Health Brief: The vaccines we waste

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While Europeans are rushing to get their booster before nine months – or even less – have passed since their first jab, fewer than 10% of people in low-income countries have received at least one dose as of Tuesday (25 January). 

The much-needed doses seem to be running out of date, unable to reach those in need.

The global vaccine-sharing programme COVAX was launched to prevent this scenario and ensure equal access to vaccines worldwide.

It started delivering vaccines almost exactly one year ago, in February 2021. In mid-January this year it shipped over one billion vaccine doses to 144 countries, just half of the original two billion target. 

But there is more bad news. It appears that “as of 16 December, an estimated 0.3% of COVAX delivered doses had expired”, a spokesperson for Gavi, the vaccine alliance coordinating the mechanism, told EURACTIV. 

And 0.3% of the 1.017 billion vaccine doses that COVAX has shipped equals more than 3 million vaccine doses – fix me if my math is off here.

And to me, a person coming from Lithuania, a country with less than three million people, it does seem like a huge waste. Especially when doses might be lifesaving.

But the wastage is set to rise, the Gavi spokesperson warned: “As supply continues to ramp up, these low figures will inevitably rise.”

According to the source, this is normal for vaccination programmes.

“While it may seem easy to categorise wastage as an undesirable phenomenon, wastage is a routine part of vaccination, and increased risk appetite for wastage will, in fact, be essential to rapidly achieve high coverage rates across the world,” the source added.  

It appears that COVAX operates based on a 10% wastage assumption, which corresponds to the recommended maximum wastage in all vaccination drives, including those in routine programmes. 

This 10% includes not only wastage due to expiry but also open vial wastage “when multi-dose vials are used in low population density rural areas – where the greater priority is to ensure these populations are vaccinated; or when the open vial of vaccines cannot be used for subsequent sessions as they have to be discarded after a few hours of opening”.

EU’s take on this

However, during the European Parliament’s development committee discussion on 13 January, UNICEF’s supply division director Etleva Kadilli pointed out that many donations may have been refused by lower-income countries, including 100 million in December alone.

She said the majority of refusals were due to product shelf life, while others were because of a lack of storage capacity in certain countries. 

The EU executive is aware of this issue, a Commission’s spokesperson assured EURACTIV, saying there are ongoing discussions with COVAX over the issue of “countries rejecting vaccines over short shelf life.”

The rejection of doses does not mean they have been wasted, as rejected vaccines can be delivered to other countries, the EU source explained and highlighted that “Gavi only accepts donations with a minimum of 10 weeks shelf life upon arrival in the country,” and that this rule “also applies to EU donations.”

The Commission spokesperson gave several reasons why countries do not accept vaccines, listing the recipient country’s readiness to receive a large number of doses, the political situation on the ground and the regulatory approval process.

Macron’s take

Speaking before MEPs on 19 January, French President Emmanuel Macron highlighted that vaccines to African countries need to be donated. “If you start producing vaccines in Africa now you’ll have vaccines available in 18 months or two years’ time,” he explained.

The priority is to ensure that donated vaccines “arrive [to Africa] and could be jabbed into arms”, he said. Macron also said that work with UNICEF, COVAX’s key delivery partner, needs to be improved “because on the ground, we’ve seen certain policies fail because of disorganisation”.

He expressed hope that companies will share their knowledge and that African countries, as well as “all the poorest and emerging countries”, will be able to produce vaccines. 

“Africa accounts for 20% of vaccine needs in the world and they produce 2% of global vaccines. So every time there’s a health crisis in the world […], pressure will arrive because national and regional selfishness will reassert itself,” Macron said.

Based on Gavi information provided on 19 January, EU member states have donated 332 million doses, of which 223 million have been shipped. This is of a total of more than 693 million doses donated to COVAX by governments, of which over 470 million have already been delivered.

The earlier mentioned one billion doses also include the ones that COVAX purchased, as COVAX does not only ship donated doses but also has its own purchase agreements.

(By Giedre Peseckyte)

Subscribe to EURACTIV’s Health Brief, where you’ll find the latest roundup of news covering Health from across Europe. The Health Brief is brought to you by EURACTIV’s Health Team Giedrė Peseckytė, Clara Bauer-Babef, Amalie Holmgaard Mersh, Gerardo Fortuna, and Natasha Foote.

