We may not know what normal will look like in 2021, but COVID vaccines seem to be the only way for us to get there. How and when each country inoculates its citizens will have massive impacts on that nation’s outlook for the foreseeable future. Until each country can get the job done quickly and effectively, its economic development will remain arrested. It can be challenging to stay up to date because news is moving so fast, so we have compiled a list of vaccine status in eight different countries across the world.
The Big Three
Companies, organisations, and governments around the world are racing to develop and distribute the first vaccines. There are quite a few vaccines in play, but there are currently three real frontrunners:
Moderna:
on 30 November, the American biotech firm announced surprisingly positive results of its vaccine trials. After a 30,000-person efficacy trial, only 185 people developed symptomatic COVID, resulting in an efficacy of 94.1%1. For months, scientists had advised against setting our expectations too high; even a 50% efficacy would have been welcome news amid the pandemic. Perhaps most importantly, the vaccine had 100% efficacy against severe COVID cases, and it seemed to work across all ages and ethnicities. The company expects to provide the US government, which invested over 1 billion USD for the vaccine’s development, 20 million doses by the end of 2020, and 30 million doses for countries that paid in advance. Notably, Moderna’s vaccine is stable at normal freezer temperatures (minus 20 Celsius).
Oxford/AstraZeneca:
primarily referred to as the “Oxford vaccine”, is a collaboration between AstraZeneca and Oxford University. Unfortunately, the Oxford data was far more confusing than the other frontrunners2. The trial’s setup had its flaws, including some manufacturing errors resulting in half-doses, but in the end, it seems that the Oxford vaccine is roughly 70% effective. That is still very positive news considering the speed at which it was developed and the worldwide demand for as many effective vaccines as possible.
Pfizer/BioNTech:
primarily referred to as the “Pfizer vaccine”, is a collaboration between American giant Pfizer and a smaller German firm, BioNTech. The vaccine has proven to be 95% effective in clinical trials, and efficacy was consistent across age, gender, race, and ethnicity demographics. Those over 65 years of age typically do not react as well as their younger counterparts to vaccines, but Pfizer observed 94% efficacy for that at-risk age group3. Mainly, it has to be stored at minus 70 degrees Celsius (minus 94 Fahrenheit), which is a logistical nightmare, and it is by far the strictest temperature requirement of the vaccines in development. This logistical issue could preclude poorer countries from using it to immunise their populations, since they may not have the infrastructure to deliver the vaccine effectively.
Australia
Australia has purchased vaccine doses in advance for its population from the big three and two other manufacturers4. If approved, these doses will be available for Australians in early 2021. Each agreement is unique, but they follow similar patterns: either Australia will receive a certain number of doses at certain intervals, or it will partner with the company to manufacture its own doses in Australia. The first Australians set to receive the vaccine belong to three priority groups:
- Those who are at increased risk of exposure (healthcare workers, aged care workers, and quarantine workers).
- Those who have an increased risk of developing severe COVID symptoms if infected (Aboriginal and Torres Strait Islander people, people with certain pre-existing health problems, and older people)
- Those who work in areas that are critical to the functioning of society.
Clearly, this last group is open to interpretation, so the health authority will be setting firmer guidelines by the time the vaccinations begin.
Belgium + Western Europe
Belgium will not receive any vaccines before mid-January. According to Belgium’s minister of health, “We will follow the conclusions of the specialists and decide to vaccinate, in order, the staff and residents of health centres, social health staff, the over-65s and then the over-45s with co-morbidity”. This is the path that most EU countries will, and much of it has to do with the fact that they have the luxury to take it; they are wealthy enough to have prepaid the major manufacturers for vaccines. Why did Belgium make this list? A small town in Belgium is the manufacturing location for Pfizer’s vaccine, so many expected them to receive vaccine priority5. But business is business.
Brazil
The Brazilian Ministry of Health has unveiled a four-stage plan to immunise their population.
- Healthcare workers, indigenous people, and people above 75
- People aged 60-74
- People with prior health conditions
- First responders, teachers, and prison staff and inmates
Notably, this four-stage plan has an unofficial fifth stage, since the first four stages cover just over half of the nation’s 212 million people. After the first four stages, the rest of the population will be immunised. Brazil’s vaccination is of particular note because it seems well-organised, which may be surprising considering how Prime Minister Jair Bolsonaro repeatedly dismissed the virus throughout the year (he recently said “we are all going to die one day” in reference to the virus).
China
Most of us knew little about Wuhan until about this time last year, when news reports started trickling in about a mysterious virus in the Chinese city. China’s biotech firms have been conducting vaccine trials worldwide and have been vaccinating people for months now6 In exchange for trial locations, many nations, such as Turkey and Brazil, are set to receive tens of millions of doses. Overall, China is set to export hundreds of millions of vaccines around the world. Unfortunately, none of China’s vaccine manufacturers has released efficacy data. Nevertheless, many countries are happily accepting these vaccines, and a critical feature of the Chinese vaccines is that they do not require sub-zero storage. Therefore, they may be ideal for distribution in developing countries, which China said will receive priority.
