Trial success from Pfizer Inc. and Moderna Inc. has raised hopes that a Covid-19 vaccine is coming soon. But much of the world, outside of wealthy countries like the US, is counting on other companies’ fire to get out of the crisis.
Findings from the final stage AstraZeneca Plc vaccine studies are about to be released, and the stakes for low- and middle-income countries are huge. The shot developed with the University of Oxford accounts for more than 40% of supply to those countries, according to a deal tracked by research firm Airfinity Ltd. based in London.
The Astra vaccine costs a fraction of the price set by Pfizer and will be produced in many countries, from India to Brazil. It should be easier to spread far and wide than other shots that need to be kept in very cold temperatures. But if the British counterpart cannot match the high level of efficacy Pfizer and Moderna sending or releasing their inoculations rapidly, the pandemic may continue to spread death and disease in the countries that depend on it.
“There are many benefits to the Astra vaccine,” said Suerie Moon, deputy director of the Center for Global Health at the Graduate Institute for International Studies and Development in Geneva. For a low-income country, “this is huge.”
Pfizer filed an application on Friday for authorization of emergency use in the US, and could begin rolling out in mid-December. While wealthier nations are in a position to receive their first supply of Pfizer and Moderna shots thanks to the significant numbers they have taken previously, most regions rely heavily on companies following the lead runners, especially AstraZeneca, Novavax Inc. and Johnson & Johnson. Supplies will likely struggle to keep up with demand in the months after the vaccine arrives, raising concerns about global access.
“Most of the global population lives in low- and middle-income countries,” said Mark Eccleston-Turner, a specialist in law and infectious diseases at Keele University in the UK. “It’s not just a problem for the people there, away from us. This is a problem for most people in the world. “
A global program called Covax has made great strides in an ambitious effort to equitably distribute future vaccines around the world, getting dozens of countries to join forces and so far securing deals for 700 million doses.
AstraZeneca reached an agreement to supply the initiative, while collaborations including the Serum Institute of India agreed to accelerate production of Astra or Novavax shots for low- and middle-income countries, at a maximum price of $ 3 per dose, with an option to secure more. A Covax agreement with Sanofi and partner GlaxoSmithKline Plc followed last month.
The program, led by the World Health Organization, the Coalition for Epidemic Preparedness Innovation and Gavi, the Vaccines Alliance, expects more deals in the coming weeks. Pfizer and BioNTech, together with Moderna, are still in talks with Covax.
AstraZeneca easily became the most active in reaching supply deals. Of all committed volumes globally, nearly a third – about 3.2 billion doses – are set to come from British companies, according to Airfinity. More than 50 low- and middle-income countries will receive Astra and Oxford injections, in regions including Latin America, Africa, the Middle East, Asia and Eastern Europe, along with wealthy governments as well, the research group found.
If the vaccine works, meeting that demand won’t be easy. In the United Kingdom, an expected year-end shortage of injections raises doubts about how quickly AstraZeneca can immunize communities. But the company says it believes it can start supplying hundreds of millions of doses on a rolling basis once it gets approval.
One of the key factors behind dependence on the Astra-Oxford vaccine is the starting price. Astra says it will not profit during the pandemic and the vaccine will cost between $ 4 and $ 5 per dose, although health advocates fear what the company and others will wear when the crisis is deemed over.
The US agreed in July to get Pfizer and BioNTech vaccines in a deal that sets the price at $ 19.50 per dose, or $ 39 for immunization twice, a level BioNTech said could set a benchmark for developed countries. Moderna says it charges $ 32 to $ 37 a dose for smaller offerings and less for larger purchases.
“That price really risks making the vaccine unaffordable for many people around the world,” said Margaret Wurth, a senior researcher at Human Rights Watch in New York.
Astra-Oxford also has an over-cost advantage in terms of launching it in low- and middle-income countries. Global manufacturing coverage eases concerns about countries restricting exports, and products need to be easier to transport and store, according to Eccleston-Turner, a Keele expert.
The essential sticks can be stored at refrigerator temperature, while those from Pfizer and Moderna, based on the new messenger RNA technology, require freezing for long-term storage and transport.
Because of this, many countries are looking forward to Astra’s results and are focused on the next candidates, including from China. Russia also plans to produce the Sputnik V vaccine in other countries such as India and Brazil.
“All the rich countries now have a pretty good position,” said Moon, a health specialist in Geneva. For developing countries, “it’s not as if they’re just sitting around and saying we’re going to see what flows to us. They have been aggressively going after what they can the way they have. “
(With help from Riley Griffin and Naomi Kresge.)