Vaccines

A closer look into vaccination in Ethiopia

j.harris — Fri, 17 Dec 2021 18:54:07 +0000

A closer look into vaccination in Ethiopia j.harris Fri, 12/17/2021 - 18:54

A closer look into vaccination in Ethiopia

By Blen Biru

Ethiopia is the second most populous country in Africa with a population of 118 million. The first COVID-19 case in Ethiopia was identified on March 13, 2020 but, like many African countries, Ethiopia had relatively low reported cases and deaths during the first wave of infections compared with other parts of the world. However, in December 2020, a larger second wave brought increased level of infections and deaths, due to a combination of factors including lower adherence to stringent public health measures. Since August 2021, Ethiopia has been experiencing a third wave of infections, recording close to 300 deaths weekly and a test positive rate of 10-20% although cases have declined in November and December. The high positivity rate suggests that the likelihood of many more infections happening beyond those diagnosed via testing.

Factors such as re-opening of schools and other public institutions, and the ongoing conflict, are exacerbating the spread of COVID-19 throughout Ethiopia, at a time when there are growing concerns about the rapid global spread of the Omicron variant (still not formally confirmed to be present in Ethiopia). Despite the increase in infections and deaths, studies show that most people are experiencing pandemic fatigue, and consequently, prevention measures such as wearing face masks are coming down.

Given this increase in cases, it’s a critical time for Ethiopia to focus on layered public health measures, including vaccination efforts.

Ethiopia has an established standard immunization system that is experienced with handling previous mass vaccination efforts and routine immunization. The country is building off of the existing system which could serve as a facilitator to administer COVID-19 vaccines. However, the country so far has only fully vaccinated 3% of its population, with ~6% having received at least one dose.

Not Enough Supply

One of the primary challenges that the country is currently facing is availability of vaccines. So far, Ethiopia has received close to 8.5 million doses through the COVAX mechanism, 108,000 doses from African Vaccine Acquisition Trust (AVAT) and 1.7 M doses through bilateral donations from China. These supplies of vaccinations are a modest start towards increasing access in Ethiopia and will only fully cover 5.5 million people, less than 5% of the population. In addition, the unpredictability of deliveries creates challenges in allocation and reaching priority groups. It is important that there is an increased and predictable flow of vaccine supply from COVAX, AVAT, and donating countries so that Ethiopian leaders can plan an effective administration strategy.

Conflict and Hesitancy Create Significant Barriers

In addition to Ethiopia having limited supply of vaccines, the country faces challenges related to vaccine hesitancy. A study conducted in the capital city, Addis Ababa found that many people have doubts about the COVID-19 vaccines mainly due to concerns related to vaccine efficacy. The availability of multiple vaccine products, coupled with rampant misinformation and misleading reports of side effects, has created confusion. On the contrary, another study found high vaccine acceptance rate in sub-Saharan Africa including Ethiopia. This conflicting information calls for a more rigorous and systematic tracking of vaccine confidence and hesitancy to generate better evidence that enables deeper understanding of the issue which will become even more important over the coming months as supply increases.

The current political climate, including the ongoing conflict and the recently declared state of emergency, adds additional challenges. Administering vaccines among those in the conflict region and those displaced due to the conflict adds an additional layer of challenge. It’s imperative that stability in affected regions is restored to curb infections and facilitate vaccine administration.

Ethiopia has a long way to go in order to meet the government’s goal of 80% vaccination by the end of 2023 and WHO’s goal of 40% vaccination by the end of 2021. It’s necessary that local and global efforts are combined to achieve the set threshold. Global and regional stakeholders such as COVAX, AVAT donors, manufacturers and local government should work towards addressing lack of supply, predictability of deliveries, vaccine administration on the ground and other challenges discussed above. Locally, in addition to the government, it’s important to involve community leaders such as religious institutions to promote vaccination given their influence in the society to address issues such as vaccine hesitancy.

Acknowledgements: we are grateful to the following individuals who provided valuable insights and perspectives on the issues addressed in this document: Yakob Ahmed, Bereket Yakob, Yohannes Lakew, and Kidist Belete. This post doesn’t necessarily reflect the personal positions of any of these individuals.

COVID Vaccine Research Update

Vaccines

vaccine delivery

Ethiopia

New Analysis Finds that G7+EU Excess Doses Can Cover 40% Supply Gap in 2021

j.harris — Fri, 26 Nov 2021 18:50:12 +0000

New Analysis Finds that G7+EU Excess Doses Can Cover 40% Supply Gap in 2021 j.harris Fri, 11/26/2021 - 18:50

New Analysis Finds that G7+EU Excess Doses Can Cover 40% Supply Gap in 2021

Author: Andrea Taylor

We are excited to announce the release of new analysis and recommendations through our initiative, the COVID Global Accountability Platform (COVID GAP), a collaboration between Duke University and the Covid Collaborative. There are a plethora of dashboards and datasets on COVID-19 response, including vaccine supply and vaccination coverage, providing detail on what is happening both globally and at the country level. However, the existence of these dashboards is not resulting in actions that meet the pressing needs. The COVID GAP pulls together key data across multiple sources to highlight the need and provide evidence-based recommendations to catalyze effective actions and share promising strategies.

Our latest report focuses on the 40% and 70% vaccination coverage targets, which have been widely endorsed by global leaders but without any action plan to ensure it happens. Drawing on data from our Launch and Scale Speedometer COVID research, as well as the Multilateral Leaders Task Force on COVID-19, and the WHO, we find that 82 countries (including most low-income and African countries) are not on track to meet 40% vaccination coverage by the end of 2021.

At the global level, this is not a supply issue but a distribution issue. The scale up of COVID-19 vaccine production over the past year has been staggeringly successful; the world is now making about 1.5 billion doses a month. We have enough doses to vaccinate far more than 40% of the population in every country. However, much of this supply is concentrated in a small number of wealthy countries, who have more than they can use. Based on supply and vaccination rate data, we expect G7 and EU countries to collectively have more than 830 million excess doses at the end of 2021. Meanwhile, many countries still face significant supply gaps. For the countries that have not yet reached 40% coverage, our analysis indicates that a further 1.05 billion doses are still needed to reach the target. After expected COVAX deliveries in November and December, these countries will still face a gap of 650 million doses.