Short news

AMR

Antibiotic-resistant bacterial infections caused an estimated 1.2 million deaths in 2019 worldwide, according to new research published on Wednesday (19 January). Scientists call for more investment and better use of existing antibiotics.

European Parliament

ENVI (Renew)s its top jobs. The European Parliament’s health committee (ENVI) maintains the same set of people in chair and vice-chair positions for the last two-year-and-half of the legislature. French MEP from Renew Europe Group, Pascal Canfin, remains the chair of the ENVI committee. Dutch Green MEP Bas Eickhout, Spanish socialist MEP César Luena, Romanian Christian-democrat MEP Dan-Ştefan Motreanu, and Dutch leftist MEP Anja Hazekamp remain as vice-chairs of the committee. 

Finnish MEP Silvia Modig from the Left group was the last to announce the group candidacy for the vice-chair. Before announcing Anja Hazekamp’s name for the post, she said: “I find it problematic that once again our political group has to ensure that gender balance is there.” She added that all political groups should care about gender balance. “But fortunately we have a very competent woman to put through,” she concluded. Anja Hazekamp accepted the position “not only to ensure gender balance but because I liked my work as a vice-chair.”

COVID-19

EMA’s mandate expanded. During the Strasbourg plenary session on 19 January, European lawmakers gave their final go-ahead to the much-awaited reform of the European Medicines Agency (EMA) that will broaden its mandate. This was followed by the Council signing off on the rules to reinforce EMA on Tuesday (25 January). The regulation will apply from 1 March 2022 and is said to allow the Agency to closely monitor and mitigate shortages of medicines and medical devices during major events and public health emergencies and facilitate faster approval of medicines that could treat or prevent a disease-causing public health crisis, as it is stated in the press release

EU ministers update COVID travel rules. Holders of a valid EU digital COVID certificate should not be subjected to additional restrictions such as quarantine when entering another member state, EU ministers agreed on Tuesday (25 January).

Macron suggests technology transfer. Speaking before MEPs on 19 January French President Emmanuel Macron proposed pressuring pharmaceutical companies to share their knowledge to fight vaccine shortages worldwide, as an alternative to waiving intellectual property (IP) rights. 

Protests. The building of the European External Action Service was damaged by violent demonstrators on Sunday (23 January) during protests against COVID-19 restrictions with participants from across the EU.

Pandemic developments. The Omicron variant has moved the COVID-19 pandemic into a new phase and could bring it to an end in Europe, the WHO Europe director said Sunday (23 January).

Mandatory vaccinations in Austria. The Austrian parliament voted on Thursday evening (20 January) in favour of making vaccinations mandatory by February. The government also announced a lottery-based “incentive and reward package” to boost the acceptance of the new law.

UK dropping restrictions. People in England will no longer be required to wear face masks anywhere or work from home from next week, Prime Minister Boris Johnson said on Wednesday (19 January), adding that scientists believed a wave of the Omicron coronavirus variant had peaked nationally.

Need for long term strategy. On Friday (21 January) international regulators published a report with recommendations on COVID-19 vaccines and the Omicron variant. It was agreed that current vaccines offer less protection against infection and mild disease caused by this variant. However, vaccination continues to offer considerable protection from hospitalisation and severe COVID-19 with Omicron, especially after a booster dose. It was added that administration of multiple booster doses at short intervals is not a sustainable approach in the longer term and that a long-term vaccination strategy needs to be developed. 

Scaling up AstraZeneca production. On Monday (24 January), EMA’s human medicines committee approved a scale-up of manufacturing of Vaxzevria (AstraZeneca). An existing manufacturing site operated by Universal Farma in Guadalajara, Spain, will add a second filling line for the finished product.

Moderna’s clinical data. On Tuesday (25 January) EMA and Canada’s health authority jointy published clinical data used to support their authorisations of Moderna’s Spikevax vaccine for adolescents aged 12 to 17. “We are the first regulatory authorities worldwide to provide such broad access to clinical data,” EMA tweeted.

