Procurement

What is going on with Canada?

j.harris — Fri, 12 Mar 2021 21:07:22 +0000

What is going on with Canada? j.harris Fri, 03/12/2021 - 21:07

Weekly Insights and Interesting Trends

What is going on with Canada?

Canada followed the same vaccine procurement playbook as its wealthy peers, making early advance market purchases across a broad range of Covid-19 vaccine candidates. Between August and October 2020, Canada purchased doses from Pfizer, Moderna, Janssen (J&J), Oxford-AstraZeneca, Sanofi-GSK, and Medicago (a domestic company). In January, they added Novavax. With 500% coverage in confirmed purchases (going up to 600% when optioned doses are included), Canada defines the top of our population coverage graph.

But as we have seen over the past few months, vaccine purchases, vaccine deliveries, and vaccinations do not always track together. Canada’s success with advance market purchases has not translated into strong supply or rate of vaccinations. They have faced delay after delay from vaccine manufacturers and have received very few of their ordered doses. Their vaccination rate of 7% (as of March 11 according to Our World in Data) ranks second to last among the G7 nations. (Japan is in last place with less than 1%, hampered by a slow start and historically high vaccine hesitancy.)

Canada was heavily criticized for purchasing so many doses per capita and then criticized again for requesting doses through COVAX, one of the only high-income countries to do so. Canada has committed to donate excess doses and helped to develop the donation framework for COVAX. But now they are in a position where they do not have any doses to donate. So what went wrong for Canada? Our analysis suggests three factors at play: the timing of vaccines coming to market, opaque negotiations and contracts, and lack of manufacturing capacity.

Canada bet more heavily on the vaccines that have been slower to get to market. Their largest purchases (in terms of number of people covered) were for Medicago, Janssen, Sanofi-GSK, and Novavax. But it was Pfizer-BioNTech, Moderna, and Oxford-AstraZeneca who cleared the finish line first. Moderna, which accepted US government funding for development and manufacturing, has been clear that they are prioritizing the US for deliveries. That means that Canada has been reliant so far on their smallest orders: Pfizer-BioNTech (40 million doses) and Oxford-AstraZeneca (20 million doses). They have recently approved Janssen, giving them one more option. But like Moderna, Janssen is prioritizing US deliveries and indicated they would fulfill Canada’s order by the end of September. They have already announced delays for Canada and there is no target date for the first shipment.

It also appears that Canada did not negotiate favorable delivery schedules as part of their purchase contracts. But because details of the contracts and negotiation processes happening globally were kept confidential, they would not have had any way to know. The lack of transparency (on both price and delivery schedules) created an information imbalance that favored vaccine makers, who had access to the contract documents across countries, and put countries at a disadvantage. Country leaders often did not know where they stood in the vaccine delivery queue until doses started shipping out.

Finally, the lack of domestic manufacturing capacity has left Canada reliant on precarious global supply chains. Other wealthy countries, including the US, UK, Switzerland, and Australia invested heavily in 2020 to build on infrastructure they had developed in previous years and swiftly unlock new capacity. But Canada, which has arguably underfunded vaccine manufacturing for more than a decade, did not have this base on which to build. The country’s manufacturing was not ready to mass produce new vaccines. This meant that Canada could not leverage manufacturing contracts to control supply or get faster delivery.

One of the market lessons highlighted through this pandemic is that location of manufacturing matters. In part, this is because of the public investment that supported rapid expansion. Plants in the US that ramped up with US government funding through Operation Warp Speed are prioritizing US orders. The same is true in Europe and in the UK. These leaves Canada without any priority status. It also makes Canada vulnerable to export controls, as countries clamp down on vaccines leaving their borders.

Canada is building manufacturing capacity now and expects to be churning out doses of Novavax by the end of 2021. At that stage, Canada may become an important supplier for countries around the world still struggling to get enough vaccine. And investment now will likely pay off in future. Next time, Canada will be more prepared. But for now, it provides a case example in the importance of transparency and local manufacturing.

