The speed and diversity of portfolio development and the scale of its manufacturing will determine how soon an effective vaccine for Covid-19 can be made available for mass use which, experts say, may cost between “1$ to 15$ per doze”, an optimum price band to extend immunisation programs to poorer countries.
“There is a question of speed and the second question is that of volume. Some vaccine approaches are very quick and some vaccine approaches are able to get to a billion-dose scale,” Dr Lynda Stuart, Deputy Director Bill and Melinda Gates Foundation, told a webinar last week. The foundation has promised $250 million for research and ramping up vaccine development for Covid-19.
The sheer spread of the disease across all continents poses an additional challenge to vaccine developers: production of more than seven billion doses to cater to the all of humanity, including poor and less developed nations, which may not be in a position to fund mass immunisation at this scale.
Between 80 to 100 labs in Europe, China and the US are currently driving this research aimed to curtail and then eradicate novel corona-virus SARS-2 which has put a third of the planet in a lockdown and claimed more than two hundred thousand lives world over.
Oxford University’s Jenner Institute has been first of the block to start Phase-1 clinical trials of a potential vaccine. The institute has also tied up with British drug-maker AstreZeneca for large scale production if the vaccine is approved by regulators. Moderna, Innovio, Johnson & Johnson and Sanofi are other pharma companies are currently in the race to develop the vaccine.
“If we get a vaccine very fast but are able to give it only ten people then it is not going to help us. If we get vaccine we are able to give to millions of people but it takes ten years then that is also not the right strategy.“; Stuart adds. She thinks cost per shot of the Covid-19 vaccine could be somewhere between “$1 to $15”.
It generally takes about a year for a vaccine to reach trial stage. The Oxford team led by Professor Sarah Gilbert gained eight to nine months over competition by reaching this stage in less than four. Some optimistic projections have estimated the roll out as early as autumn this year. Most experts, however, predict the vaccine would be available for mass usage between 14 to 18 months from now.
Scale of manufacturing is also critical to ensure equitable distribution of the vaccine though inoculation of healthcare workers, the elderly and vulnerable sections would be the priority as first batches roll out.
Speaking on the ethics of scarce resource planning organised last month Ruth R Faden, Professor of Biomedical Ethics at John Hopkins, delineated the equitable distribution of resources in the face of a medical emergency, issues which may find resonance in prioritisation of immunisation as and when a vaccine is ready for mass usage.
“There are two parts to justice, there is certainitive part where you have to identify the principles of the rules that you are going to use to allocate the scarce resources. And then we also need process to make sure that whatever the rules that are adopted they are adhered to fairly, impartially and as best as possible,” Faden said.
To meet demands as and when Covid-19 vaccines are cleared by drug regulators, manufacturers like Pune-based Serum Institute are preparing to start production of some of the proposed vaccines which are yet to undertake advanced clinical trials.
India, Indonesia and Thailand are world’s largest vaccine manufacturers. WHO is currently coordinating with these countries and their drug regulatory authorities to ramp up manufacturing and lay a roadmap for the distribution of Covid-19 vaccine.
It is estimated that an investment of $ 2 billion would be needed to develop the vaccine in the next 12 to 18 months. In their attempts to provide ‘vaccine for all’, international donors are investing on a wide range of portfolios to maximise chances of success and ensure equitable distribution.