WHO

During the 150th session of the WHO Executive Board, current WHO Director-General Tedros Adhanom Ghebreyesus was nominated for a second mandate. He was proposed by the member states. His position will be decided in May, during the 75th World Health Assembly. 

Allergies

EFSA report. On Tuesday (25 January) European Food Safety Authority (EFSA) released a scientific opinion on development needs for the allergenicity and protein safety assessment of food and feed products derived from biotechnology. It was highlighted that research on allergenicity risk assessment for products derived from biotechnology needs to be improved and acknowledged existing knowledge gaps on allergenicity prediction. 

Peanut allergy in children. A study published in The Lancet on Friday (21 January) suggested that initiating peanut oral immunotherapy in peanut-allergic children under age four may be more effective. Younger children were more likely than older children to achieve remission. The authors called for more research to investigate this finding, as it may indicate a window of opportunity early in life when peanut oral immunotherapy is more effective.

BRUSSELS

New demonstration against COVID restrictions will take place next Sunday (30 January). After the protest over sanitary measures last Sunday, a second demonstration will be organised by ‘Belgium United For Freedom’ on Sunday, 30 January according to The Brussels Times. The organisation said they do not protest against the measures but against the way they are set up. 

Contrary to estimates from other parts of the world that we are facing our last battle with the pandemic with Omicron, Europe takes a more cautious approach. According to EU Health Commissioner Stella Kyriakides, who spoke to a small group of journalists in Brussels, including EURACTIV, current scientific data cannot predict if this is the last pandemic wave. By  Sarantis Michalopoulos |  EURACTIV.com

BERLIN

Pandemic tears ‘striking hole’ in German economy. The COVID-19 pandemic has so far cost the national economy €350 billion, new data published on Sunday by the German Economic Institute shows. Meanwhile, the government lowered its growth forecast for 2022. By  Julia Dahm |  EURACTIV.de

MADRID

Some Spanish regions extend COVID-19 measures as others relax them. Some regions have decided to extend the extraordinary COVID-19 measures, while others opted to gradually relax them to reach a “new normal”. By  Fernando Heller |  EuroEFE.EURACTIV.es

VIENNA

Austrian parliament passes compulsory vaccination law. The Austrian parliament voted last Thursday evening to make vaccinations mandatory by February. The government also announced a lottery-based “incentive and reward package” to boost the acceptance of the new law. By  Oliver Noyan |  EURACTIV.com

DUBLIN 

Ireland lifts almost all COVID-19 restrictions. Ireland has removed almost all pandemic restrictions following advice from public health officials on Friday (21 January). By  Molly Killeen |  EURACTIV.com

Frontline healthcare workers to receive €1,000 bonus. Healthcare workers in Ireland who staffed the frontlines throughout the COVID-19 pandemic will receive a €1,000 tax-free bonus, the cabinet agreed last Tuesday. By  Molly Killeen |  EURACTIV.com

COPENHAGEN 

Danish PM says it’s time to rethink country’s COVID-19 restrictions. It is high time to review the COVID-19 restrictions, said Danish Prime Minister Mette Frederiksen, citing the drop in the number of patients in intensive care units (ICUs). By  Charles Szumski |  EURACTIV.com

SOFIA

Doctor in Bulgaria attacked by anti-vaxxer. A doctor was attacked on 17 January in a Bulgarian village over a COVID vaccine. One of the attackers was a wouldbe politician, who had been in prison for drug trafficking and participated in the anti-vax protest in front of the parliament last week. By  Krassen Nikolov |  EURACTIV.bg

26 January – Introducing the Innovative Health Initiative: Europe’s new partnership for health.

26 January – WHO virtual event on the inequalities that characterize Neglected Tropical Diseases (NTDs), right before World Neglected Tropical Diseases Day (WNTDD) celebrated on Sunday, 30 January.

27 January – Oslo Medicines Initiative 2022 webinar series – Pricing, reimbursement and coverage policies for sustainable access to affordable innovative medicines.

31 January – 04 February –  Eden Doctoral Seminar on Research Methodology in Operations Management.

3 February – Oslo Medicines Initiative 2022 webinar series – Non-financial incentives for stimulating affordable innovation.

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