Interesting Trends

Significant news, updates, and trends last week:

COVAX has delivered more nearly 29 million doses to 37 countries since it began shipments in late February. Deliveries have prioritized African countries so far but have also shipped to countries in Asia and the Middle East.

The single-dose vaccine from Janssen (J&J) received emergency use listing (EUL) from the WHO, opening the path for rollout through COVAX.

Vaccines from China’s Sinopharm and Sinovac are under review for WHO EUL, with a decision expected by the end of March.

We’ve seen a few countries enter the Covid-19 global market with their first negotiations and purchases recently, including Cambodia, Honduras, Macau, and San Marino.

Novavax released final efficacy data showing 95% efficacy against the original strain and 86% efficacy against the UK variant in the Phase 3 trial, with 100% protection against severe disease and death. Results from the Phase 2b trial in South Africa demonstrated 55% protection against infection from the South Africa variant and 100% protection from severe disease and death.

Thailand and many countries in Europe have paused rollout of the Oxford-AstraZeneca vaccine as a precautionary measure while reports of blood clots among a small number of people who received the vaccine are investigated. Data from the UK, where more than 11 million people have been vaccinated with Oxford-AstraZeneca indicate no increase in blood clots.

China has launched the first “vaccination passport” program though social media platform WeChat.

A group of countries known as the Quad – US, Australia, India, and Japan – announced a plan to expand vaccine manufacturing capacity in India by as much as a billion doses by 2022. The effort is intended to increase supply for the Indo-Pacific region.

A Swiss pharma company has signed an agreement with Russia to manufacture the Sputnik V vaccine in their Italian facility. Meanwhile, the EU asked member states to hold off on approving Sputnik V in their own countries until the European Medicines Agency has finished their review.

The Inter-American Development Bank (IDB) has developed a new mechanism to provide a financial backstop that can resolve indemnity and liability issues in vaccine purchase agreements. Indemnification requirements (pushed by vaccine developers) have held up, and in some cases prevented, purchase agreements, particularly among middle-income countries.

There were reports this week that Pfizer was interested in manufacturing their Covid-19 vaccine, co-developed with BioNTech, in India if the Indian government could assure faster regulatory authority and no price controls. Other reporting, however, indicates that Pfizer is not currently pursuing this option.

While the WTO member countries did not reach agreement over the proposed IP waiver for Covid-19 vaccines this week, the chief has called for an increase in vaccine production in developing countries.

The US is reportedly sitting on millions of Oxford-AstraZeneca doses that cannot be administered, as the vaccine has not yet received emergency authorization in the US. However, the US government has refused to ship the doses abroad where they could be used.

For more information on our research on Covid-19 vaccine supply, please see https://launchandscalefaster.org/COVID-19.

Weekly COVID Vaccine Research Update

Vaccines

Procurement

Canada

Data Updates

High-income country confirmed dose total:	4.6 billion
Upper-middle-income country total:	1.5 billion
Lower-middle-income country total:	614 million
Low-income country total:	670 million
COVAX total:	1.12 billion
Total worldwide confirmed purchases of Covid-19 vaccines:	8.5 billion doses

COVID-19 vaccines are flowing into the private sector. What does this mean for equity?

j.harris — Tue, 09 Mar 2021 04:46:06 +0000

COVID-19 vaccines are flowing into the private sector. What does this mean for equity? j.harris Tue, 03/09/2021 - 04:46

Weekly Insights and Interesting Trends

COVID-19 vaccines are flowing into the private sector. What does this mean for equity?

While the vast majority of Covid-19 purchases have been through the public sector, we have also seen some private sector deals. This appears to be increasing recently, as governments are partnering with private sector health providers to widen the reach of their vaccine rollouts.

Back in 2020, the Russian Direct Investment Fund (RDIF) was selling Sputnik V to private companies and setting up private distributers in countries including Egypt, India, and Mexico. At the time, there was very little private sector involvement with any other vaccine and most developers pledged that they would work only with governments during the pandemic.

