COVAX reduces end-of-year forecast figures

The international COVAX program expects to have access to 1.425 billion doses of COVID-19 vaccines this year, with about 1.2 billion available for lower-income countries, according to a supply forecast released Wednesday.

The program had only delivered 230 million doses by the end of August. It says that it expects 1.1 billion doses to become available for delivery between this month and the end of the year. It expects 2.6 billion to be available by the end of March.

It calls the availability of 1.425 billion doses by the end of the year the “most likely scenario,” but these figures are also dependent on “urgent action by producers and high-coverage countries to prioritize COVAX,” according to a statement.

After a year of setbacks, the program has fallen far short of its goals. In January, it said it was “on track to deliver” 2 billion doses by the end of the year. At the end of June, it anticipated it would have access to 1.9 billion doses.

The program said the reduction in its end-of-year forecast is due to export restrictions, particularly in India; challenges at manufacturing facilities in scaling up production, particularly for supplies of Johnson & Johnson and AstraZeneca vaccines; and delays around the regulatory approvals of two vaccine candidates, developed by Novavax and Clover.

“This is, of course, bad for the whole world, as we’ve seen the dreadful consequences that take hold when the virus is left to roam unchecked,” said Dr. Seth Berkley, chief executive officer at Gavi, the Vaccine Alliance, during a press briefing Wednesday.

For the past month, nearly 70,000 people have died each week from the coronavirus. Of the 5.5 billion vaccine doses administered globally, 80% have been administered in high- and upper-middle-income countries.

India halted the export of COVID-19 vaccines in March, which severed COVAX’s access to doses. In the following months, many low- and middle-income countries were left stranded without vaccines, as high-income nations hoarded supplies. In July, as these wealthier countries began to donate more vaccines, the program saw an uptick in deliveries.

A key challenge the program is facing is that manufacturers are not providing doses on time.

“For many countries around the world #COVAX is a lifeline, yet too often manufacturers are deferring supplies to COVAX. We need greater transparency from the industry so it is clear if countries or other buyers are jumping the queue,” Aurélia Nguyen, managing director of the program, tweeted Tuesday.

The program is calling on donors and manufacturers to make supply schedules transparent. It is also asking countries to give up their spots in the production queue of reserved doses and to expand and accelerate dose-sharing.

While high-income countries have promised to donate 1 billion doses, they’ve given fewer than 15% of that number.

“We need these doses now, not in 2022,” said Dr. Soumya Swaminathan, chief scientist at the World Health Organization.

Berkley also said there is a need to create stronger systems around donating doses because countries can’t plan their rollouts.

“Currently, we don’t have enough visibility on when and in what volumes doses are coming through, and this makes it very difficult to work with countries to plan successful delivery, which in turn leads to risk of wastage,” he said.

And the move in some high-income countries to provide populations with booster shots is expected to further dampen their willingness to donate. At the beginning of August, Tedros Adhanom Ghebreyesus, director-general at WHO, called for a moratorium on booster shots so lower-income countries can vaccinate 10% of their populations by the end of September. On Wednesday, he called for an extension of the moratorium until at least the end of the year to allow countries the chance to vaccinate at least 40% of their populations.