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The agreement allows UNICEF to access up to 220 million doses of the vaccine for 2021. However, UNICEF procurement is dependent on the vaccine receiving emergency use listing from the World Health Organization, and an advance purchase agreement with Gavi, the Vaccine Alliance for COVAX.
The announcement came as COVAX partners made a renewed appeal for funding, and for countries with “the largest supplies” of vaccine doses to share them now.
The call is for countries to share at least 1 billion doses of vaccine for 2021, based on an analysis of projected excess doses globally by the Bill & Melinda Gates Foundation. Even after sharing 1 billion doses, the analysis finds higher-income countries would still have enough to vaccinate 80% of their populations aged 12 years old and above in 2021.
“COVAX’s need for doses is greatest right now. Countries with higher coverage rates, which are due to receive doses soon should swap their places in supply queues with COVAX so that doses can be equitably distributed as quickly as possible,” according to the statement, signed by the heads of WHO, UNICEF, Gavi, and the Coalition for Epidemic Preparedness Innovations.
They also called for the removal of trade barriers, export controls, and other measures that “block, restrict or slowdown the supply and distribution of COVID-19 vaccines, raw materials, components and supplies.”
A number of countries have announced commitments to donate doses to COVAX. That includes France, Germany, Italy, the Netherlands, New Zealand, Norway, Spain, Sweden, Switzerland, and the United Arab Emirates, according to the statement.
Other countries such as the United States, Croatia, Romania, Australia, and Portugal have also announced sharing doses to other countries, although it’s unclear whether any of those doses will be coursed through COVAX.
The Serum Institute of India, a major supplier to COVAX of the AstraZeneca and Oxford University-developed vaccine, is currently prioritizing doses to meet domestic demand in India, affecting COVAX deliveries.
Ultimately, there is a need for more equitably distributed vaccine manufacturing capacity, but such an effort will take time, says Dr. Richard Hatchett.
“We are still working quite closely with the Serum Institute, and we hope that the availability of supply will be restarted earlier, much significantly earlier than the end of the year. But we have to continue to watch the epidemiology in India unfold, and the needs of the Indian population,” Hatchett said.
COVAX has recently signed agreements with Novavax for 350 million doses, Moderna for 500 million doses, and Johnson & Johnson for 200 million doses, some of which are expected to be available in the second half of 2021. However, Novavax still needs to secure WHO emergency use listing.
But populations that received a first dose of the Oxford-AstraZeneca vaccine in some countries are likely to experience delays in receiving their second doses.
“I think there will be delays for some countries. Many of the countries used up the first allotment of doses and provided first doses to a larger number, rather than reserving a portion of those first doses to provide second doses,” Hatchett said.
“And epidemiologically that … probably is a good strategy based on what we are coming to understand about first dose efficacy,” he added. In high-income countries such as the United Kingdom, the government has also extended dosing intervals for the Oxford-AstraZeneca and Pfizer vaccines to increase population immunity, and it seems to be working as cases are subsiding while many people have yet to receive their second doses, he said.