We are seeing an uptick of private sector involvement now, often at the invitation of governments, as countries struggle to ensure both supply and distribution. This makes sense particularly in countries where a large proportion of health care is provided in the private sector. Private sector involvement is a wide tent, however, and there are at least three key variables:

Who purchases the vaccine – private company or government?
Who pays for the vaccine – purchaser or end user? and
Who decides the priority groups and schedule for recipients?

The third variable holds the most risk of inequity at the country level.

For example, private companies could deliver government-purchased vaccine following the government’s priority schedule. This is a pragmatic move, leveraging all available health care providers and locations and is happening in many countries, both rich and poor, as vaccines are rolled out through local pharmacies and private care providers.

Or private companies could purchase their own vaccine and provide it to end users willing to pay. Where vaccines are sold directly to the public through private sector pharmacy chains or provided by employers, it can reduce the cost burden for governments that have not been able yet to purchase enough vaccine for their population. This may be on balance a positive trend in countries such as India, that have wide income disparity, where a large wealthy population can (and will) pay for a vaccine, ensuring that limited government funds support those in most need.

As in the case of India and Indonesia, private employers could purchase the vaccine and provide it to their employees free of charge. (In Indonesia, these doses must be acquired through the government and also be separate from the doses intended for the public sector campaign.) In the Philippines, more than 30 companies came together to purchase vaccine doses and promised to donate half to the government, while using half to cover their employees.

All of these options can relieve pressure on overburdened public health systems. But if people willing to pay are able to get vaccinated ahead of the priority schedule set by the government, countries risk creating a two-track vaccine rollout. Rich people will be vaccinated before poor people and may have access to different vaccines. It may also drive up prices for vaccines as a commercial product, tempt manufacturers to prioritize higher-paying private sector purchasers, and lead to an increase in fraud and black market activity.

While there is a critical and positive role for the private sector in the equitable distribution of vaccines at the national level in many countries, the key risk is when these companies work outside of the government priority schedule. Vulnerable populations around the world need to receive the vaccine on the same timescale to ensure the best results for everyone; the same is true at the country level. Public health priorities should continue to guide vaccine rollout, regardless of which sector administers the doses.

Interesting Trends

Significant updates, news, and trends we saw last week:

COVAX has delivered more than 12 million doses to 21 countries over the past two weeks: Ghana, Ivory Coast, South Korea, Nigeria, Angola, Cambodia, Democratic Republic of the Congo, the Gambia, Rwanda, Kenya, Senegal, Lesotho, Sudan, the Philippines, Indonesia, Fiji, Moldova, Uganda, Mali, Malawi, and Afghanistan. COVAX also this week published projected allocations by country through May.

Bharat Biotech released interim Phase 3 results, demonstrating 81% efficacy.

Sinovac’s vaccine (Coronavac) demonstrated 83% efficacy in phase 3 trials in Turkey. This data release follows phase 3 data announcements from Sinopharm (Wuhan) and CanSino last week.

Good news in real world data from the UK suggesting that the first dose of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines prevents symptomatic cases among the elderly.

The European Medicines Agency has begun a rolling review of the Sputnik V vaccine. The vaccine has racked up a slate of approvals recently, including in Democratic Republic of the Congo, Iraq, and Sri Lanka.

Novartis will manufacture drug substance for CureVac’s mRNA vaccine in their Austrian facility. Novartis is also helping to produce the Pfizer-BioNTech vaccine in their Switzerland facility.

Merck will partner with J&J to produce the Janssen vaccine in the US.

Canada approved the Janssen (J&J) vaccine but may not receive its ordered doses before September.

The US government projects it will have enough doses in hand by May to cover the adult population.

France and Germany have only distributed a fraction of their Oxford-AstraZeneca doses. Meanwhile, the EU is offering an additional 100,000 vaccine doses each to Austria, Czech Republic, and Slovakia to combat rising Covid-19 cases. Italy and Germany are following in France and Spain’s footsteps, hoping to conserve vaccine by giving only a single dose to people confirmed to have already had Covid-19.

