The international COVAX initiative has published its fourth round of dose allocations aimed at ensuring that countries are able to administer second shots of AstraZeneca’s COVID-19 vaccine. This includes over 17 million doses of AstraZeneca vaccines for 43 countries under COVAX’s advance market commitment, or AMC.
But the details are unclear.
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The document does not specify where doses will come from, and the spokesperson from Gavi, the Vaccine Alliance, only mentioned that the vaccines — which a report published in June identified to be AZD1222-Vaxzevria, the approved European brand name of the AstraZeneca vaccine — will come from the AstraZeneca manufacturing network.
There is also no clarity on when AstraZeneca doses from this round of allocations will be shipped. The Gavi spokesperson only said that UNICEF’s dashboard “will be updated as deliveries are scheduled.”
Countries waiting for the second shot
Many of the countries under the COVAX AMC received vaccines between February and May 2021, and have been expecting to receive more to complete vaccination of those who received a first dose of the AstraZeneca vaccine. The World Health Organization recommended dose-interval for the vaccine is up to 12 weeks.
But there have been serious concerns of delays in administering the second dose after disruptions in the supply of the AstraZeneca vaccine manufactured by the Serum Institute of India. A deadly surge in COVID-19 cases in India led the company to prioritize supply in the country, affecting its deliveries to other countries, including to COVAX. This left many countries without any supply to administer second doses of the vaccine.
A number of countries will be receiving doses equivalent to the number they received during the first dose shipments early in the year. For example, Afghanistan will receive 468,000 doses, and Bolivia 228,000, the same amounts each country received back in March.
But for some countries, allocated doses are fewer than what they first received. Some countries such as Rwanda and Mauritania that received the first shipments of AstraZeneca doses via COVAX also did not receive any allocations during this round.
A Gavi spokesperson told Devex via email that countries that were given different dose quantities or were not included in the allocations for this fourth round either received recent dose donations or redeployed doses of AstraZeneca prior to the allocation. Donated and redeployed doses of AstraZeneca vaccine were taken into account when determining the allocation amounts.
How countries are adapting to AstraZeneca vaccine shortages
Countries that received vaccine shipments through COVAX are now waiting for the second shot. Some have started mixing vaccines, while others are looking at other means to secure doses.
That explains why Zambia, for instance, which received 228,000 doses of AstraZeneca vaccine in April was only allocated 120,000 doses during this latest round of allocation. The country received donations of 108,000 doses of AstraZeneca from France in April, according to the spokesperson.
Some countries that had not yet received any AstraZeneca doses at all are also included in this round of allocations. They include Bangladesh and Pakistan, which each received an allocation of 1,000,800 for this round. The amount of doses is lower than what they were supposed to receive during the first shipments, but dose donations may be filling this gap.
On Friday, Gavi announced the first Japan-donated doses of AstraZeneca vaccines arriving in COVAX AMC countries. These first shipments include 332,000 doses and 1,087,570 doses arriving in Cambodia and Iran, respectively, today, July 23, as well as 245,200 doses arriving in Bangladesh on July 24.
Allocations were also made to Bhutan, Haiti, and Kyrgyzstan of 108,000,129,600, and 228,000 doses, respectively. These countries did not receive any vaccines earlier via COVAX “due to preparedness issues,” according to the June report.
However, countries such as Myanmar, Republic of Congo, and Zimbabwe were still excluded from the allocation, as they “had not yet cleared either pre-allocation or post-allocation readiness/preparedness steps,” according to the Gavi spokesperson. Zimbabwe has been administering Chinese-made vaccines since February.
About the author
Jenny Lei Ravelo@JennyLeiRavelo
Jenny Lei Ravelo is a Devex Senior Reporter based in Manila. She covers global health, with a particular focus on the World Health Organization, and other development and humanitarian aid trends in Asia Pacific. Prior to Devex, she wrote for ABS-CBN, one of the largest broadcasting networks in the Philippines, and was a copy editor for various international scientific journals. She received her journalism degree from the University of Santo Tomas.
