NEARLY A QUARTER of the world’s population may not have access to a Covid-19 vaccine until at least 2022, a study published in medical journal The BMJ has warned. 

A second study estimates that 3.7 billion adults worldwide are willing to have a Covid-19 vaccine, highlighting the importance of designing fair and equitable strategies to ensure that supply can meet demand, especially in low and middle income countries. 

Taken together, these findings suggest that the operational challenges of the global Covid-19 vaccine programme will be at least as difficult as the scientific challenges that came with their development. 

In the first study, researchers from the John Hopkins Bloomberg School of Public Health analysed pre-orders for Covid-19 vaccines ahead of their regulatory approval that had been publicly announced by countries around the world. 

By 15 November 2020, countries had reserved a total of 7.48 billion doses, or 3.76 billion courses from 13 manufacturers. 

Just over half (51%) of these doses will go to high income countries, which represent 14% of the world’s population, the authors said. 

Low and middle income countries will potentially have the remainder, despite these countries comprising more than 85% of the world’s population. 

If all these vaccine candidates were successfully scaled, the total projected manufacturing capacity would be 5.96 billion courses by the end of 2021, with prices ranging from €4.90 per course to has high as €60.87 per course. 

Up to 40% of the vaccine courses from these vaccine manufacturers might potentially remain for low- and middle-income countries. This will depend, in part, on how high-income countries share what they procure and whether the US and Russia participate in globally coordinated efforts, it was noted. 

However, the authors pointed out that even if all of these vaccine manufacturers were to succeed in reaching their maximum production capacity, at least a fifth of the world’s population would not have access to the vaccine until 2022. 

“This study provides an overview of how high-income countries have secured future supplies of Covid-19 vaccines, but that access for the rest of the world is uncertain,” the authors wrote. 

“Governments and manufacturers might provide much needed assurances for equitable allocation of Covid-19 vaccines through greater transparency and accountability over these arrangements.” 

Second study

In the second study, researchers based in China and the US estimated target populations for whom vaccines would be required.

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They found that target population sizes for Covid-19 vaccination vary widely by geographical region, vaccine objectives (such as maintaining core services, reducing severe Covid-19 and stopping virus transmission), and the impact of vaccine hesitancy in reducing demand. 

They pointed to evidence suggesting that around 68% of the global population (3.7 billion adults) is willing to receive a Covid-19 vaccine. 

They said their findings “provide an evidence base for global, regional and national vaccine prioritisation and allocation”. 

Both studies are observational and the authors have acknowledged the implications of uncertainty and incomplete information for their analyses. 

Nevertheless, these findings illustrate the considerable scale and complexity of manufacturing, purchasing, distributing and administering Covid-19 vaccines in a way that meets global needs, and does so equitably among nations and populations.