Driven by this analysis, the COVID GAP team urgently recommends that vaccine makers and donor countries:

Improve transparency on vaccine production, supply, and allocation to drive accountability and effective vaccination planning – countries need advance notice of delivery schedules

Allocate increasing supply of vaccines more equitably, through “queue swapping” and fulfilling donation pledges

Strengthen country-level capacity to ensure doses get from airports into arms as quickly and efficiently as possible

Future analyses will focus on the quantifying the need and tracking commitments for therapeutics, diagnostics, and oxygen, as well as future preparedness. The COVID GAP team is working closely with leaders in low- and middle-income countries as well as multilateral organizations and major funders to build stronger data on the challenges, bottlenecks, and promising strategies to advance access to COVID-19 vaccines, therapeutics, and other resources around the world. We will continue to update the data and insights on the covid19gap.org website, just as we do for the Launch and Scale Speedometer COVID data and will draw on these analyses to develop practical recommendations.

As always, we welcome input on how you are using these analyses and if there are particular areas of focus for our data tracking through Launch and Scale Speedometer or COVID GAP that would be helpful.

COVID Vaccine Research Update

Vaccines

Covid Gap

Booster shots ahead of the holidays

j.harris — Fri, 29 Oct 2021 17:26:20 +0000

Booster shots ahead of the holidays j.harris Fri, 10/29/2021 - 17:26

INSIGHTS

Booster shots ahead of the holidays

Author: Blen Biru

Most high income and upper middle-income countries have fully vaccinated more than half of their population. Portugal ranks first having covered 85% of its population followed by UAE (83%) and Spain (78%). The US ranks 18th having 55% of its population fully vaccinated. In contrast, resource limited countries such as Nigeria, Ethiopia, and Tanzania have only vaccinated less than 5% of their population.

In light of the new COVID-19 variants, countries such as the US are observing increase in cases even with having half of their population vaccinated. To curb new infections and increase immunity, vaccine candidates have developed booster shots.

Guidance on booster shots in the US has been confusing and inconsistent, with President Biden announcing the need for booster shots prior to authorization from the FDA, followed by the CDC overriding recommendations from its advisory panel (which would have excluded frontline workers). The debate within the US and other wealthy countries has primarily involved the purpose of the vaccines (preventing hospitalizations vs infections) and balancing the urgent global need for first shots vs the local need for third shots. After review and discussion, the US has granted emergency authorization to administer third shots of the Pfizer/BioNTech vaccine to people above age 65 and people with underlying conditions in order to protect against waning immunity.

The eligible priority group in the US (around 60 million people) can now receive a third Pfizer-BioNTech shot at least six months after receiving their second shot. However, it appears that people who aren’t eligible can also get a booster since the system doesn’t require authentication while signing up online or showing up at the vaccination site.

And US residents who received other COVID-19 vaccines may soon be eligible for a booster as well. The FDA is reportedly considering authorization of a half-dose Moderna booster and momentum is growing to support boosters for J&J’s vaccine. J&J recipients are concerned that booster plans for the single-shot vaccine are not clear yet, although the company has submitted clinical trial data showing booster effectiveness to the FDA.

J&J’s efficacy against the delta variant was reported to be marginally lower than Pfizer and Moderna, but early data show strong gains from a booster. Although there’s not enough evidence yet, some studies reported better immunity when booster shots are mixed and matched. However, CDC’s guidance so far is to stick with the same brand of vaccine until further evidence is available.

Side effects of the Pfizer booster vaccine are expected to be the same as the previous doses (mostly fatigue, headache, and muscle pain). The dose size is also the same at 30 micrograms. Moderna’s first two doses were 100 micrograms each, and experts believe that adding a 50-microgram booster will suffice to increase immunity without increasing side effects.

The booster shot drive in the US is coinciding with the annual push for flu vaccinations. The CDC affirms that COVID vaccines can be taken simultaneously with other vaccines, such as the flu vaccine, without additional side effects.

In addition to the US, many other countries such as the UK, Israel, Chile, and Singapore have started administering booster shots to their population. The European Medicines Agency (EMA) and Canada’s vaccine advisory body have also recommended boosters for highly vulnerable populations. Most of these countries are administering mRNA booster shots. Chile, however, is starting with a booster shot of Sinovac (which also proved effective in increasing immunity) given that most of its population (60%) took Sinovac for the original series.

Booster shots ahead of the holidays seem to be the focus the US and other high-income countries to prevent hospitalizations and further lockdowns. Given the persistent inequity in vaccine access around the world, and the related risk of new more infectious variants, it is important that these countries do not also neglect their commitments to ensure global vaccine equity at the same time.

Some of the commitments include dose donations and shipment to lower income countries that lack access to vaccines. The US is in the forefront of donations having pledged more than 1B doses through the COVAX system and bilaterally. Our dashboard on donations provides more detail on pledges countries have made and their progress fulfilling their pledges. We hope that it serves as an accountability platform, pushing wealthy countries to work towards their set goal in achieving vaccine equity not only domestically, but also globally.

INTERESTING TRENDS

Significant updates, news, and trends we saw the last two weeks:

AstraZeneca’s US trial showed a 74% efficacy, a result that the company hopes to leverage and apply for FDA approval.

Pfizer and BioNTech submitted phase 2/3 trial results in children less than 12 years old for FDA’s review.

India to produce its own home-grown mRNA-based vaccine by the end of 2021 following Pfizer’s and Moderna’s technology platform.

China’s new protein-based Clover vaccine could be game-changing for the world given that recent findings show its effectiveness against five variants and minimal refrigeration requirement.

Sanofi is abandoning its mRNA COVID-19 vaccine candidate and will focus on using the mRNA platform for other pathogens such as influenza instead, as well as continuing work on their protein subunit COCID-19 vaccine with GSK.

COVAX to modify vaccine allocation approach, not just based on population but also to consider vaccination coverage.

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

Weekly COVID Vaccine Research Update

Vaccines

Boosters

	Confirmed Vaccine Purchases	Confirmed Donations (by recipient, includes pledges)
High income countries	7 B	7 M
Upper middle income countries	2.6 B	75 M
Lower middle income countries	2.6 B	84.7 M
Low income countries	238 M	66 M
COVAX	2.5 B	945 M
WORLDWIDE TOTALS	15 B	1.2 B

What the latest Global COVID-19 Summit achieved (and missed)

j.harris — Fri, 24 Sep 2021 20:13:26 +0000

What the latest Global COVID-19 Summit achieved (and missed) j.harris Fri, 09/24/2021 - 20:13

INSIGHTS

What the latest Global COVID-19 Summit achieved (and missed)

Author: Andrea Taylor

As we and a coalition of over 100 leaders and organizations called for, President Biden hosted a Global COVID-19 Summit on Wednesday. With participation of world leaders mostly virtually, the Summit covered familiar ground as well as some new territory.

