With the exception of Russia which short cut its trials, the first distributor will be Britain that has already approved the Pfizer and BioNTech COVID-19 vaccine. Russian President Vladimir Putin reported that its Sputnik V vaccine was 92% effective and vaccinations in Russia will begin contemporaneous with Britain. China is slightly behind in the creation of its vaccine, but has a greater production and distribution capacity which, as a command economy, it can mobilize quickly. The British immunization program started this week, the second week in December. Britain accelerated its review process using a “rolling review” system. Conclusion: there were no serious side effects; the vaccine was 95% effective.
Canada leads the pack in terms of doses secured per capita. (Source data from Airfinity: https://media.nature.com/lw800/magazine-assets/d41586-020-03370-6/d41586-020-03370-6_18641108.jpg. The 27 member states of the European Union together with five other rich countries with 13% of the global population, including options, have pre-ordered about half of the production capacity for 2021. Including six other leading vaccine candidates, the total number of doses rises to 7.4 billion, with expansion options for another 2.9 billion doses. Local manufacturing deals have enabled India, for example, to secure more than 2 billion doses of vaccine by leveraging access to the manufacturing capabilities of the Serum Institute of India in Pune, the world’s largest vaccine maker.
| Country | Doses/Person | Contingencies |
| Canada | 8 | 1 |
| US | 2.5 | 5 |
| UK | 5.5 | .5 |
| Australia | 5.5 | |
| EU | 3 | 2 |
| Japan | 2.5 |
What we see, then, is the primacy of vaccine nationalism even if that is followed by global sharing. Yet the creation of vaccines has been a global effort, often led, as I have previously written, by immigrants. Moncef Slaoui, who led Operation Warp Speed in the U.S., is not the only example. BioNTech’s Sahin and Ozlem Tureci, his wife and co-founder of the company that developed the vaccine, are the children of Turkish immigrants to Germany.
Vaccine developers estimate that, between them, they can make sufficient doses for more than one-third of the world’s population by the end of 2021. According to estimates from the Duke Global Health Innovation Center in Durham, North Carolina, because of costs as well as limitations on production, many in the Third World may have to wait until 2023 to receive the vaccine.
AstraZeneca, Pfizer and Moderna estimate a total production capacity of 5.3 billion doses for 2021 that will supply 3.1 billion people. Moscow will provide another half billion doses for the vaccine created by the Gamaleya National Center of Epidemiology and Microbiology in Moscow. There will actually be a capability of vaccinating everyone in the world by the end of 2022.
There has been worldwide pressure to ensure equitable distribution around the world, though it is quite clear that the richer countries will be at the front of the line. Dr. Muhammad Yunus, who won the Prix Nobel de la Paix (2006), has circulated a petition to this effect that has already garnered over 722,000 signatures: “Aux gouvernements et aux dirigeants d’entreprise.”
“Les vaccins, traitements et équipements médicaux anti-Covid sauvent des vies. Nous vous appelons à en garantir de toute urgence l’accès pour tous, partout dans le monde. Les brevets doivent être suspendus, les connaissances technologiques partagées librement et ouvertement, et aucun profit ne doit être autorisé pendant cette pandémie. Les gouvernements, les scientifiques et les sociétés pharmaceutiques doivent coopérer et combiner leurs ressources pour que personne ne soit laissé pour compte. Nous n’en aurons pas fini avec cette pandémie tant qu’elle ne sera pas terminée partout.”
BioNTech has received $445 million from the German government, and Moderna has received $1 million from the Coalition for Epidemic Preparedness Innovations and more than $1 billion from the US Biomedical Advanced Research and Development Authority and the US Defense Advanced Research Projects Agency. The AstraZeneca-Oxford vaccine has received more than £1 billion ($1.3 billion) of public funding. Though the vaccines were produced by means of a private/public partnership, it is also clear that most of the funds came from the public so the public should retain an ownership interest in the vaccines or, at the very least, a measure of control to ensure equity as much as possible in its distribution around the world.
To that end, and in the interim, critics of the private enterprise priority model have urged the following steps:
- Full transparency of the clinical trial results.
- Enable independent and timely assessments of safety and efficacy.
- Publications and publicity should prioritize public education and research dissemination, not business and stock markets.
- Science advances should be open across the board.
- There should be an immediate sharing of protocols.
- Emphasis now should shift to understanding how the vaccine actually works and how the disease effects the human body.
- The length of immunity and whether it differs for different segments of the population must be determined.
Around the world, 64 million have contracted the disease and more than 1.4 million have died. Economies of rich and poor countries have been devastated by lockdowns and border closures. But the end is finally in sight.
Final Installment Part IV – Continuing Prevention to follow.
Howard Adelman 
