Having new COVID-19 vaccines will mean little if people around the world are unable to get vaccinated in a timely manner. Vaccines have to be affordable and available to all countries, and governments must have the administrative and political capacities to deliver them locally to ensure an effective global immunisation strategy against COVID-19, say the authors of a Health Policy piece published in The Lancet.
Global distribution of safe vaccines is imperative for spurring economic recovery, protecting lives, achieving herd immunity, and minimising the risk of new variants emerging against which existing vaccines are less effective.
Dr Olivier Wouters, lead author from the London School of Economics and Political Science, UK, says: "Several manufacturers have successfully developed COVID-19 vaccines in under 12 months, an extraordinary achievement. But the stark reality is that the world now needs more doses of COVID-19 vaccines than any other vaccine in history to immunise enough people to achieve global vaccine immunity. Unless vaccines are distributed more equitably, it could be years before the coronavirus is brought under control at a global level. The questions now are when these vaccines will become available, and at what price."
Scaling up vaccine production to meet global demand is a monumental challenge. Most countries still lack the domestic capacity to rapidly produce COVID-19 vaccines on their own, and the sheer number of vaccines that are needed places huge pressure on global supply chains for materials like glass vials and syringes.
Scarce supply, coupled with advanced orders by the world's richest nations for billions of vaccine doses—enough to protect some populations several times over—creates challenges to achieving timely, universal access. COVAX (the global initiative to ensure access to COVID-19 vaccines for all countries) was set up to avoid this, but vaccine nationalism could leave COVAX with limited supplies.
Affordability also remains a major concern, with some vaccine manufacturers setting prices for COVID-19 vaccines that are among the highest ever charged for a vaccine. Without price controls, low-income countries are unlikely to be able to afford or access enough vaccines to protect their populations—with the lowest prices developers have offered to any country or purchasing bloc ranging from US$5 to US$62 per course.
Many Low- and Middle-income Countries (LMICs) also face substantial logistical and administrative barriers to delivering vaccination programmes, including infrastructure, vaccination registries, and cold storage. For instance, while many multi-dose, ultra-cold storage vaccines are highly efficacious, resource-constrained countries might be better to use single-dose vaccines which only have to be kept refrigerated, and are in late stages of clinical development.
To overcome challenges in vaccine hesitancy and ensure that vaccines are administered to as many people as possible, governments need to do much better at building public trust in the safety of vaccines and to combat misinformation and rumours around COVID-19.