2020 warnings said that the ‘cornering’ of the vaccine market by the richest western nations would lead to a bifurcated world. A year later, that world has emerged: The pandemic rages on and more mutations appear. The West is healing, while lower and middle income countries are still in deep despair.
The U.S. passed the 50% vaccination rate - 50.3% w/ at least one dose by end-of-May. Vaccination rates have slowed considerably. Peak was 4.2 Million shots/day - now down to 1.3 Million/day in a matter of weeks. Current rate would take 5 more months to reach 75% of the target population.
U.S. Consumer research suggests that core Anti-Vaxxer segment may be as low as 18%, leading to an increase of incentive 'nudge economics" to encourage vaccination, including free participation in lotteries, discounts on supermarket shopping, free Uber and Lyft rides to get a vaccine - paid for by the White House - walk-in vaccinations at sporting events, e.g., at four locations at the Indy 500 auto race.
70 Million unused vaccines exist within the U.S. distribution system, allowing same day, no appointment, walk-in vaccination, and even choice of vaccine, in much of the U.S..
Many other major western countries are catching up (France 36%, Germany 43%) and a few are ahead (UK 58%, Canada 55%, Chile 54%, Hungary 52%).
For advanced economies in the West, the pandemic is seen as coming under control, and attention is shifting to: 1) Incentives needed to get close to herd immunity, (at least 70%); 2) How long does immunity last; and 3) Combating dangerous new variants. In the UK and France, a 3rd round of shots has already been arranged, with longer term plans for annual boosters for the next 3 to 5 years.
Some advanced economies have lagged behind: Australia 14%; South Korea 9%; Japan 6%. In Australia the Qantas airline is offering unlimited flights for a year incentive to support the vaccine push.
Rest of the world? Global cases now exceed 171 Million with over 3.6 Million deaths officially reported.
85% of the 1.91 Billion vaccine shots administered have been in upper income countries, but only 0.3% of shots in low-income countries. Of the daily global vaccination rate of 34 Million per day, 25 Million are taking place in China, USA, EU and UK. This leaves just 9 Million per day for the "other 5 Billion people".
India with a population of nearly 1.4 Billion, and a large domestic vaccine manufacturing industry, is achieving just 2.5 Million vaccinations a day, allowing the pandemic to continue to spread, and leading to somewhere between 4,000 (official) and 20,000 (unofficial estimates) deaths per day.
Refana has modeled vaccine availability/administration for the remaining 3.5 Billion people - 5 billion less India, 45% of the world's population - forecasts 5 years to achieve a 70% vaccination rate globally.
The Business of Vaccines
The WHO has now approved two Whole Inactivated Virus Vaccines (WIV) for Emergency Use Access, Siopharm and now Sinovac, both produced in China.
Airfinity market study reports that 2021 would see between $115-$190 Billion of actual vaccine sales this year, almost equalling the entire previous 5 year market forecast of $157 Billion for 2021-2025. These figures represent potential given reported orders, but may be constrained given production constraints.
A significant factor in these large market values is that vaccine pricing is at a level 300% higher than prior earlier forecasts, as the enormous value of Covid vaccines, even at these prices, is being clearly recognized compared to the human and economic costs of the pandemic.
The big winners forecast by Airfinity for 2021 revenue are Pfizer-BioNTech at $44 Billion, Moderna at $32 Billion, Sinovac at $25 Billion and Sinopharm at $23 Billion.
Medical/ Vaccine Updates
SARS-CoV-2 is mutating at an alarming rate. New mutations are progressively more virulent, with increased capacity to both infect and cause more severe illness.
While single “epitope” vaccines (e.g. Pfizer, Moderna, Novovax, J&J) continue to show efficacy against new variants, the efficacy/ protection of these vaccines is significantly reduced.
Given > 50% vaccination of populations in wealthy countries, new variants are unlikely to spread in those countries. Even with reduced efficacy, vaccines still slow the spread significantly: “Shifting the curve”
BUT, given epidemiological considerations of variant spread, less vaccinated 2nd/3rd world countries will need to utilize new vaccines effective against the new variants, to significantly reduce disease spread.
Recent analysis shows that in 18-36 months, new variants of SARS-CoV-2 may have mutated sufficiently to enable reinfection in populations vaccinated with existing vaccines for the earlier variants. To prevent this outcome, the reservoir of new variants from the unvaccinated poorer populations will have to be eliminated through broad and comprehensive vaccination programs.