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 The expected change comes with headaches for receiving countries
that lack sufficient cold storage capacity to handle the Pfizer
vaccine, and amid risks of a shortage of syringes needed to
administer that shot.
AstraZeneca is currently the most distributed vaccine by COVAX,
according to data from Gavi, the vaccine alliance that co-manages
the programme with the World Health Organization (WHO).
The programme has so far delivered more than 600 million shots to
nearly 150 countries, of which more than 220 million are
AstraZeneca's and about 160 million Pfizer's.
But in the first quarter of next year Pfizer is set to take over,
according to Gavi and WHO figures on doses assigned by the COVAX
programme for future supplies.
By the end of March, another 150 million Pfizer doses are to be
distributed by COVAX, a WHO document shows.
A spokesperson for Gavi confirmed that Pfizer is far ahead in terms
of "allocated" jabs, with about 470 million doses delivered or
readied for delivery, against 350 million from AstraZeneca.
Pfizer is the first provider of COVID-19 vaccines to the European
Union, the United States and Japan.
It has bilateral agreements for more than 6 billion doses, making it
by far the largest supplier of COVID-19 vaccines, according to data
from UNICEF, a U.N. agency.
But AstraZeneca has been seen as a crucial supplier to less
developed countries, because its shot is cheaper and easier to
deliver.
COVAX bet heavily on AstraZeneca at the beginning of the pandemic,
but supply problems and export restrictions from top producer India
gradually reduced its reliance on the Anglo-Swedish shot.
As the programme faced problems in securing doses directly from
vaccine makers amid a global scramble for shots, donations from rich
nations became more important, turning Pfizer into the main supplier
to COVAX. The United States is donating mostly Pfizer shots to the
programme.
COLD CHAIN AND SYRINGES
The change forced Gavi to rush to invest more in cold chain capacity
in receiving countries that do not have enough refrigerators and
cold transport equipment to handle the Pfizer shot, which requires
lower storage temperatures than the AstraZeneca vaccine.
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 The organization warned about
insufficient cold chain capacity in some
countries, according to an internal report
submitted to Gavi's board at the beginning of
December and seen by Reuters.
The problem is compounded by a risk of shortages
of special syringes needed to administer the
Pfizer vaccine, Gavi warned in the document.
The Pfizer jab is "the hardest to deliver given
ultra-cold chain and special syringe
requirements", Gavi says in its internal
document. It is also "the
hardest to plan for as these (donated vaccines) often come with
earmarking and little notice or in a staggered manner and in small
volumes and with short shelf lives", the document says.
Wealthy countries donating COVID-19 vaccines with a relatively short
shelf life has been a "major problem" for COVAX, a WHO official said
last week, as many doses were wasted.
An EU official told a news briefing last week that EU donations of
Pfizer vaccines to COVAX were slowed by a lack of syringes. A second
official familiar with the issue told Reuters that Gavi had to
postpone the delivery of some Pfizer doses from Europe because of
the lack of syringes.
Pfizer declined to comment on syringes because it said it does not
produce or buy them directly.
As more doses are made available to poorer nations, UNICEF and the
WHO have long been warning of the insufficient supply of the
auto-disable syringes, which are crucial for inoculations in poorer
nations.
Auto-disable syringes lock automatically to prevent re-use, which is
otherwise common in poorer nations and could spread of diseases. To
make things more complicated, auto-disable syringes needed for the
Pfizer vaccine are different from standard syringes, UNICEF said.
(Reporting by Francesco Guarascio; Editing by Alex Richardson)
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