Global Vaccination: The Way Forward

As of October 21, 3.8 billion people, or 49.6% of the world’s population, have received at least one dose of a COVID-19 vaccine.¹ As we approach the end of 2021, we are proud of the work we have accomplished, but we know that our work is not yet done.

By the end of 2021, global vaccine production² across all manufacturers is expected to reach 12.5 billion doses.

By June 2022, vaccine production is expected to double again to 24 billion doses, when global vaccine supply will most likely exceed global demand.

Through the end of September, Moderna manufactured more than 500 million doses of our COVID vaccine. With 2,000 employees globally, this is approximately 250,000 vaccine doses per Moderna employee, a number that no other company can match. And we believe that we will be able to make even more in 2022.

We recently announced that the COVAX facility exercised its option to purchase 176.5 million additional doses of our vaccine in the first half of 2022 to ensure vaccine distribution to low- and middle-income countries. COVAX retains the option to purchase an additional 233 million doses through 2022. Over the last few weeks, we have made proposals to the U.S. government and to COVAX to potentially provide significantly more doses in 2022 for low-income countries. I look forward to sharing more as these discussions continue.

As we look ahead, the challenge is not just ensuring that we have enough supply, which I believe we will.  It will be about ensuring that vaccines are administered to people, particularly in low-and middle-income countries, where underdeveloped distribution infrastructure and financial constraints make this a challenge.

Only last week, Haiti, with one of the lowest COVID-19 vaccination rates in the Western Hemisphere, announced that it will be returning more than 400,000 doses of the Moderna COVID-19 vaccine to keep them from expiring. These doses were donated by the U.S. government earlier this year. Thankfully, most of these doses can be deployed elsewhere and Haiti will receive a new batch. But the same situation is likely to emerge in many other countries in the coming months.³

The best solution is a concerted effort by governments, NGOs and vaccine manufacturers to ensure that once doses are delivered, they are administered in a timely and efficient manner.

We believe that in the coming months, there will be enough COVID-19 vaccine doses for any adult in the world who wants one. Despite vaccine production increasing each month, what we worry about is that the number of doses in arms around the world is decreasing.

Dose sharing is already helping to ensure an equitable global distribution of COVID-19 vaccines. Countries with a greater supply of vaccine than is necessary to vaccinate their population are sharing excess doses with less fortunate countries.

In countries where much of the world’s supply of the vaccine is manufactured, governments are working to remove administrative bottlenecks to ensure that doses leave those countries quickly.

The next step is to work with countries individually to shore up – or build from the ground up – the system of local vaccine distribution. Many low- and middle-income countries have well-established pediatric vaccine delivery systems but are less equipped to target large numbers of adults and to reach them more than once, as most COVID-19 vaccines require two doses.

A viable vaccine distribution infrastructure has a multitude of moving parts. In many countries, roads to remote communities are in a state of repair. Solutions include vaccine delivery by air or foot. Countries such as Malawi and Vanautu have tested vaccine deliveries via drone.

Cold chain capabilities differ widely. Many countries have limited refrigeration facilities, whether vaccines are in transit or are stored in warehouses. But there are learnings that can be applied from experiences in transporting and storing such refrigerated vaccines, such as Ebola.

Then there is the challenge of staff to administer the vaccine. There has long been a significant shortage of healthcare workers, particularly in less advantaged countries. Staff recruitment and training are essential to ensure successful administration of the COVID-19 vaccine around the world. The World Health Organization offers online training for frontline staff in a wide range of languages, and this should be supplemented by on the ground training by health care workers from abroad.

Data reporting, collection and tracking systems should be ramped up simultaneously with distribution systems to ensure timely local course corrections as well as a library of knowledge that can be drawn upon by other countries in similar situations.

Finally, there is the real challenge of vaccine hesitancy. Whether based upon religious or cultural factors, fears about safety, or misinformation, we live in a world in which unfounded claims can spread globally within hours.

We must generate trust in groups or geographic areas most in need of accurate information, but we cannot do it alone. We need the support of governments, community-based organizations and healthcare providers to work together.

Ultimately, we believe that we will win the battle against COVID-19. But it is essential that we focus our efforts where they are most needed, and at this point, that appears to be ensuring timely and comprehensive vaccine distribution and administration to countries that historically have been underserved.