In order to make progress, we need clear goals, an action plan, and an accountability mechanism. Using this framework, we’ve reviewed the Summit communications out so far. The good news is that we are closer post-Summit than we were before. The White House laid out goals and a proposed plan for how governments, multilateral organizations, and private sector can work together. It remains to be seen how enthusiastically other world leaders will receive this proposal. Here is our guide to the Summit results so far.

(Note: there were also goals and actions related to diagnostics and therapeutics, as well as future preparedness but we are focusing on vaccine related goals here.)

Goals

This is perhaps where the Summit was strongest. The US Summit Fact Sheet lists several proposed goals, of which two are actually clear.

40% of the population in all countries, across all income groups, vaccinated by end of 2021.
70% of the population in all countries, across all income groups, vaccinated by September 2022.
There is also a vague goal about “additional doses and adequate supplies” for all countries next year. Adequate is difficult to measure.

Action plan

To reach these goals, we need agreement on the steps that governments, multilateral organizations, and the private sector will take. This plan of action should ensure that everyone is rowing in the same direction. Summit communications brought some specificity not only to where we want to go but how we can get there. The White House proposes that global leaders do the following.

Fund the purchase of 1 billion additional doses for COVAX
Urgently move the nearly 2 billion doses already promised by 1) shipping pledged doses, 2) swapping delivery dates to prioritize deliver to low- and middle-income (LMIC) countries, and 3) addressing export bottlenecks for vaccine supplies.
Raise $3 billion in 2021 and $7 billion in 2022 to support the deployment of vaccines within LMICs
Procure up to 3 billion additional doses for LMICs if WHO recommends boosters.
Something vague about governments and the private sector supporting the expansion of global production of vaccines.
Launch a “COVID-19 Corps” to support vaccine readiness (with the private sector)
Improve transparency of manufacturing (actual and projected) and delivery schedules by vaccine makers

This action plan continues to be fragmented, seeking piecemeal commitments from various actors but without clear, cohesive, and strategic alignment and coordination. President Biden announced the purchase of an additional 500 million doses of Pfizer vaccine to donate globally, a good step forward. Unfortunately, all of those doses will come in 2022, missing the urgency of the current need. Several other smaller commitments were also made at the Summit – we are expecting a Chair’s Summary from the White House capturing all commitments.

Accountability mechanisms

We are pleased to see the word “accountability” appear in the Summit communications. This concept has been notably lacking in previous multilateral vaccine equity summits but, as we all know from experience, it is how things actually get done. We do what we measure.

The accountability mechanisms for this global plan are still at the beginning stages but it’s a start. The White House fact sheet calls for a “robust” global dashboard that can track progress toward the goals for vaccines, consumables, and ancillary supplies. The US government committed to coordinate this tracking effort, beginning with a brainstorming session in October to identify the data and metrics needed. At the end of 2021, the US Secretary of State will convene ministers to check in on progress.

Given that we are more than 18 months into this pandemic and still discussing shared goals and targets, without any clear progress made, it is fair to say that our multilateral approach so far has been ineffective at best. It is encouraging to see a proposal with measurable goals, timelines, and a plan to achieve them, though these are still US proposals rather than consensus commitments.

The targets (40% by the end of 2021, 70% by mid-2022) are both critical and also aggressive. Success will require strong independent accountability. We are committed to expanding our data aggregation and analysis to provide such a platform and will work with other partners to drive evidence-based action.

The fractured nature of the global response thus far has left us all worse off. The G7 and G20 alliances have consistently underdelivered, and international organizations and alliances including WHO and ACT-A have remained ineffective in leading a global, coordinated, effective response, with the weight of the US supporting it directly.

As WHO Director-General Dr. Tedros said in his response to the Summit, what is needed now “is for commitments to turn into immediate actions.” The plan proposed in this Summit represents the next attempt to more forward a global response to this global crisis. Now is the time for all leaders, across public and private sectors, to live up to their rhetoric and demonstrate that we are, in fact, all in this together.

INTERESTING TRENDS

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

Novavax and Serum Institute of India applied for emergency use listing (EUL) with the WHO this week. The protein-subunit vaccine has not yet been authorized in any countries but boasts Phase 3 efficacy data upwards of 90% efficacy. If approved, the Novavax vaccine is expected to be a significant component of vaccine supply for low- and middle-income countries.

Clover Biopharmaceuticals, headquartered in China, released clinical trial data for their COVID-19 vaccine demonstrating 79% efficacy against the delta variant (though this decreased to 59% against the mu variant), with 100% efficacy against severe disease.

The US government announced the purchase of another 500 million doses of Pfizer-BioNTech vaccine (for a total of 1 billion doses) to be donated to LMICs. This was coupled with a commitment of $750 million to support country-level distribution of the vaccines.

On Wednesday the US FDA authorized Pfizer-BioNTech booster shots for people over the age of 65 and those 18-64 with underlying conditions, living in care homes, and front-line workers frequently exposed to COVID-19 as part of their job. On Thursday a CDC advisory committee recommended the booster shots not be extended to front-line workers but on Friday, the CDC director issued recommendations including front-line workers in the booster scheme, in line with the FDA authorization.

Johnson & Johnson announced new data this week from a clinical trial that found that a second shot of the Janssen (J&J) Covid-19 vaccine at two months increased protection from symptomatic infection to 75% globally and 95% in the US, with 100% protection against severe disease.

Cuba’s president told the UN General Assembly that the country expects to vaccinate its entire population by the end of the year, using domestically developed and produced vaccines. (See our recent blog post on Cuba’s homegrown vaccine effort.)

Recent modeling from New Zealand suggests that the country needs to achieve a 90% vaccination rate (of over-12s) to avoid future lockdowns.

The Pan-American Health Organization (PAHO) announced that WHO will collaborate with two pharmaceutical manufacturers in Argentina and Brazil to become regional hubs of mRNA vaccine production for Latin America.

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

Weekly COVID Vaccine Research Update

Vaccines

summit

	Confirmed Vaccine Purchases	Confirmed Donations (by recipient, includes pledges)
High income countries	6.97 B	7 M
Upper middle income countries	2.58 B	62.5 M
Lower middle income countries	2.7 B	78 M
Low income countries	238 M	65.1 M
COVAX	2.5 B	740 M
WORLDWIDE TOTALS	15 B	953 M

The World needs more deliveries, not pledges

j.harris — Sat, 18 Sep 2021 20:18:12 +0000

The World needs more deliveries, not pledges j.harris Sat, 09/18/2021 - 20:18

INSIGHTS

The world needs deliveries, not pledges

Authors: Andrea Taylor and Blen Biru

Deliveries of vaccine donations are more important than ever, given the persistent gaps in vaccine coverage globally and threat of the highly contagious delta variant. High-income countries, several of which control much of the manufacturing and existing supply of COVID-19 vaccines, have pledged hundreds of millions in dose donations to target low- and middle-income countries.

