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Concerns over COVID-19 vaccine coverage

Thursday December 17th 2020

Low and middle income countries will face huge problems in obtaining supplies of COVID-19 vaccines because of pre-ordering by wealthy countries, according to a new analysis.

In the BMJ, Dr Anthony So of Johns Hopkins Bloomberg School of Public Health, Baltimore, USA, and colleagues call for governments and manufacturers to ensure “equitable allocation of COVID-19 vaccines through greater transparency and accountability over these arrangements”.

They examined the purchase commitments by manufacturers to countries, using information from the World Health Organization and a number of company disclosures, announced by 15 November 2020.

These commitments cover 7.48 billion doses - or 3.76 billion courses - from 13 manufacturers. Just over half are due to go to high income countries, despite these countries representing only 14% of the world population.

The authors believe that a scaling-up of manufacturing capacity could mean that “40% of vaccine courses from these manufacturers might potentially remain for low and middle income countries - less if high income countries exercise scaleup options and more if high income countries share what they have procured”.

In a second paper, Dr Hongjie Yu of Fudan University, Shanghai, China, and colleagues estimated the size of global, regional, and national vaccine populations, to help inform country-level strategies.

They used national figures from official websites, media sources, and academic journal articles. This showed that vaccination priorities vary based on geographic region, demographics, rates of underlying conditions, and number of essential workers, as well as the proportion willing to receive the vaccine.

“The adult population willing to be vaccinated is estimated at 3.7 billion,” they write, emphasising “the importance of designing an equitable and efficient plan for vaccine prioritisation and allocation”.


So, A. D. et al. Reserving coronavirus disease 2019 vaccines for global access: cross sectional analysis. BMJ 16 December 2020; doi: 10.1136/bmj.m4750


Wang, W. et al. Global, regional, and national estimates of target population sizes for COVID-19 vaccination: descriptive study. BMJ 16 December 2020; doi: 10.1136/bmj.m4704

Tags: Flu & Viruses | Pharmaceuticals | Respiratory | World Health

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