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Coronavirus: AstraZeneca shelf life complicated when rolling out to poor countries

BRUSSELS/LONDON – The relatively short shelf life of AstraZeneca Plc’s COVID-19 vaccine is complicating deployment for the world’s poorest countries, according to WHO officials and internal documents World economy reviewed by Reuters.

This is the latest headache to plague the COVAX vaccine-sharing project, which is co-led by WHO and aims to vaccinate those most in need in the world.

Initially, the poorer countries and COVAX lagged behind the richer countries in securing vaccine supplies, as the rich nations used their financial strength to get the first doses of the drug. first.

As vaccine production increases and wealthier countries begin to supply excess doses, some countries – particularly in Africa – are currently having difficulty managing large shipments.

The need to reject short-shelf life vaccines, coupled with initial inequality, hesitancy and other barriers, have contributed to much lower vaccination rates in Africa, where Only about 10% of people have been vaccinated, compared with more than 70% in richer countries.

Many vaccines will arrive months, and sometimes weeks, before their use-by date, adding to the scramble to get the shot in hand. Several countries have had to destroy expired doses, including Nigeria, which dumped up to 1 million AstraZeneca vaccines in November.

According to data from COVAX and officials, the issue of the short shelf life is largely related to AstraZeneca.

An internal WHO document reviewed by Reuters detailing vaccine stockpiles in several Central and West African countries for the week ended 6 February highlights the issue.

Most of the 19 African countries listed used expired doses of AstraZeneca, compared with a small number of countries with expired doses from other manufacturers. Of the total expired doses announced by those countries this week, about 1.3 million were AstraZeneca, 280,000 Johnson & Johnson, 15,000 Moderna and 13,000 Sputnik from Russia, the documents show.

More vaccines are expected to be rejected as African countries and COVAX said from January they would not accept vaccines with a shelf life of less than two and a half months.

However, Benin received 80,400 doses of AstraZeneca from COVAX on January 30, which is due to expire on February 28. It also received 100,000 doses of the Sputnik Light vaccine from Russia, with the same shelf life – but outside of COVAX’s initiative. According to the document, vaccines from other manufacturers have a much longer shelf life.

The two-and-a-half month shelf life is the minimum period that African countries consider they need to be vaccinated.

AstraZeneca, COVAX’s second-largest supplier after Pfizer, said that since the start of its global rollout, more than 250 million of its products have left factories in less than two and a half months before their expiration date.

A short shelf life is usually not a problem for a country rich in expertise and infrastructure. But without a system, it can be insurmountable.

A spokesperson for Anglo-Swedish AstraZeneca said vaccines undergo thorough quality checks and pointed out that the company is a company that plays a vital role in supporting vaccinations in poor countries. than. With donations from wealthy nations, more AstraZeneca vaccines have been distributed by COVAX than any other injection.

AstraZeneca has delivered 2.6 billion doses of vaccines globally, about two-thirds of which are provided to low- and middle-income countries.

INTO THE WATCH

The volume of vaccine delivered was far more than the dose wasted, but the loss was largely due to time pressure. This caused AstraZeneca’s photos to be rejected even before they were shipped.

Gavi, the nonprofit that co-runs COVAX with WHO, said that taking into account donated doses alone, which account for nearly half a billion vaccines distributed by COVAX, some 30 million AstraZeneca injections have been denied or delayed. last year by poor countries. That number represents a quarter of the photos donated by AstraZeneca through COVAX.

Gavi added that many were later transferred to other countries, noting that more than 95% of them were AstraZeneca. It doesn’t say where to.

According to an internal EU document reviewed by Reuters, millions of doses of AstraZeneca shared by the EU, COVAX’s biggest donor, have yet to be distributed.

The key issue is the vaccine’s shelf life of just six months from bottling date, the shortest shelf life among COVAX’s top suppliers, several COVAX and EU officials told Reuters.

In addition, the company’s quality checks can sometimes take months.

COVAX’s complex system for assigning doses to countries and donors’ requirements to distribute them to selected countries, often ingrained in a vaccine’s short life cycle, sometimes as little as several weeks before expiration.

Quality checks are performed by all vaccine manufacturers, but time constraints are not an issue for other leading COVAX suppliers. Johnson & Johnson’s vaccine has a shelf life of two years when frozen, nine months from Pfizer and seven months from Moderna, according to WHO-approved storage guidelines.

Several African countries have warned in the WHO document that millions of Moderna and Pfizer vaccines could also be wasted, with the problem often linked to low vaccine uptake and insufficient cold chain equipment. to distribute these injections in remote areas.

EXTENSION OF THE TERM OF USE

Gavi said it had encouraged AstraZeneca to apply to the WHO for an extension of the expiration date, but negotiations have yet to result in a formal application. AstraZeneca says the process is complicated due to the large network of companies that make vaccines around the globe.

One of its manufacturing partners, the Serum Institute of India, has been approved by the WHO for a shelf life of nine months, after initially being allowed only six months. But the other batches produced by AstraZeneca in the rest of the world are only six pieces.

“We are currently in discussions with the World Health Organization … but this is a complex task that requires data to be gathered from across our global manufacturing network,” a spokesman for the company said. AstraZeneca said.

A WHO spokesperson did not comment on the talks.

On average, African countries used two-thirds of the doses received, but this fell to 11% in Burundi and 15% in the Congo, while other large countries, including Madagascar, Zambia, Somalia and Uganda, uses only about a third, Gavi said, citing figures from late January.

Gavi said the total waste rate was about 0.3% of the doses delivered in mid-December. It declined to share more updated figures, but said the rate is expected to increase.

(Reporting by Francesco Guarascio and Jennifer Rigby; additional reporting by Maggie Fick in Nairobi and MacDonald Dzirutwe in Lagos, Alexander Win and James Macharia Chege in Johannesburg, and Polina Nikolskaya in Moscow; editing by Josephine Mason and Nick Macfie)

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