But it has been difficult to hold countries accountable for these pledges. Information on the shipment of doses has not been released with the same fanfare as the pledges themselves. Based on what we have seen so far, dose donations have been more about rhetoric than action.

European Commission President Ursula von der Leyen announced this week that the EU will increase its donation pledge by an additional 200 million doses (for mid-2022 delivery). However, the EU is woefully behind in fulfilling its existing pledge of either 200 or 250 million doses (depending on the source) for 2021 delivery, having delivered an estimated 18 million so far.

As the head of Africa Centers for Disease Control and Prevention Dr. John Nkengasong said earlier this month, “Pledges do not put vaccines into people’s arms.”

As world leaders prepare for the Global Covid-19 Summit to be hosted by the US alongside the UN General Assembly this coming week, we are sure to see more donation pledges fly through speeches and press releases with language about our collective responsibility and how we are all in this together. But if the Summit’s goals are to be met, we need to see shipments, not pledges.

To better track progress on donations, we are excited to release new data this week, tracking deliveries of pledged vaccine donations. New charts on our Vaccine Donations page track progress by donating country and by category (right now we include G7 and top 10 donor countries, but we plan to add more categories next week). This allows comparison of the relative size of pledges and shipments, as well as progress toward fulfilling pledges.

In the new visualizations, a bar chart shows the total number of doses shipped and pledged by country. The US stands out with by far the highest number of pledged doses, more than 600M. Even the amount of donations shipped so far by the US (110M doses) exceeds the amount pledged by any other country.

Donut charts show the progress toward meeting donation pledges. Among the top 10 donor countries, China leads by proportion of pledged donations shipped, with 75% of its pledged donations delivered. Japan follows at 50% and then there is a steep drop to Canada at 19%, the US at 17% and Italy at 12%. To be clear: as we near the fourth quarter of 2021, fulling 12% of vaccine donation pledges is enough to land a country in the top 5.

Among G7 countries, all except Japan have shipped less than 20% of their pledges. Based on the reports we were able to find, the UK brings up the rear with 3% delivered. The data show that there is a long way to go, especially for G7 countries, at risk of pledges being empty promises.

Chairwoman of the African Vaccine Delivery Alliance Dr. Ayoade Olatunbosun-Alakija said this week, “Ask the rich countries: Where are Africa’s vaccines? Where are the vaccines for the low- and middle-income countries of the world?” The upcoming Global COVID-19 Summit must answer these questions and demonstrate the political will necessary to move vaccine doses where they are most desperately needed. For everyone’s sake, countries must be accountable for the commitments they make to vaccine access around the world.

INTERESTING TRENDS

The US is hosting a global virtual summit – the Global COVID-19 Summit: Ending the Pandemic and Building Back Better, to bring world leaders together and make commitments to end the pandemic.

The International Monetary Fund, World Bank, World Health Organization, and World Trade Organization released a joint statement about the dire state of vaccine access in most of the world and noting that the 2021 40% target is at serious risk, calling on countries with vaccines to urgently share.

A perspectives piece published by leading global scientists in the Lancet summarizes evidence that the vaccines remain effective against the new variants and that booster shots are not warranted at this stage of the pandemic for the general public.

A study released this week by the UK’s Office for National Statistics found that full vaccination against COVID-19 is highly effective in preventing death. Analysis of nearly 300,000 deaths between January and July 2021 found that COVID-19 accounted for 37% of deaths among unvaccinated people but less than 1% among those fully vaccinated.

The UK overturned its decision on youth vaccinations and has announced that children of ages 12-15 are now eligible for a single shot COVID vaccine. Second shots might be administered based on additional evidence.

Australia also opened vaccinations for 12- to 15-year-olds.

A study published in Science warned that new variants could emerge from Africa if the continent falls behind the necessary pandemic response.

The US government moved to mandate vaccinations for much of the US workforce. A CNN poll revealed that more than half of Americans support vaccine mandates for large gatherings (office setting, schools, sport events, concerts).

Cases are surging in most parts of the US overburdening the healthcare system, leading to deployment of federal military to states such as Idaho and rationing care in Alaska.

Israel started administering 3rd shots in August and is preparing for a possible 4th round of doses in light of increased cases due to the Delta variant.

The UK canceled their Valneva COVID-19 vaccine purchase contract despite investing in a manufacturing center in Scotland to make the vaccine. Valneva claims the UK government cited a breach of the supply agreement when canceling, which Valneva denies.

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

Weekly COVID Vaccine Research Update

Vaccines

Donations

	Confirmed Vaccine Purchases	Confirmed Donations (by recipient, includes pledges)
High income countries	6.9 B	6.5 M
Upper middle income countries	2.5 B	54 M
Lower middle income countries	2.6 B	63.9 M
Low income countries	238 M	64.9 M
COVAX	2.5 B	741 M
WORLDWIDE TOTALS	14.9 B	930 M

Will Cuba's home-grown vaccine strategy pay off?

j.harris — Sat, 11 Sep 2021 03:45:10 +0000

Will Cuba's home-grown vaccine strategy pay off? j.harris Sat, 09/11/2021 - 03:45

INSIGHTS

Will Cuba’s home-grown vaccine strategy pay off?

Author: Blen Biru

Cuba has become the leader of COVID-19 vaccine development in Latin America – producing a total of five vaccine candidates so far, four of which are awaiting submission to WHO’s Emergency Use Listing Procedure (EUL). All of the vaccines have names that express Cubans’ pride in developing successful home-grown vaccines as a small nation: Abdala (named after a patriotic poem), Soberana 1 (meaning “sovereign”), Soberana 2, Soberana Plus, and Mambisa (named after independence fighters in the 19th century). These vaccines are game-changing for Cuba and have the potential to address vaccine equity in Latin America and rest of the world if approval is received by the Pan American Health Organization (PAHO) and WHO.

The two most promising vaccines with high rates of efficacy are the 3-dose Abdala (92% efficacy) and 2-dose Soberana 2 (62% efficacy, reportedly increased to 91% when combined with a booster of Soberana Plus). Cuba started inoculating its citizens with these vaccines even prior to regulatory approval (at-risk population in March 2021 and mass vaccination in May 2021).

