Vaccines

Launched as a global cross-organization collaboration only one month after the pandemic was declared, COVAX was built to facilitate global equity in the pandemic response. As COVAX passes the one-year mark this month, there are some early lessons and insights that can inform its further development and help us prepare for future crises.

COVID-19 vaccines across the world have been produced and authorized for use with record speed. So far, 13 vaccines have received either limited or full regulatory approval. It’s important to note that the safety of the vaccines is continuously monitored even after limited and full regulatory approvals are granted.

A promising new vaccine candidate is getting a flurry of attention this week, even in a very crowded landscape that includes 11 vaccines on the market and 50+ more in Phase 2 or 3 trials. The newcomer NDV-HXP-S vaccine, developed through collaborations between researchers at University of Texas at Austin, PATH, and Mount Sinai, among others, is a mouthful to say but the name captures the two reasons people are excited about it.

The global imbalance in Covid-19 vaccines is often framed in terms of wealthy versus poor countries. While it can be summed that way (wealthy countries do have the majority of doses, while low-income countries have almost none), this overlooks the experience of upper-middle income countries (UMICs), such as Brazil, Indonesia, and China.

India’s announcement this week that it would halt exports of domestically produced Covid-19 vaccines in the short term seemed to take the world by surprise. It probably shouldn’t have.

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).

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.

There were two significant developments this week that are great news for Covid-19 vaccine equity. To be clear, the picture is still bleak: rich countries hold more than half of the vaccine purchased and don’t want to share until they’ve had their fill.

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.) 

Global manufacturing capacity has been the primary rate limiter for Covid-19 vaccinations. Our vaccine manufacturing infrastructure was not designed to produce enough doses to cover 70% of the world’s population within a year (in addition to regular and routine vaccines) and, as expected, demand is outstripping supply. There has been good news on the manufacturing front, however, with several large pharma companies recently joining with rivals to ramp up production.