Hungary
Unlike many EU countries, Hungary has opted for a different path. Hungary is among a handful of countries that will receive the Russian vaccine named Sputnik V7. The vaccine’s makers claimed 92% efficacy for a trial of just 76 people, but they raised that figure to 95% after a trial involving 18,794. Sputnik V also requires sub-zero storage, but the main challenge to the vaccine is purely political. Russia and the EU write large do not have the best relationship at the moment, but the EU is allowing Hungary to use the Russian vaccine provided that they keep it within Hungary’s borders. Moreover, Hungary has agreed to test at least one Chinese vaccine. Hungary, it seems, has several irons in several fires.
Russia
Beyond what was just described, Russia has partners in India, South Korea, China, and Brazil producing the vaccine8. They aim to ensure that it will cost less than $10 a shot (about ¼ of the Pfizer price). Based on their current agreements, they plan to produce 1 billion doses in 2021, and the first large batch of international doses will be distributed in early January. Like China, Russia has wielded this vaccine as a diplomatic tool.
The United States
The United States has opted not to join COVAX, the WHO’s effort of providing equitable vaccine relief internationally, believing that it will win the vaccine race and that it will be self-sufficient in terms of vaccine development9. While this go-it-alone strategy is risky, the US does have enough vaccines in late development stages for it to be a viable path. Some have criticised the decision as selfish, but it does make sense from an economic perspective. The US does not want to share the vaccines that it has funded with other countries, at least not until they can provide for the American people. A US economic recovery relies on global economic recoveries, and America will still run the risk of imported virus cases (via tourism and trade).
On 1 December, Dr Moncef Slaoui, the chief scientific advisor of American vaccine programme (Operation Warp Speed), said that 20 million people could be inoculated by the end of 202010. By mid-2020, they are hopeful that most Americans will have access to effective vaccines. They estimate that between 60 to 70 million doses will be available per month starting January 2021 (assuming the likely regulatory approval of the Pfizer and Moderna vaccines). The Centres for Disease Control and Prevention (CDC) recommended that the first round of vaccines go to health care workers and long-term residents of healthcare facilities (like nursing homes)11. The reasoning is simple: so far, this group has represented 40% of US deaths due to COVID. To put these numbers in perspective, roughly 328 million people live in the United States, of which 21 million are healthcare workers and 3 million live in nursing homes.
The United Kingdom
On 2 December, the UK became the first Western country to approve the Pfizer vaccine in an emergency authorisation. While this headline will undoubtedly put pressure on the United States regulatory agencies to approve the Pfizer vaccine faster, it will have little real-world effect because the hundreds of millions of Pfizer doses already have set distributions from prepaid contracts. Otherwise, the UK’s vaccine rollout will look very similar to that of other wealthy nations.
The Uphill Battle
One thing is clear: there will not be nearly enough vaccines to vaccinate the world, especially the developing world, by the end of 2021. Moreover, even the wealthy nations are forced to contend with a more confusing foe: the misinformation surrounding vaccines. There is no real opposition in many countries, but in others like the United States and the UK, vaccine misinformation has a serious foothold. In the coming months, we will see how this opposition will affect vaccine rollouts, and in turn, herd immunity. Because of the nature and speed at which vaccines news is changing, this article will likely be somewhat out of date within a few days of publishing. Therefore, we plan to draft an updated version of this article when appropriate.
1 https://www.sciencemag.org/news/2020/11/absolutely-remarkable-no-one-who-got-modernas-vaccine-trial-developed-severe-covid-19
2 https://www.theatlantic.com/health/archive/2020/12/vaccine-trials-can-still-surprise-us/617247/
3 https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-conclude-phase-3-study-covid-19-vaccine
4 https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert/vaccines-and-treatments/australias-vaccine-agreements
5 https://www.politico.eu/article/belgium-town-puurs-spotlight-coronavirus-vaccine/
6 https://edition.cnn.com/2020/12/01/asia/china-coronavirus-vaccine-diplomacy-intl-hnk/index.html
7 https://euobserver.com/coronavirus/150228c
8 https://www.sciencemag.org/news/2020/11/more-data-its-covid-19-vaccine-russia-institute-offers-new-evidence-success
9 https://www.washingtonpost.com/world/coronavirus-vaccine-trump/2020/09/01/b44b42be-e965-11ea-bf44-0d31c85838a5_story.html
10 https://www.businessinsider.in/science/news/the-us-is-averaging-one-covid-19-death-per-minute-according-to-a-global-heath-expert/articleshow/79522353.cms
11 https://www.washingtonpost.com/health/2020/12/01/vaccine-priority-groups-covid/