Mapping global vaccine production

Policy Monitor, March 25th 2021

By Dylan Barry, GCPPP staff

With COVID-19 vaccines available in much of the developed world, for some nations the end of the global COVID-19 pandemic looks to be in sight. Many advanced countries will complete the vaccination of most of their adult population at points between June and December 2021, with others following, according to The Economist Intelligence Unit (EIU)’s estimates, by mid-2022. For middle-income nations, on current trends majority-vaccination will likely take until mid-2023, says the EIU. For the poorest economies, it will take until 2024.

On the face of it, these forecasts look strangely pessimistic. Manufacturers’ declared production targets imply that there should be sufficient vaccine doses available by early 2022 to vaccinate most of the world’s adult population, if they can be financed and distributed. Funding and logistics are both formidable tasks, but in principle are solvable, given fair global policy winds. The tougher issue is production itself, and whether the declared targets, which on paper amount to 11.7 billion vaccine doses this year, are achievable. If not, there will be a strong case for public policy intervention to solve production bottlenecks.

This Policy Monitor seeks to map the issue, describing the supply-chain of each major approved or soon-to-be approved COVID-19 vaccine along with a summary of its production targets, followed by a discussion of possible ways forward.

Approved vaccines as of March 2021

There are currently only a handful of approved vaccines being manufactured in a limited set of locations worldwide. Some of the primary locations – the United States and the United Kingdom – have made public investments and contractual arrangements that seek to ensure production goes first to vaccinate their own citizens. Others – notably the European Union and India – are already big exporters but face political pressures to limit those exports owing to slow progress in domestic vaccination programmes. Meanwhile, China, Russia and India are seeking to leverage their vaccine production as a tool of diplomacy, though they too are facing output constraints.

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Amongst western vaccines, the Oxford-AstraZeneca vaccine is manufactured by the most global network of production plants. The company’s supply chain consists of serum manufacturing facilities in the United Kingdom, Belgium, the Netherlands, the United States, India and Australia—with prospective plants under development in China and Japan. Notably, AstraZeneca manages none of the plants itself. The entire vaccine supply-chain is outsourced to licensed manufacturers.

Despite its global supply chain, AstraZeneca is struggling to meet its commitments. In January, the company cut its first-quarter delivery target to the European Union from 120 million doses to 31 million doses. In March, it cut that figure further to 30 million. The original issue cited by AstraZeneca was underwhelming production at its Belgian plant (the plant disputes this). However, in recent weeks it has become clear that there are more general issues with its global supply chain, which are leading to conflicting contractual commitments. AstraZeneca is contractually obligated to deliver 300 million doses to the EU before July—it now forecasts that it will manage only 210 million. The UK is also getting worried about shortfalls in supply, chiefly from Halix’s plant in the Netherlands but also from India.

The company was previously targeting the production of 3 billion vaccine doses in 2021, but that is now unlikely to be achieved. The company now says it is aiming to get production up to the mark of 200 million doses a month by April, which if maintained would imply 1.8 billion doses in the final nine months of the year and so a full-year total of a little over two-thirds of its annual target.

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The Pfizer-BioNTech vaccine is primarily manufactured at three facilities in the United States—each tackling a different stage of the serum production process. There are also two operational European plants, with prospective plants under development in Germany and China to be managed by external manufacturers operating under license.

Early in the year, Pfizer temporarily reduced its vaccine production so as to expand its Belgian plant—once again affecting vaccine deliveries to the EU. As a consequence, its German partner BioNTech approachedsome of Pfizer’s traditional competitors—including Sanofi, Merck and Novartis—for licensing to increase production.

For the most part, however, Pfizer and BioNTech appear on track to meet their first quarter delivery targets. As a consequence, the partnership continues to stand by its initial 2021 production target of 2 billion vaccine doses. With output rising rapidly in the United States, that ambitious target may still be in reach.

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Of the established western vaccines, Moderna’s is produced by the leanest supply-chain, with only three manufacturing plants worldwide. Of these, two are in the United States with another in Switzerland. Moderna has not made any plans public for new plants or additional licensing arrangements.

Of the various manufacturers, Moderna has had the fewest supply-chain hiccups and is on track to meet its various first-quarter delivery targets. The company has a 2021 production target of 700 million vaccine doses, but says that it hopes to produce up to a billion, with steadily rising production in the United States.