The protein-subunit technology that all five Cuban COVID-19 vaccines use is different from the other COVID-19 vaccines on the market so far, which mainly use mRNA, viral vector, or inactivated vaccine platforms. (There are several other protein subunit vaccine candidates expected to come to market soon, including from Novavax, Bio E, Sanofi-GSK, and Vaxxinity.) Protein subunit vaccines are generally cheaper to manufacture and don’t require extreme refrigeration, which makes them more suitable for resource limited settings than mRNA vaccines like Pfizer-BioNTech's Comirnaty.

Cuba is committed to only using home-grown vaccines, building on its well-established routine vaccination technology and infrastructure, and has not joined the COVAX initiative or shown interest in making bilateral deals. The country’s initial plan to inoculate 70% percent of its population by end of August 2021 and its whole population by the end of 2021 would have made Cuba the only country in the world to inoculate its population with just home-grown vaccines.

However, the country hasn’t met its 70% goal for the summer (with 41% of its population fully vaccinated so far), and has welcomed imports of the Sinopharm vaccine to curb the rising infections on the island. There has been no official communication to explain the slower-than-expected vaccine rollout but it is most likely due to local production delays. Cuba’s recent openness to imported vaccines demonstrates the difficulty faced by countries trying to address the pandemic in isolation and the importance of global collaboration.

Beyond Cuba, Venezuela has also started administering the Abdala vaccine to its citizens. Soberana 2 and Abdala are being tested in clinical trials in countries such as Iran and Mexico. Cuba also plans to transfer manufacturing technology to countries such as Argentina and Vietnam, potentially setting up a global network of manufacturing that could help supply vaccines to Latin America and Asia.

The Cuban government approved vaccination for youth (ages 12+) at the beginning of September and earlier this week became the first country in the world to vaccinate children under the age of six, following clinical trials of Soberana and Abdala vaccines on minors. A rigorous scientific peer review and WHO Emergency Use Listing are still pending, however. If Cuba manages to obtain those in a timely manner, these vaccines could perhaps go a long way in curbing the pandemic in Cuba and other countries in the world.

INTERESTING TRENDS

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

Brazil has suspended the use of 12 million doses of Sinovac (plus another 9 million doses en route to Brazil) that appear to have been produced in an unauthorized plant. Brazil’s health regulatory agency Avisa will inspect the plant before issuing a final decision.

Several Latin American countries are threatening to cancel purchase contracts for the Sputnik V vaccine after significant delivery delays. Brazil announced in late July that it was canceling a purchase of 10 million doses, as the country’s regulatory agency Anvisa has still not received data required for emergency approval. Guatemala renegotiated their purchase of 16 million doses, reducing it to 8 million doses after delivery delays. Argentina’s health minister visited the Gamaleya Center in Russia after a shortage of 18.5 million doses forced the country to mix-and-match other vaccines for second doses and prompted the country to threaten cancelation of their contract.

New supply forecast from COVAX estimates delivery of 1.1 billion doses between now and the end of 2021 and a total of 2.6 billion by the end of March 2022.

Tortoise media launched a campaign and released an Arms Race tracker to increase access to vaccination and urge stakeholders to work towards achieving global herd immunity by mid-2022.

New analysis from Airfinity and the IFPMA forecast that the world will have 7.5 billion doses of COVID-19 vaccine by the end of September and that 1.5 billion doses are now being produced globally each month.

Health ministers from G20 countries released a joint statement this week reiterating their commitment to global health equity and collective responsibility addressing the pandemic.

President Biden announced a mandate requiring vaccinations for federal employees and vaccinations/weekly COVID tests for employers that have 100+ employees in light of increased COVID-19 cases.

India approved ZyCoV-D, the first DNA based vaccine which is administered needle-free via a device that presses against the skin. The efficacy is reported to be 67% from early-stage trials, late-stage trials are underway to publish comprehensive results.

Chilean health regulator approves CoronaVac use among children over age 6.

WHO’s Director General Tedros Adhanom announced the extension of the global moratorium on booster doses from end of Sept to end of the year to allow countries vaccinate at least 40% of their population at the Sept 8th COVID-19 media briefing.

The US headquartered biotech startup, National Resilience will manufacture doses for Moderna at its Ontario based facility, which will ramp up Moderna’s total production capacity.

J&J single shot vaccine manufactured by the India based company, Biological. E is expected to be on the market by October 2021.

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

Weekly COVID Vaccine Research Update

Vaccines

Cuba

	Confirmed Vaccine Purchases	Confirmed Donations (by recipient, includes pledges)
High income countries	6.9 B	6.5 B
Upper middle income countries	2.5 B	54 M
Lower middle income countries	2.6 B	64 M
Low income countries	238 M	63 M
COVAX	2.5 B	741 M
WORLDWIDE TOTALS	14.8 B	927 M

We need a better plan.

elina.urli.hodges — Fri, 27 Aug 2021 19:13:03 +0000

We need a better plan. elina.urli.hodges Fri, 08/27/2021 - 19:13

INSIGHTS

We need a better plan.

Author: Andrea Taylor

The past 18 months have shown us what happens when we rely on fragmented responses to a pandemic – the result is an uncoordinated patchwork of insufficient approaches and the continued spread of an ever-mutating virus. It sounds obvious but still needs to be said: pandemics are global and our response must be as well.

Together with colleagues at the COVID Collaborative, the Pandemic Action Network, the Center for Global Development, and many others, we developed a Framework for a Global Action Plan for COVID-19 Response. As the framework states, “an ‘all-hands-on-deck’ crisis response must deploy all available resources and capabilities – multilateral and bilateral, public and private sector.” We need to pull in all willing partners and make sure everyone is rowing in the same direction.

The need for coordinated, comprehensive global action is urgent. It is not enough for high-income countries to say, “we’ve done our bit” and then focus attention back on national priorities. Without a global plan and accountability, we cannot effectively address this crisis anywhere, including at home.

We are calling on world leaders to urgently convene a Global Pandemic Response and Vaccination Summit and commit to six steps:

Strengthen global leadership and accountability. We need clear leadership structures, accountability mechanisms, and coordination across all partners, countries, and resources.
Develop and implement a Global COVID-19 Response Roadmap, a fully-costed plan to achieve 70% vaccination rates in every country by mid-2022 along with targets for access to tests, treatments, and other critical interventions.
Empower a global taskforce for supply chain and manufacturing to accelerate and expand manufacturing capacity in LMICs and increase transparency across the supply chain.
Accelerate sharing of vaccines and other life-saving interventions, including the sharing of at least 1 billion doses, with the aim of 2 billion doses, by end of 2021 from G7/EU and G20 member countries.
Strengthen country-level distribution and deliver capabilities, augmenting multilateral efforts through national initiatives modeled on successful programs such as PEPFAR.
Increase multi-year financing for the pandemic response in LMICs, leveraging funding from governments, multilateral development banks, the IMF, and private donors.

