Every player in global jab race has weaknesses
Last week, President Joe Biden pledged to make the United States the world’s “arsenal of vaccines”, promising half a billion Pfizer doses to the developing world. It was an impressive offer — but of 560 million vaccines the US had already promised, it has delivered only 160 million.
With the US and multiple European countries now intending to offer a booster this autumn, it would now take around 11 billion doses to vaccinate 70% of the global population. So far, more than 3.53 billion have a received at least one dose vaccine, data from the University of Oxford suggests.
That rollout, however, is deeply, deeply patchy. In Africa, less than 7% of the population have received a vaccine. And while multiple major countries — the US, Russia, China, India, Britain and others — all have high hopes of making geopolitical capital through “vaccine diplomacy”, almost all have failed to deliver what they hoped.
In the US vaccine hesitancy has been a major factor in driving up the death toll, particularly in southern states. The same is true to a lesser extent in other developed countries — but in poorer nations, demand for vaccines has simply far outstripped supply.
Almost 80% of vaccinations have been delivered in upper and middle income countries, with only 0.5% in the lowest income nations. The United Nations-administered Covax programme had hoped to deliver 2 billion doses by the end of the year — but estimates now suggest it may manage barely half of that, with officials complaining some donations have been late and close to the end of their shelf lives, prompting wastage.
China, the world’s leading international vaccine donor, says it has now delivered more than 1.1 billion vaccines to more than 100 countries. Perhaps unsurprisingly, many of those donations have been extremely small, inevitably fuelling suspicions that they have primarily gone into the arms of elites.
Beijing hopes to have shifted another billion doses by year end — although appetite for its vaccine has been reduced by data suggesting its Sinovac shot is only 51% effective against dramatic infection and Sinopharm 79% effective, lower than most other vaccines.
Some experts even doubt those figures — prompting countries like Malaysia to switch their focus to Pfizer despite their ongoing struggles with a devastating fourth Covid-19 wave. Reluctance to accept Chinese vaccines has also been reported in other nations.
The Sinovac vaccine has only one registration in 40 nations, while Sinopharm is registered in 74 (not all small nations run their own registration programmes, instead choosing to rely on the World Health Organization, European or other regulators).
Pfizer has been approved in 136 nations, more than any other bar the Oxford-AstraZeneca vaccine which can be used in 181. The AstraZeneca vaccine, however, has seen its uptake hit drastically in the developed world by initial reports of adverse events particularly blood clots. Some of these reports were amplified by European officials and regulators elsewhere, including Australia, prompting a switch in focus to Pfizer and Moderna.
Unlike the other Western-developed vaccines, the majority of AstraZeneca doses administered so far have been in lower or middle income countries, where Pfizer, Moderna and the single dose Johnson & Johnson shots are much less available.
Russia’s Sputnik V has also struggled with production issues despite claiming to have won registration in more than 70 countries.
An August report by the Carnegie Endowment for International Peace said Moscow appeared to have over-promised initial shipments to multiple nations before suffering production problems. Exact details are hard to get — but as of May, Russia has reportedly only managed to produce 33 million doses of the more than 500 million promised.
According to Carnegie, several nations — including Ghana and Kenya — have cancelled Sputnik doses complaining the pricing was more expensive than initially promised. Elsewhere, however, Russia has successfully struck supply deals to manufacture its vaccine abroad, most notably in India.
India had hoped to present itself as the global vaccine export powerhouse, but upended those predictions when it banned exports in the face of its own rapidly spiralling death toll. As deaths fall, New Delhi says it will resume vaccine exports in the last quarter of this year, including Indian manufactured AstraZeneca, Sputnik and India’s own vaccine.
How the pandemic develops next year remains unclear, but whatever the outcome, the world’s vaccine response to the coronavirus has been simultaneously both historically impressive in speed and volume and yet fallen well short of its greatest hopes. Whether that augurs well or badly for the next pandemic is also an open question.