet of Things temperature sensors alongside digital smart contracts, the study measures the impact of real-time visibility on stakeholder behavior and collaboration. The findings indicate that blockchain audit trails significantly reduce dispute resolution times and enhance confidence in cold chain integrity. Furthermore, the continuous and transparent recording of data transforms accountability, forcing supply chain actors to rely on algorithmic consensus rather than interpersonal assurances. This paper provides a comprehensive analysis of the technological, operational, and psychological dimensions of deploying distributed ledgers, offering critical insights into how systemic trust is formed and sustained in critical healthcare logistics.