Please see the framework for more detail on each step and a full list of signatories.

INTERESTING TRENDS

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

The US FDA provided full approval this week of the Pfizer-BioNTech vaccine in people ages 16 and older, its first full approval for any COVID-19 vaccine. Use in children ages 12 to 15 is still covered under emergency use authorization.

The US also announced that 50% of adolescents aged 12 to 17 have now received at least their first dose and this group has the fastest growing vaccination rate in the US.

Despite domestic manufacturing, Thailand is facing significant shortages of vaccine in the face of surging infections and is in talks to purchase surplus doses from Europe and is “borrowing” doses from neighboring Bhutan.

Pfizer and BioNTech have signed a manufacturing agreement with Eurofarma in Brazil, their first manufacturing partnership in Latin America. Eurofarma will provide fill-finish production of the mRNA vaccine, using drug substance produced in the US, beginning in 2022, with an annual capacity of 100 million doses per year at full capacity.

The Philippines gave emergency use approval this week to the single-dose Sputnik Light vaccine (which is the first dose of the two-dose Sputnik V vaccine).

Japan has suspended the use of some Moderna vaccine doses after “foreign materials” were found in the vials, which were manufactured by Rovi in Spain.

A recent article in the New York Times explores the shortfalls of the US vaccine donations so far and the need for a global response that prioritizes first and second doses.

The Atlantic writes about the tensions inherent in booster policies for wealthy countries that do not appear to be learning the lessons of the past year.

In a study of 29 million people in England, published this week in BMJ, researchers found that the risk of hospital admission or death from blood clots is higher from COVID-19 infection than from receiving either the Oxford-AstraZeneca or Pfizer-BioNTech vaccines.

NEW INSIGHTS, September 3, 2021

Multilateral Leaders Taskforce on COVID-19 (MLT), along with WHO, IMF, WBG and WTO issued a statement to address vaccine inequity after holding a meeting with Africa CDC, GAVI, and UNICEF.

Pfizer’s vaccine approval is delayed in China in fear of lowering confidence in homegrown Chinese vaccines.

Bharat Biotech of India is in need of international COVID-19 vaccine manufacturing partners as it expands its capacity.

Many low-income countries are facing challenges in rolling out vaccines due to unpredictable delivery of donated and procured doses.

Some countries such as Peru are observing a decline in vaccine hesitancy.

CDC’s latest report states that at least 15.1 million doses of Covid-19 vaccines have been wasted since March 1 2021 in the US.

The EU to return millions of South Africa imported J&J’s doses due to criticism of taking away shots from the African continent that needs it the most.

The US government announced that it will invest 2.7 billion in vaccine production to better prepare for domestic and global vaccine needs.

EU resolves AstraZeneca’s dispute over a newly proposed delivery schedule.

Cuba is set to supply its home-grown Abdala vaccine along with the technology transfer to Vietnam.

Mu variant from Colombia is labeled as the new variant of interest.

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

Weekly COVID Vaccine Research Update

Vaccines

	Confirmed Vaccine Purchases	Confirmed Donations (by recipient, includes pledges)
High income countries	6,907,677,500	6,451,921
Upper middle income countries	2,478,840,075	53,773,774
Lower middle income countries	2,633,578,000	63,128,436
Low income countries	288,200,000	61,603,912
COVAX	2,534,000,000	731,028,571
WORLDWIDE TOTALS	14,842,295,575	915,986,614

Are third shots vs first shots a “false choice?” Then the US and other high-income countries should prove it

j.harris — Fri, 20 Aug 2021 22:35:02 +0000

Are third shots vs first shots a “false choice?” Then the US and other high-income countries should prove it j.harris Fri, 08/20/2021 - 22:35

INSIGHTS

Are third shots vs first shots a “false choice?” Then the US and other high-income countries should prove it.

Author: Andrea Taylor

The US has continued to advance plans for boosters since we wrote about the issue earlier this month, with an announcement that a third dose will be offered to all residents (not just the highly vulnerable), eight months after the second dose. Israel has already begun its booster campaign, while Germany, France, and the UK are expected to begin boosters for the elderly and immunocompromised next month.

Data from the US, Israel, and the UK help explain why. Despite relatively high levels of vaccination and early vaccine roll-out campaigns, all three countries (and many others) have experienced significant surges in infection over the past few months. Breakthrough infections (those occurring among fully vaccinated people) are increasing, particularly for people over the age of 60 and those with underlying conditions. While full vaccination clearly provides powerful protection against Covid-19, efficacy appears to diminish over time, particularly against Delta.

Brushing aside criticism from the WHO and other global advocates, the US government continues to say that boosters versus vaccines for the world is a false dichotomy and we can (and must) do both. The US Surgeon General Dr. Murthy echoed a frequently repeated line from government spokespeople, saying, “I do not accept the idea that we have to choose between America and the world. We clearly see our responsibility to both.”

Supply is improving

The increasingly good news on the supply front supports this view. Our estimates of manufacturing indicate that the world is now producing close to 1 billion doses of Covid-19 vaccines per month. This represents an enormous scale-up of manufacturing, across all of the vaccine platforms, since the beginning of the year.

There are also new candidates poised to enter the market with significant production capacity (including Novavax, Bio E’s Corbevax, and Medicago) which will further improve the supply picture. Even our conservative estimate indicates that the world can make 5 billion vaccine doses between August and December this year. When we consider that most wealthy countries are nearing the demand ceiling for full vaccination and have hundreds of millions of doses on hand already, this bodes well for global exports.

Can political will keep up?

But supply is only part of the equation – political will is another. Just saying that boosters vs global vaccine access is a false choice does not make it so. The US government (and other high-income nations) now have the opportunity to prove it.

The US talking points consistently include a reminder that the US is doing more than its peers. As White House Coronavirus Response Coordinator Jeff Zients said this week, “the 115 million doses that we’ve already donated is more than all the other countries combined.” But this rather misses the point. The measure of success is not “have we done more than others?” but “do all countries have enough vaccine to slow transmission?”

The gaps in vaccine access globally remain dismally wide. High-income countries have purchased nearly half of the total vaccine doses bought so far but represent only 16 percent of the world’s population. More than 80 percent of vaccines administered worldwide went to people in high- and upper-middle income countries. Meanwhile, less than 1 percent of people living in low-income countries are fully vaccinated.

