What Needs to Change to Enhance Covid-19 Vaccine Access – World Health Organization

The Independent Allocation Vaccine Group (IAVG) was established by the WHO in January 2021 and is composed of 12 members who serve in their personal, independent capacities to review and assess Vaccine Allocation Decision (VAD) proposals generated by the COVAX Facility Joint Allocation Taskforce (JAT) on the volumes of vaccines that should be allocated to each participant under COVAX within a given time frame[1].

The IAVG continues to be very concerned about the evolution of the pandemic, and its health, social and economic impacts, and offers its full support to COVAX Partners to ensure that critical messages are channelled to the relevant fora to raise the awareness of governments, manufacturers and stakeholders of challenges in access to COVID-19 vaccines.

The IAVG is concerned about the 25% reduction in supply forecast for the fourth quarter of 2021. It is also concerned about the prioritization of bilateral deals over international collaboration and solidarity, export restrictions and decisions by some countries to administer booster doses to their adult populations.

During its last meeting on 17 September, the IAVG revisited issues previously raised pertaining to vaccine supply, vaccine allocation, and vaccine administration and offers the following perspectives:

The IAVG continues to be concerned by the low supply of vaccines to COVAX, and reiterates the need for manufacturers, vaccine producing and high-coverage countries to prioritize vaccine equity and transparency, the sharing of information about manufacturing capacity and supply schedules to COVAX, as well as vaccine access plans. While recognizing the need for additional doses to protect certain vulnerable, immune-compromised populations, the IAVG suggests countries collect and review more evidence before implementing policies regarding the administration of booster doses to their populations.

The recent exceptional allocation round at which the recommendation was made that the October COVAX supply be fully dedicated to those countries with a low population coverage, after accounting for all sources of vaccines, is a step forward in achieving equitable access. The IAVG supports the decision of prioritizing COVAX supply for those countries most likely relying solely on COVAX for access to COVID-19 vaccines and supports the continuation of this approach in future rounds.

The IAVG notes that so far only three manufacturers have waived indemnification and liability for use in humanitarian settings, and none have been waived for use at country level. This has consequences for vaccines allocated to the humanitarian buffer, as well as potentially setting precedents for future use.

The IAVG has considered the information and data on absorptive capacity in countries with low total population coverage and brings the following issues to the attention of the COVAX Partners for further consideration:

COVAX remains the main global access mechanism able to serve all countries and ensure equitable access. The IAVG stands strongly behind this initiative.

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[1] The IAVG (https://www.who.int/groups/iavg) acknowledges that the role of the WHO within COVAX is to provide guidance on vaccine policy, regulation, safety, research and development, vaccine allocation, and country readiness and delivery, in partnership with UNICEF. As of today, the IAVG has validated allocation through COVAX for a total of 362.8 million doses of vaccines.

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What Needs to Change to Enhance Covid-19 Vaccine Access - World Health Organization