Italy invoked the EU export controls to block shipment of 250,000 doses of the Oxford-AstraZeneca vaccine to Australia, highlighting the vulnerability of global supply contracts. Australia is domestically manufacturing the vast majority of its Oxford-AstraZeneca order, however, so the export block is more of a diplomatic than supply issue.

On the topic of export controls, the CEO of the Serum Institute of India said this week that US export controls on raw materials such as bags and filters are a limiting factor for global manufacture of Covid-19 vaccines.

Pfizer’s opaque distribution strategy is motivated by order size, timing of deal, relationship between country and company leaders, data sharing agreements, and profit opportunity according to in-depth article in Bloomberg this week.

Chile donated 20,000 doses to Ecuador in one of the first donations we’ve seen among Latin American countries.

For more information on our research on Covid-19 vaccine supply, please see https://launchandscalefaster.org/COVID-19.

Weekly COVID Vaccine Research Update

Data Updates

High-income country confirmed dose total:	4.6 billion
Upper-middle-income country total:	1.3 billion
Lower-middle-income country total:	608 million
Low-income country total:	670 million
COVAX total:	1.12 billion
Total worldwide confirmed purchases of Covid-19 vaccines:	8.3 billion doses*

*Change from March 9, 2021 reported total of 14.7 billion, which included potential dose purchases

Rhetoric first, action later: the G7 approach to global equity

j.harris — Mon, 22 Feb 2021 22:46:17 +0000

Rhetoric first, action later: the G7 approach to global equity j.harris Mon, 02/22/2021 - 22:46

Weekly Insights and Interesting Trends

Rhetoric first, action later: the G7 approach to global equity

The G7 countries met (virtually) on Friday, February 19, to share variants of “no one is safe until everyone is safe” and discuss the importance of global equity of Covid-19 vaccines and the need for international cooperation. (Sound familiar? That’s because we heard the same things from the G20 in November.)

The countries together pledged another $7.5 billion in funding for COVAX (including the $4 billion that the US Congress set aside for COVAX in December’s Covid relief bill). Funding, while important, is unlikely to improve the immediate picture for global equity as manufacturers churn out millions of doses heading for the same wealthy countries.

Low- and middle-income countries need doses now. As even wealthy countries are learning, purchases on paper are not the same as doses in hand. (Canada, which purchased more doses per capita than any other country, has received very little and is behind most other rich nations in its vaccine roll-out.)

And COVAX, while important, does not solve for equity at 20% coverage. Even with COVAX, poor countries still need to purchase supply for 40% to 50% of their population in order to reach herd immunity levels. But low- and middle-income countries making purchases now will have to wait in the queue to receive delivery, while manufacturing slots for much of 2021 are already reserved.

French President Emmanuel Macron joined Norway in calling for rich countries, which have purchased far more than they need (see table below), to donate doses now, as they are still vaccinating their priority populations. Asking countries to pledge 5% of their supply immediately, Macron made the point that it is speed that counts. Seeming to miss this entirely, UK leadership suggested they would likely donate a much more generous amount but that it was “difficult to say” when. The US and Canada, as well as EU leadership, have similarly committed to donations in principle but hedged on timing.

This appears to run counter to leaders’ oft repeated belief that “no one is safe until everyone is safe.” Because of manufacturing limitations, the fastest way to ensure that countries are able to move together to vaccinate their priority populations is for rich countries to send a portion of doses as they receive them.

The G7 countries (including the EU) have already purchased enough vaccine to cover more than 2 billion people. Even after vaccinating 100% of their populations, they would still have enough vaccine left to cover a combined 1.2 billion people.

Rich countries have tied up the bulk of the supply for this year. If these countries wait to share until after their adult populations have been covered and until after they know whether or not boosters will be needed, as the UK has suggested it will do, global inequities will grow. Meanwhile, while rich countries dither, China and India have moved quickly to donate millions of doses to poor countries even while both countries face shortages for domestic supply.