If other wealthy countries are not pulling their weight (spoiler: they are not), the US can work to bring them along. As the first country to approve boosters for the general population, the US should set an example by coupling the rollout of boosters with a coordinated plan of action to get vaccine doses where they are needed most around the world. Along with other global health and policy experts, we recently proposed a specific path through which the US can demonstrate this type of necessary global leadership.

Slowing transmission of the virus everywhere is critical. We cannot stop the pandemic at home (wherever home may be) until every part of the world is able to reduce infections.

INTERESTING TRENDS

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

The US government announced that Covid-19 booster shots will be made available to the general population, eight months after the second shot, in order to combat waning efficacy. (See the post above for our take on this.)

A new study from Oxford University found that both the Pfizer-BioNTech and Oxford-AstraZeneca vaccines provide strong protection against the Delta variant but that the efficacy does wane over time.

Australia extends lockdown for Sydney until end of September

Millions of the Janssen (J&J) vaccine doses coming from the Aspen plant in South Africa are being exported to Europe, while South Africa is still waiting for its order of 31 million to be filled.

New article in Science looks at the evolution of Covid-19 variants and what we can learn from other viruses.

Also in Science this month, insights on how the “super immunity” of those who survived the 2003 SARS epidemic contribute to development of a pan-coronavirus vaccine.

WHO flags counterfeit versions of the Serum Institute’s Covishield (Oxford-AstraZeneca) vaccine in both India and Africa.

Pope Francis encouraged Covid-19 vaccination, calling it an “act of love” and stating that “vaccination is a simple but profound way of promoting the common good and caring for each other, especially the most vulnerable."

The US Centers for Disease Control and Prevention (CDC) announced a new Center for Forecasting and Outbreak Analytics, to increase the availability and use of data in public health decision making. new disease forecasting

Australia’s government faced criticism this week for ordering 500,000 doses of Pfizer-BioNTech’s vaccine from COVAX. Faced with a population suspicious of the Oxford-AstraZeneca vaccine, which was meant to form the bulk of Australia’s national supply, the government is scrambling to secure additional doses of Pfizer-BioNTech.

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

Weekly COVID Vaccine Research Update

Vaccines

Boosters

supply

High-income country confirmed dose total:	6.8 billion
Upper-middle-income country total:	2.5 billion
Lower-middle-income country total:	3.2 billion
Low-income country total:	288 million
COVAX total:	3.3 billion
Total worldwide confirmed purchases of Covid-19 vaccines:	15 billion doses

Looking into Vaccine Wastage

j.harris — Fri, 13 Aug 2021 12:53:53 +0000

Looking into Vaccine Wastage j.harris Fri, 08/13/2021 - 12:53

INSIGHTS

Author: Blen Biru

Looking into Vaccine Wastage

Despite the shortage of Covid-19 vaccines globally, millions of doses are being wasted rather than used. Vaccine wastage is defined as vaccines discarded, lost, damaged or destroyed according to the WHO. There are two phases where vaccines are exposed to wastage – opened and unopened vials. Unopened vials are mostly wasted due to expiration, heat exposure, and incorrect inventory, and open vials are primarily wasted through contamination.

A certain amount of wastage is expected, given the nature and complexity of vaccine campaigns. WHO has previously estimated as much as 50% of annual vaccine wastage across all vaccines, though reported wastage of COVID-19 vaccines is significantly lower. Even with just 1% wastage, with 4.6 billion COVID-19 doses administered so far globally and likely total of 7+ billion by the end of 2021, we would expect to see ~70 million doses wasted by the end of 2021. Wastage of Covid-19 vaccines is particularly concerning since demand is still outstripping supply in most of the world. Interestingly, wastage is happening at relatively high rates in both high-income and lower-income countries.

Like so many aspects of this pandemic, a lack of data makes it difficult to define the scope of the problem. In the US, the CDC created a system for each state to report wasted doses which is not fully being used, confounding efforts to estimate the total number of doses wasted so far across the country. Data from 10 states show that since the beginning of vaccination drives in December 2020, at least one million doses have been wasted. Examples of states that reported high number of wastage include Ohio (370,000 doses), Georgia (110,000 doses), Alabama (65,000 doses; also one of the least vaccinated states), and Maryland (50,000 doses).

Lifesaving vaccines are going to waste due to low uptake in high income countries when most resource-limited settings are struggling to get access. Strategies that the US and other countries such as Canada are using to minimize wastage include giving the vaccine to anyone who needs it regardless of priority group domestically and selling or donating doses to other countries. Providing booster shots for seniors and at-risk populations is also being considered to minimize wastage.

Countries such as Israel have swapped doses to avoid vaccine wastage. South Korea received 700,000 doses of Pfizer vaccines from Israel as part of a swapping agreement in July 2021 and is expected to ship the same amount of vaccines to Israel in September or October 2021.

This is not only a high-income country problem; low-income countries are also experiencing concerns related to vaccine wastage. African Countries (e.g. Malawi, South Sudan, Liberia, etc.) have had to destroy at least 450,000 doses as of mid-July due to short expiration and shipment delays. Some shipments of desperately needed vaccine arrived without enough time left to distribute them before expiring. Most Covid-19 vaccines have relatively short expiration dates due to limited data (~6 months) available at the time of authorization. (We’re seeing a move toward extension of expiration dates now, as additional data can inform updates to authorizations.)

Vaccine hesitancy also contributes to wastage in both wealthy and poor countries. This issue seems to be higher for certain vaccines such as AstraZeneca (AZ), perhaps due to perceived risk after the US and EU paused rollout, even though other countries, like the UK, continued on without any pause. The Netherlands, for example, reported wasting AZ vaccines because of in-country lack of demand. To that end, the Dutch government plans to donate unused AZ vaccines abroad. (As noted above, it is important to keep expiration dates in mind in the process of donations. If the doses are near-expired, they make donation much more complex as it takes a long time to get doses reallocated for donation and shipped out - by that time, the recipient countries may not have time to distribute before they expire.)

It is imperative that countries minimize vaccine wastage as much as possible, particularly given the inequitable access to vaccines globally – improving access worldwide is the only way that will curb the pandemic. Minimizing vaccine wastage will also save a large amount of money that could be spent otherwise. We call on all countries and relevant stakeholders for increased investment and capacity for vaccine distribution, delivery, and demand generation. We also urge countries to create consistent monitoring requirement and use available tools such as the WHO wastage rate calculator to make evidence-based decisions in ordering and administering vaccines.

INTERESTING TRENDS

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

The FDA authorized a third booster shot for at-risk people that need more protection.

The first locally acquired case in more than a year in Canberra, Australia led to a snap week-long lockdown.

