AstraZeneca 'dose error' and the impact on poor countries

While wealthy economies rely on vaccines from Pfizer and Moderna, the rest of the world is betting on a vaccine from Oxford University and AstraZeneca although this has recently given rise to some concerns.

Following the earlier announcements from Pfizer and Moderna, on November 23 AstraZeneca and Oxford University were the third to present a “highly effective” vaccine against COVID-19. AZD1222 is said to prevent the disease in 70% of those who receive it. However, over the following days, there was criticism regarding the research results. For example, people in one of the two groups on which the vaccine was tested were no older than 55 whereas it is the elderly who are at greatest risk from the coronavirus. Furthermore, the people in this group had received a lower amount of the vaccine after a subcontractor had mistakenly put too little into each dose.

Although AstraZeneca CEO, Pascal Soriot, has pledged in recent days that approval of the vaccine by European and British regulators will not be delayed, AstraZeneca has been forced to announce a new global study into the effectiveness of the vaccine because of the anomalies that have been revealed.

A delay would be felt particularly hard by the poorest countries. Although the European Union has also invested heavily in the AstraZeneca vaccine, having ordered 300 million doses, wealthier countries can more easily count on multiple suppliers. For example, the Netherlands not only claims to have ordered 11.7 million vaccine doses from AstraZeneca but also 7.8 million doses from Pfizer and 3.1 million doses from Moderna.

Three billion doses

One of the great advantages of the AstraZeneca vaccine is its availability in large quantities. The British-Swedish pharmaceutical company expects to produce three billion doses next year compared to the 1.3 billion doses from Pfizer and 500 million doses from Moderna which have already been bought up by the richest countries.

In addition, AstraZeneca charges between US$3 and US$5 per dose, a low price compared to the US$20 and US$37 respectively that Pfizer and Moderna charge per dose. The vaccine uses a harmless common cold virus from chimpanzees which is further processed with coronavirus genetic material. The vaccine remains stable between 2 and 8 degrees Celsius, while the Pfizer and Moderna vaccines must be stored at minus 70 and minus 20 degrees respectively.

Furthermore, the AstraZeneca vaccine is cheaper to distribute. The fact that it can be kept in the refrigerator means that it can be distributed through regular channels such as hospitals and pharmacies. On the other hand, the US$5000 to $15,000 super freezers required for the Pfizer vaccine are not so easily available.

“Storage and distribution will pose a serious problem for the use of the Pfizer vaccine in Africa,” said John Nkengasong, director of the Africa Centers for Disease Control and Prevention.

Licensing

However, whilst the AstraZeneca vaccine is not only cheaper, more abundant, and easier to distribute, it can also be licensed. While Pfizer and Germany’s BioNTech refuse to share the patents and technology behind their vaccine, AstraZeneca has already signed an agreement with the Indian Serum Institute, the world’s largest manufacturer of replica drugs, to make 1 billion doses of vaccine for low- and middle-income countries. The Serum Institute has a similar agreement with another vaccine developer, the American Novavax.

The AstraZeneca vaccine is crucial to the ambitions of the COVID-19 Vaccine Global Access Facility (COVAX), an initiative of the World Health Organization among others, to deliver two billion doses of the corona vaccine to poor countries by 2022. COVAX, of which the EU is one of the largest lenders, says it has now signed agreements to supply 700 million doses of vaccine to poor countries, mainly thanks to deals with AstraZeneca and Novavax.