Vaccine purchases by G7 countries (including EU)

Country	People covered by vaccine purchased	% population covered	Surplus (in people covered)
Canada	190,000,000	505%	152,410,738
EU	1,017,500,000	227%	569,987,959
Japan	157,000,000	124%	30,735,069
UK	243,500,000	364%	176,665,595
USA	655,000,000	200%	326,760,477
TOTAL			1,256,559,838

Note: Data accurate as of February 19, 2021. Purchase data includes only finalized purchases and does not include optioned doses.

Interesting Trends
Significant updates, news, and trends we saw last week:

The G7 countries increased their financial support to COVAX, while remaining non-committal on the timing for donations of actual doses (our take below).

Novavax and SII have signed an MOU with Gavi to supply 1.1 billion doses of the Novavax vaccine to COVAX, though delivery schedule is not provided.

Vaccine scandals in Argentina and Peru prompted the resignation of government officials, who were found to have jumped the queue for vaccinations, in some cases receiving shots before national immunization programs had even begun.

Gavi announced a global no-fault compensation program for the 92 COVAX-funded countries, offering lump sum compensation in the case of vaccine injury. Russia has offered 300 million doses of Sputnik V to the African Union, which if taken up by African countries, would bring the AU total to 970 million purchased doses.

South Africa will share its now-unwanted SII Oxford-AstraZeneca doses with the African Union, though it is unclear if this will be a donation, trade, or other arrangement.

CEO of the Serum Institute of India noted in a tweet that SII has been directed to prioritize India’s domestic supply needs with manufacture of the Oxford-AstraZeneca vaccine.

Bharat Biotech has filed for approval of their Covid-19 vaccine in more than 40 countries. The vaccine has been widely rolled out in India, though Phase III clinical data is not expected until March at the earliest.

Russia approved its third Covid-19 vaccine, CoviVac, this week before large-scale trials have even begun.

New data submitted for FDA review suggest that the Pfizer-BioNTech vaccine may remain stable when stored at standard freezer temperatures. • Oxford University is testing the Oxford-AstraZeneca vaccine in children aged 6 to 17.

Pfizer-BioNTech announced that it is working on a booster to address new variants, following similar announcements from Moderna and Oxford-AstraZeneca.

For more information on our research on Covid-19 vaccine supply, please see https://launchandscalefaster.org/COVID-19.

Weekly COVID Vaccine Research Update

COVID

Vaccines

Procurement

Data Updates

High-income country confirmed dose total:	4.6 billion
Upper-middle-income country total:	1.3 billion
Lower-middle-income country total:	631 million
Low-income country total:	671 million
COVAX total:	1.12 billion
Total worldwide confirmed purchases of Covid-19 vaccines:	8.25 billion doses

Direct COVID vaccine deals by poorer countries are an important and encouraging development

rwatkins — Tue, 19 Jan 2021 13:00:00 +0000

Direct COVID vaccine deals by poorer countries are an important and encouraging development rwatkins Tue, 01/19/2021 - 13:00

Weekly Insights and Interesting Trends

Direct deals by poorer countries are an important and encouraging development

This past week, we saw the first direct vaccine purchases made for low-income countries with the African Union’s purchase of 270 million doses of Covid-19 vaccines from Pfizer-BioNTech, OxfordAstraZeneca, and Johnson & Johnson (J&J). A relatively modest purchase of 270 million doses, when 7 billion doses have already been bought, might be overlooked but it actually represents a significant shift in the global power dynamics of the Covid-19 response.

COVAX, a partnership between Gavi, CEPI, and WHO, is the only mechanism we have to promote global equity to Covid-19 vaccines. With 190 countries participating, COVAX leverages its large market share to bulk buy vaccines and then allocates them equally among member countries, based on population. Lower-income countries will be provided vaccines to cover 20% of their population at no cost. The aim is to vaccinate high-priority and vulnerable populations worldwide on the same timescale, to protect healthcare systems and emergency services, and reduce mortality. We know that this approach to vaccination is better for everyone, both in terms of health and economic outcomes.

