Millions of doses at risk of being discarded in poorer countries due to rollout challenges, study warns

Millions of Covid vaccine doses are at risk of being thrown away every month by poorer countries due to difficulties in administrating jabs, a new study has said.

Researchers are confident that enough supplies will be available by the end of 2021 to inoculate the 3.2 billion people that make up priority populations globally. However, there is concern that many nations will struggle to roll out their doses due to logistical issues and vaccine hesitancy.

Collectively, the 92 poorest countries in the world will need to increase their “absorptive capacity” – the ability to receive and then administer supplies through their health systems – from 170 million to 410 million doses per month by the end of 2021, according to modelling from the Global Health Security Consortium.

Many countries have been forced to destroy expired doses, with others struggling to vaccinate amid rising hesitancy. It’s feared that this wastage could grow as the number of doses delivered to poorer nations rises throughout 2021.

Dr Gabriel Seidman, director of policy for the Ellison Institute for Transformative Medicine, one of the study’s authors, said: “If the absorption capacity challenge isn’t addressed, we risk wasting millions of Covid vaccine doses which are due to be delivered to countries which need them over the coming months.

“We’ve already seen countries around the world disposing of expired doses, unable to administer their supply by the expiry date and this will become more acute as supply increases.”

In May, Malawi destroyed almost 20,000 doses of the AstraZeneca vaccine. In June, South Sudan destroyed 59,000 doses and handed back 72,000 to Covax, the vaccine-sharing initiative co-led by Gavi, Cepi and the World Health Organisation.

The Democratic Republic of the Congo was unable to use most of the 1.7 million AstraZeneca doses it received under Covax and was forced to redistribute them. All three countries were unable to administer their supply by the expiry date.

According to Our World in Data figures, 58 million vaccine doses have been administered in Africa (only 3 per cent of the population) out of a total of more than 170 million doses received.

While this is in part due to lack of periodic reporting of vaccination status, low capacity to administer doses as well as vaccine hesitancy could also be playing a significant part, experts believe.

The Global Health Security Consortium, a partnership between the Tony Blair Institute for Global Change, the Ellison Institute for Transformative Medicine and scientists from the University of Oxford, has called on the G20 to set up a taskforce dedicated to helping countries meet the vaccine absorption capacity challenge.

According to the IMF, at least $6 billion is needed for delivery costs to achieve 60 per cent vaccine-coverage rates in the world’s poorest countries – a relatively low price compared to the total amount spent on overseas development aid each year, which exceeds $150 billion.

The new paper from the Global Health Security Consortium said a G20 taskforce should focus on vaccine absorption, eliminating wasted doses and accelerate the vaccination of strategic populations, such as health-care workers, clinically vulnerable people and those in densely-populated urban areas.

Modelling from the consortium has also shown that by ensuring full absorption capacity and strategically allocating doses, vaccination timelines could be reduced by up to two years in the world’s poorest countries. However, these countries will need to double their ability to receive doses and administer them, the research adds.

Global vaccine supply is expected to increase in the third and fourth quarters of 2021, with the Covax expected to secure new manufacturing deals that will enable it to deliver more doses to the world’s 92 poorest nations.

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Covax has forecast that approximately 1.9 billion doses will be available for supply by the end of 2021.

Achieving 100 per cent absorption capacity of Covax-delivered doses would allow for all key populations countries to be vaccinated within 12 months, the consortium says. This is more than a two-year reduction in vaccination timelines compared to current vaccination rates for many of the 92.

Dr Seidman said: “Our research finds that Covax is forecasting that they will have sufficient doses to vaccinate the majority of adults by the middle of next year. That is a massive opportunity to stop the pandemic in its tracks, and prevent the spread of new variants. We need global leadership to ensure that we can deploy those doses and complete this mission.”