#Covid19 Vaccine – Uncertain Global Access

Scotland’s Vaccination Programme

In Scotland the first Pfizer vaccines against COVID-19 were administered on Tuesday 8 December and by Sunday 18,644 people received their first dose of the vaccine.

Scotland has 130,650 doses available for delivery (as of 16th December) with 50% of those having to be retained as all those vaccinated require 2 doses. Call For “Patience” in Roll Out of #Covid19 Vaccine in Scotland

There were initial concerns that the issues surrounding transportation of the Pfizer vaccine would affect island communities.

In a letter issued on Wednesday, Joe Fitzpatrick, the then Minister for Public Health, Sport and Wellbeing, informed MSPs that the Scottish Government had received:

“confirmation from the MHRA that the undiluted vaccine can be transported by boat, at 2-8 oC, in a suitable vaccine transporter, after it has been ‘packed down’ into smaller quantities. There is no stability data from Pfizer for helicopter or plane transportation which means that neither of these options are available.

The MHRA confirmation will now enable us to get the vaccine to these communities and local Health Boards are liaising with us on the practicalities and timescales for this. I expect them to ensure local residents are informed as soon as possible and that local MSPs are updated.”

Covid19 is a Pandemic. What are the implications for global access to vaccines?

Nearly a quarter of the world’s population may not have access to a covid-19 vaccine until at least 2022, warns a study published by The BMJ.

A second study estimates that 3.7 billion adults worldwide are willing to have a covid-19 vaccine, highlighting the importance of designing fair and equitable strategies to ensure that supply can meet demand, especially in low and middle income countries.

Taken together, these findings suggest that the operational challenges of the global covid-19 vaccination programme will be at least as difficult as the scientific challenges associated with their development.

In the first study, researchers from the Johns Hopkins Bloomberg School of Public Health analysed pre-orders for covid-19 vaccines ahead of their regulatory approval that had been publicly announced by countries around the world.

By 15 November 2020, several countries had reserved a total of 7.48 billion doses, or 3.76 billion courses from 13 manufacturers, out of 48 covid-19 vaccine candidates in clinical trials.

Just over half of these doses will go to high income countries, which represent 14% of the world’s population, say the authors. Low and middle income countries will potentially have the remainder, despite these countries comprising more than 85% of the world’s population.

If all of these vaccine candidates were successfully scaled, the total projected manufacturing capacity would be 5.96 billion courses by the end of 2021, with prices ranging from $6.00 (£4.50; €4.90) per course to as high as $74 per course.

Up to 40% of the vaccine courses from these vaccine manufacturers might potentially remain for low- and middle-income countries. However, this will depend, in part, on how high-income countries share what they procure and whether the US and Russia participate in globally coordinated efforts.

New Zealand has announced that it has purchased vaccines for its total population from AstraZeneca and Novavax. It will also provide free doses to its neighboring nations Tokelau, Cook Islands, Niue, Samoa, Tonga, and Tuvalu, should they want them.

The authors of the BMJ report state:

“This study provides an overview of how high income countries have secured future supplies of covid-19 vaccines, but that access for the rest of the world is uncertain.

“Governments and manufacturers might provide much needed assurances for equitable allocation of covid-19 vaccines through greater transparency and accountability over these arrangements.”

Even if all of these vaccine manufacturers were to succeed in reaching their maximum production capacity, at least a fifth of the world’s population would not have access to vaccines until 2022.

In the second study, researchers based in China and the US estimated target populations for whom vaccines would be required, to help guide development of fair and equitable allocation strategies across the globe.

They find that target population sizes for covid-19 vaccination vary widely by geographical region, vaccine objectives (such as maintaining essential core services, reducing severe covid-19, and stopping virus transmission), and the impact of vaccine hesitancy in reducing demand.

They point to evidence suggesting that around 68% of the global population (3.7 billion adults) is willing to receive a covid-19 vaccine, and say their findings “provide an evidence base for global, regional, and national vaccine prioritisation and allocation.”

“Variations in the size of the target populations within and between regions emphasise the tenuous balance between vaccine demand and supply, especially in low and middle income countries without sufficient capacity to meet domestic demand for covid-19 vaccine” they conclude.

Both studies are observational, and the authors acknowledge the implications of uncertainty and incomplete information for their analyses.

Nevertheless, these findings illustrate the considerable scale and complexity of manufacturing, purchasing, distributing, and administering covid-19 vaccines in a way that meets global needs, and does so equitably among nations and populations.

Photo Kenny Armet

Reporter: Fiona Grahame

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