While COVAX is important and must succeed, we need to support additional, complementary mechanisms for low- and middle-income countries (LMICs) to get priority access to Covid-19 vaccines. Even with the 20% population coverage provided through Covax, LMICs will need another 40% to 50% population coverage to reach herd immunity levels. As our data show, however, most LMICs are nowhere near this goal. The African Union and Africa CDC have coordinated leadership across African countries to pool procurement and increase the purchasing power in the global vaccines market.

The timing of the African Union deal is at least as important as the quantity of doses: all 270 million doses are to be delivered in 2021, with 50 million doses delivered between April and June. African countries won’t have to wait at the back of the line to begin vaccination campaigns for their highest priority populations.

Also important is the selection of vaccines. Pfizer-BioNTech is the only Covid-19 vaccine that currently has WHO Emergency Use Listing (EUL) status, and the purchase by the African Union demonstrates that this isn’t just a vaccine for wealthy countries. As Dr. Ahmed Ogwell, Deputy Director of the Africa CDC stated, the capital cities will be able to store and administer Pfizer’s mRNA vaccine that requires ultracold storage. The Oxford-AstraZeneca vaccine has emergency approval in the UK (for the AstraZeneca- manufactured version) and is currently under review for WHO EUL status. The Serum Institute has committed to prioritize distribution to LMICs with the doses they manufacture. The J&J single-dose vaccine, with US emergency approval expected in February, will reduce both cost and burden of vaccination by eliminating the need for a second shot per person.

The purchase of 270 million vaccines as part of the whole-Africa approach represents an encouraging step towards global equity. Pooled procurement by LMIC leadership can increase leverage in the global market and should be encouraged and supported by global leaders and vaccine developers.

Interesting Trends

Significant updates, changes, and trends we are seeing this week:

The first purchase by low-income countries was made through the African Union’s pooled procurement approach. A total of 270 million doses (50 million from Pfizer-BioNTech, 100 million from Oxford-AstraZeneca through Serum Institute, and 120 million from Johnson and Johnson) will be allocated to countries across Africa.

The Indian government made its first official purchase, with 11 million doses of the OxfordAstraZeneca vaccine through Serum Institute, which were quickly rolled out through a mass immunization campaign.

Switzerland and the EU granted emergency use approval for Moderna’s Covid-19 vaccine and the EU is currently reviewing an application by the Oxford-AstraZeneca vaccine, with a decision possible in late January.

BioNTech increased its manufacturing goal from 1.3 billion to 2 billion doses in 2021. The scaleup is expected to cause temporary disruption in supply but the company expects capacity to increase by mid-February.

Johnson and Johnson expects to submit final Phase III data to regulatory authorities within the next two weeks and plans to manufacture 1 billion doses in 2021.

Brazil granted emergency use authorization to Sinovac’s Coronavac (despite disappointing results from the Phase III trial) and the Oxford-AstraZeneca vaccine, launching vaccinations moments after approval was granted. Turkey also granted emergency use authorization to Sinovac this week.

For more information on this research and our findings, please go to
https://launchandscalefaster.org/COVID-19.

Weekly COVID Vaccine Research Update

Data Updates

High-income country confirmed dose total:	4.2 billion
Upper-middle-income country total:	1.12 billion
Lower-middle-income country total:	411 million
Low-income country total:	270 million
COVAX total	1.07 billion
Total worldwide confirmed purchases of Covid-19 vaccines:	7.4 billion doses

Changing how India's vaccine numbers are represented in our data

rwatkins — Mon, 11 Jan 2021 13:00:00 +0000

Changing how India's vaccine numbers are represented in our data rwatkins Mon, 01/11/2021 - 13:00

Weekly Insights and Interesting Trends

Changing how India's vaccine numbers are represented in our data

We have changed this week the way that India’s reserved doses of vaccine are represented in our data, moving the majority of the doses out of “confirmed” to “potential” doses.

The way we have been counting India’s numbers in past weeks is a bit different than for other countries. Our numbers typically come from publicly reported purchases by governments (and occasionally private sector buyers). But because India is such a pivotal vaccine manufacturer, the story there is a bit more complex.