Novavax pushed back plans to file for full authorization in the US in Q4, but has begun the process in India, Indonesia, and the Philippines and plans to file in the UK, Australia, and Canada in September.

Moderna plans to build a manufacturing plant in Canada in the next two years, though the location has not yet been finalized.

India granted emergency approval to Janssen's (J&J) single-dose vaccine, which is being manufactured within India by Bio E.

Aspen in South Africa will increase their output of the Janssen (J&J) vaccine by an additional 200 million doses in 2022, according to the African Union.

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

Weekly COVID Vaccine Research Update

Vaccines

wastage

expiration

High-income country confirmed dose total:	6.6 billion
Upper-middle-income country total:	2.5 billion
Lower-middle-income country total:	3.2 billion
Low-income country total:	331 million
COVAX total:	3.3 billion
Total worldwide confirmed purchases of Covid-19 vaccines:	15 billion doses

Will booster shots prolong the pandemic?

j.harris — Fri, 06 Aug 2021 04:19:03 +0000

Will booster shots prolong the pandemic? j.harris Fri, 08/06/2021 - 04:19

INSIGHTS

Author: Andrea Taylor

Will booster shots prolong the pandemic?

A handful of wealthy countries recently announced plans to roll out booster shots in late 2021 for vulnerable populations already fully vaccinated against Covid-19. Israel has already begun providing third shots for immunocompromised people and is opening eligibility this week to everyone over the age of 60. Germany, France, the UK, and the US have indicated they will begin boosters for priority groups as early as September.

The WHO responded quickly with a reminder that most of the world is still waiting for their first two doses and we must prioritize global coverage before boosters. It looks inevitable that many of the world’s wealthiest countries will move forward with booster plans all the same. So how much of a problem will this be?

Prioritization, not supply, is the issue

We are in the midst of a shift as distribution challenges, rather than limited supply, are becoming the key barriers to global coverage. Production of Covid-19 vaccines continues to ramp up at the same time that most wealthy countries are approaching demand saturation among adult populations. Globally, manufacturers are now making many hundreds of millions of doses per month. There is enough supply projected in the next 12 months to vaccinate the world and cover boosters for high income countries.

What matters now is the order in which we do this.

The only way to end local transmission is to end global transmission and the only way to do that is to ensure distribution of effective vaccines worldwide. We are facing a global crisis and we cannot solve it with isolated local interventions. We must approach the problem in a coordinated global way. If we do not, we open the door for new, more dangerous variants that bring us back to the start and even high-income countries will be stuck circling round again.

Global solutions are less costly

The longer the acute phase of this pandemic continues, the more we all lose. These costs can be measured in economic, health, and political terms. The International Monetary Fund (IMF) estimates that a coordinated global response to end transmission of Covid-19 would cost about $50 billion USD. But continued emergence and spread of new, more infectious variants could cost $4.5 trillion in lost gross domestic product globally by 2025. That is a cost of more than a trillion dollars a year for the next four years.

Continued spread of the virus also means millions more people suffering severe illness, debilitating symptoms from long-term infections, and preventable deaths. We have already experienced this in North America, Europe, and South Asia. Now countries in Africa are reporting a surge of infections as the delta variant races across the continent, with an 80% rise in Covid-19 deaths over the last four weeks. With a vaccination rate hovering around 1.5%, the situation will likely get much worse in the coming months.

In the first half of 2021, we have distributed vaccines in such a way that some countries have surplus, most have shortages, and others have none at all. More than 80% of Covid-19 vaccinations have been given in high- and upper middle-income countries, while only about 1% of vaccinations have been administered in low-income countries. These disparities not only prolong the acute phase of the pandemic but also threaten to overwhelm health and emergency services, strain governments, and push societies to the brink. The impact of continued spread of Covid-19 will increase severe poverty and threaten geopolitical stability.

Not an either/or

Within the next year, we will have enough supply to vaccinate the world and provide booster shots in high-income economies. In the meantime, providing boosters in a tiered way to the most vulnerable in those countries is not likely to derail supply for global efforts. But we must simultaneously remain focused on the critical task at hand.

We are calling for a global target of vaccinating 70% of the world’s population by mid-2022. We will need to produce and distribute 10 billion doses globally in the next year to do this, an ambitious but achievable goal. This year, we have seen inequitable distribution of vaccine lead to the emergence of infectious variants that now threaten even highly vaccinated countries. The hard-won lessons of the past six months should prompt us to adjust course going forward.

INTERESTING TRENDS

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

Oxford University and AstraZeneca announced the production of 1 billion doses of their vaccine, 18 months after work on the vaccine began. The Oxford-AstraZeneca vaccine has been distributed to 170 countries.

US government funding for domestic production of Novavax is on hold until the company strengthens quality control measures.

The Emergent plant in Baltimore, MD (US) is expected to resume production of the Janssen (J&J) vaccine, which was stopped in April following cross contamination with materials intended for the Oxford-AstraZeneca vaccine. The plant is no longer manufacturing the Oxford-AstraZeneca vaccine.

Pfizer and BioNTech have inked a deal with Biovac, a South African firm, which will provide fill-finish production for the mRNA vaccine, with the first doses expected in early 2022. Once at full capacity, the partner expects to produce 100 million doses per year, exclusively for distribution across Africa.

A study in South Africa found the single shot J&J vaccine to be highly protective (91% to 96.2% protection against death, 67% efficacy against Beta variant and about 71% against the Delta variant)

The WHO, IMF, World Bank, and World Trade Organization have launched datasets tracking vaccine supply, delivery, and administration, which incorporate some of our data.

China announced a $100 million contribution to COVAX to support the distribution of vaccines in developing countries.

US president Biden reported a major milestone of 110 million doses donated and shipped to 60 countries across the world, which makes the US a leader in vaccine donations.

Spain committed to donate 7.5 million vaccines to Latin America and Caribbean countries through COVAX; first round of shipments will be delivered to Paraguay, Guatemala, Peru, Ecuador and Nicaragua.

The FDA is expediting its review timeline to grant full approval to the Pfizer-BioNTech vaccine in the US by early September given the rise in cases.

Sputnik’s vaccine delivery to Argentina is delayed leaving 6 million people with just the first dose, risking contract cancellation as a result. Countries like Kenya and Ghana have also canceled Sputnik orders due to delivery issues.

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

Weekly COVID Vaccine Research Update

Boosters

Vaccines

High-income country confirmed dose total:	6.5 billion
Upper-middle-income country total:	2.5 billion
Lower-middle-income country total:	3.2 billion
Low-income country total:	331 million
COVAX total:	3.3 billion
Total worldwide confirmed purchases of Covid-19 vaccines:	15.8 billion doses