It is the latest headache to plague the COVAX vaccine-sharing
project, co-led by the WHO and aimed at getting shots to the world's
neediest people.
Initially, poorer countries and COVAX lagged richer countries in
securing vaccine supplies, as wealthier nations used their financial
might to acquire the first available doses.
As vaccine production ramped up and richer states began donating
excess doses, some countries - particularly in Africa – are now
struggling to administer the big shipments.
The need to turn down vaccines with short shelf lives, along with
the initial inequality, hesitancy and other barriers, has
contributed to a much lower vaccination rate in Africa where only
around 10% of people have been immunised, compared with more than
70% in richer nations.
Many vaccines are arriving with only a few months, and sometimes
weeks, before their use-by date, adding to the scramble to get shots
in arms. Some countries have had to destroy expired doses, including
Nigeria which dumped up to 1 million AstraZeneca vaccines in
November.
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The problem with a short shelf life largely concerns AstraZeneca,
according to COVAX data and officials.
An internal WHO document reviewed by Reuters detailing vaccine
stocks in several central and west African countries for the week
ending Feb. 6 highlighted the problem.
Most of the 19 listed African nations had expired AstraZeneca doses,
compared to a handful of countries with expired doses from other
manufacturers. Of the total expired doses declared by those
countries in the week, about 1.3 million were AstraZeneca, 280,000
Johnson & Johnson, 15,000 Moderna and 13,000 Russia's Sputnik, the
document shows.
Many more vaccines are expected to be rejected as African nations
and COVAX said that from January they would not accept vaccines with
less than two-and-a-half months' shelf life.
Yet Benin received 80,400 AstraZeneca doses from COVAX on Jan. 30,
set to expire on Feb. 28. It also got 100,000 doses of the Sputnik
Light vaccine from Russia, with the same expiry date - but outside
the COVAX initiative. Vaccines from other manufacturers had a much
longer shelf life, according to the document.
Two and a half months of shelf life is the minimum duration African
countries reckon they need to administer the shots.
AstraZeneca, COVAX's second-biggest supplier after Pfizer, said that
since the start of the global rollout, more than 250 million of its
shots left factories with less than two-and-a-half months before
expiry.
Short shelf life is not generally a problem for a wealthy country
with expertise and infrastructure. But without systems in place, it
can be insurmountable.
A spokesperson for Anglo-Swedish AstraZeneca said vaccines had to
undergo scrupulous quality checks and pointed to the fact that the
company was a major player in supporting vaccination drives in
poorer nations. With donations from rich countries included, more
AstraZeneca vaccines have been distributed by COVAX than any other
shot.
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"AstraZeneca has supplied 2.6 billion vaccine doses globally,
approximately two thirds of which have gone to low and lower
middle-income countries," the spokesperson said.
"Almost nine out of 10 doses released from our manufacturing sites
ready for donation have a shelf life of at least two and a half
months which is consistent with the rest of our supply chains," the
spokesperson added.
CLOCK TICKING
The volumes of delivered vaccines vastly outnumber wasted doses, but
the losses have been substantial thanks in part to the time
pressures. This has led to AstraZeneca shots being turned down even
before being shipped.
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![](http://archives.lincolndailynews.com/2022/Feb/16/images/ads/current/heartland_lda_NOV2021.png) Taking into account only donated doses, which
represent nearly half the billion vaccines
distributed by COVAX, about 30 million
AstraZeneca shots were rejected or deferred last
year by poor nations, said Gavi, the nonprofit
that co-runs COVAX alongside the WHO. That
amounts to a quarter of AstraZeneca's donated
shots via COVAX. Many were later
re-assigned to other countries, Gavi added, noting that more than
95% of them were AstraZeneca. It did not say where to.
Millions of additional AstraZeneca doses shared by the EU, COVAX's
biggest donor, have not been distributed yet, according to an EU
internal document reviewed by Reuters.
The main problem is the vaccine's shelf life of just six months from
the date of bottling, the shortest among COVAX's top suppliers,
several COVAX and EU officials told Reuters.
In addition, the company's quality checks can themselves sometimes
take months. COVAX's complex system to assign doses
to countries, and donors' requests to deliver them to selected
nations, often further eat into the vaccine's short life, leaving
sometimes only a few weeks before they expire.
Quality checks are conducted by all vaccine makers, but the time
constraints are less of an issue for COVAX's other top suppliers.
Johnson & Johnson's vaccines last two years when frozen, Pfizer's
last nine months and Moderna's seven months, according to storage
instructions approved by the WHO.
Millions of Moderna and Pfizer vaccines could also go wasted, some
African countries warned in the WHO document, with the problem being
linked usually to low vaccine uptake and insufficient cold-chain
equipment to distribute these shots in remote regions.
EXTENDING SHELF LIFE
Gavi said it has encouraged AstraZeneca to apply to the WHO for an
extension of the expiration date, but talks have not led yet to a
formal application. AstraZeneca said the process is complex due to
its vast global network of companies manufacturing its vaccine.
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One of its production partners, the Serum Institute of India, has
been granted WHO approval for a nine-month shelf life, after it was
initially authorised only for six. But other batches produced by
AstraZeneca in the rest of the world have only six.
"We are currently in discussions with the World Health Organisation
... but this is a complex task which requires data to be collected
from across our global manufacturing network," a spokesperson for
AstraZeneca said.
A WHO spokesperson did not comment on the talks.
On average, African countries have used two-thirds of received
doses, but that drops to 11% in Burundi and 15% in Congo, with other
large countries, including Madagascar, Zambia, Somalia and Uganda,
having used only about one-third, Gavi said, citing figures from
late January.
Gavi said the total wastage rate was around 0.3% of doses delivered
by mid-December. It declined to share more updated figures, but said
the rate was expected to rise.
(Reporting by Francesco Guarascio @fraguarascio and Jennifer Rigby;
Additional reporting by Maggie Fick in Nairobi and MacDonald
Dzirutwe in Lagos, Alexander Winning and James Macharia Chege in
Johannesburg, and Polina Nikolskaya in Moscow; Editing by Josephine
Mason and Nick Macfie)
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