The Serum Institute of India (SII), one of the world’s largest vaccine manufacturers, has publicly committed that half of the Covid-19 vaccines they produce will stay in India to serve the domestic market, while the remainder will be shipped out to other countries. SII currently has a contract with Novavax to produce 1 billion doses and with AstraZeneca to produce 1 billion doses, so we are assuming that there are 500 million doses of Novavax and 500 million doses of Oxford-AZ vaccine being produced by SII exclusively for India.

We do not know what proportion of these doses will be purchased by the government of India versus sold through the private sector, but we do expect this amount to remain in India. Though we have not yet seen these come through as announced purchases, we decided two months ago that including these doses provided the most accurate picture of India’s relatively strong position amongst lower-middle income countries (due to their robust manufacturing industry). This is a bit different than the other data points in our spreadsheet, as most represent clear purchase deals. In the case of SII, manufacturing deals implicitly include supply deals for India.

We have been representing these doses as “confirmed” for India in our data but this week have decided to move SII’s doses to “potential.” We still assume that the doses are reserved for India and, indeed, the Indian government appears to be counting on them. However, India has now issued emergency authorization to two vaccines, the Oxford-AstraZeneca vaccine being manufactured by SII and Bharat Biotech’s India-based vaccine, and is launching a mass immunization campaign this week. But we have not yet seen any public announcement of a formal vaccine purchase by the government.

Last week brought an uproar over rumors that the government of India was blocking the shipment of Covid-19 vaccines out of India through export restrictions, which would have dire consequences for the many low- and middle-income countries counting on SII for vaccine supply. The government denies blocking (or having any plans to block) export of vaccines.

This does beg the question of where the government of India plans to procure the doses needed for its mass immunization campaign. If there is a formal purchase agreement in place with SII or Bharat Biotech, we have not uncovered it. We have decided that including the doses reserved for India under SII’s manufacturing deals as potential (rather than confirmed) will increase clarity about India’s current position and will allow us to mark specific purchases as they occur.

We will continue to keep a close watch on the situation, updating as possible. If you have (verifiable) information about purchases from India, we would be grateful if you could share this with us.

Interesting Trends

Significant updates, changes, and trends we are seeing this week:

We have changed the way that we report India’s reserved vaccine in our data, moving the doses produced by the Serum Institute to potential rather than confirmed. See the Insights section below for further detail.

Results from a small-scale study indicate that Pfizer-BioNTech’s vaccine is likely effective against the new strains of Covid-19 that have developed in the UK and South Africa.

The UK approved the Moderna vaccine for emergency use this week but will likely be waiting until April for the first shipment.

China approved its Sinopharm-Beijing vaccine for general use, reporting that it is 79.3% effective.

Janssen (J&J) expects to release data from its Phase III trial by the end of January. The singledose Janssen vaccine candidate is under rolling review in more than 20 countries and could potentially receive emergency use authorization by next month.

The WHO approved the Pfizer-BioNTech vaccine for Emergency Use Listing (EUL), allowing UNICEF and the Pan-American Health Organization (PAHO) to procure and distribute the vaccine. The EUL status also means that countries can expedite their own review and approval process for the vaccine.

The WHO also indicated that it has received 13 applications of Covid-19 vaccines seeking Emergency Use Listing, including the Oxford-AstraZeneca vaccine and Sinopharm.

Several countries announced their first vaccine purchases this week, including South Africa, Bolivia, Serbia, Ukraine, Algeria, and Pakistan.

The US contributed $4 billion to GAVI to support global Covid-19 vaccine procurement and distribution.

For more information on this research and our findings, please go to
https://launchandscalefaster.org/COVID-19.

Weekly COVID Vaccine Research Update

COVID

Procurement

Vaccines

Data Updates

High-income country confirmed dose total:	4.2 billion
Upper-middle-income country total:	1.24 billion
Lower-middle-income country total:	495 million
Low-income country total:	0
COVAX total:	1.07 billion
Total worldwide confirmed purchases of Covid-19 vaccines:	7 billion doses