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The Johnson & Johnson vaccine is the most recent western vaccine to receive widespread approval; unlike those from Pfizer-BioNTech, Oxford-AstraZeneca or Moderna it is a single-dose vaccine, and like Oxford-AstraZeneca it is easy to transport and store. However, its manufacturing capacity is still underdeveloped. There is one manufacturing plant currently operational in the Netherlands, but further licensing agreements have been made with facilities in the United States, Europe and India—with plants still being revamped to produce the vaccine.

To accelerate its catch-up, Johnson & Johnson recently entered into an agreement with rival Merck to boost production, in a deal brokered, using the Defense Production Act (and partly financed by) the US Government. The company still says it is aiming to produce one billion vaccine doses this year. However the European Union was recently told by Johnson & Johnson that the company is struggling to establish enough production to meet its second-quarter delivery targets of 55 million doses to the bloc. To the United States, J&J has promised 100 million doses by the end of May.

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Of the various vaccines, the Russian Sputnik V vaccine has the smallest existing production capacity—but is also the subject of the most ambitious international licensing effort.

The vaccine is currently produced in four manufacturing plants, three in Russia and one in Kazakhstan—all with limited capacity. However, in recent months, the Russian Direct Investment Fund (RDIF) has reached agreements with at least 16 external manufacturers to produce the vaccine under license: these include five firms in India, four in Europe, three in China, and one each in Turkey, Saudi Arabia, Brazil and South Korea.

The focus on rapid expansion of production capacity reflects the Gamaleya Institute’s struggles to meet its vaccine delivery targets. This means that RDIF’s 2021 production target of one billion vaccine doses is almost certainly out of reach. Nevertheless, the avalanche of new plants from licensed manufacturers is still expected to dramatically increase production.

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The Chinese Sinopharm vaccine is currently produced in two mass-manufacturing plants in Wuhan and Beijing. The state-owned company has also come to an agreement with the United Arab Emirates to produce the vaccine there. The Sinovac vaccine is primarily produced in Beijing, but with a plant also under construction in Sao Paulo, Brazil. Relatively little is known for sure about the efficacy of the vaccines as data from clinical trials or from vaccination programmes has yet to be published in peer-reviewed journals.

Neither firm has reported particular production issues. Both firms are targeting vaccine production of one billion doses this year, but with public information limited it is not possible to judge whether this is conservative or ambitious.

On the horizon

Of forthcoming vaccines, the Novavax vaccine is likely to receive widespread approval the soonest and has announced the largest manufacturing network: reportedly it is aiming for emergency-use approval in the United States and United Kingdom to be granted during May, and its trial data is under rolling review by the European Medicines Agency. The vaccine is a two-dose regime which can be stored in a refrigerator.

Novavax announced in September 2020 an extensive worldwide manufacturing network, including licensed collaborations with Fujifilm Diosynth in the United States and United Kingdom, Takeda Pharmaceutical in Japan, SK Bioscience in South Korea and, most ambitiously, with the Serum Institute of India, which also partners with Oxford-AstraZeneca. Novavax has also announced a deal to produce its vaccine in Canada, once it receives regulatory approval from Health Canada. Novavax has set an overall 2021 production target of 2.1 billion vaccine doses.

In January 2021 Novavax’s CEO gave Reuters an updated forecast, saying he expected production to be at “full capacity” by May or June, producing “maybe as much as 150 million doses per month globally.” If achieved, that would imply production of 1.8 billion doses over a 12-month period, but somewhere between 1 billion and 1.2 billion during 2021 itself.

The prospect

What do these manufacturing networks, production targets and achievements amount to? The least encouraging insight is that first-quarter vaccine production worldwide has undershot initial targets. Conflicting contractual commitments can explain shortfalls in supply to particular customers, notably the European Union, but the broader picture is one of production constraints.

As the chart shows, declared production up to March 17^th totalled 508.1 million doses worldwide. With supply increasing, the total might amount to 600 million or so by the end of the first quarter. That can be compared to the initial production targets of the eight vaccines surveyed here that totalled 11.8 billion doses for 2021. The updated corporate forecasts for the five western vaccines amount to somewhere between 6.8 billion and 7 billion doses by December 31^st, to which should be added somewhere between 1 billion and 3 billion of the Russian and Chinese vaccines.

Thus the first conclusion is that this is a steep uphill climb: first quarter output equates to just 5-7% of these aspired-to annual totals.

The second conclusion is that if reached, output of between 8 billion and 10 billion doses this year would be an extraordinary achievement that would go a long way towards confounding the pessimistic forecasts of when global mass vaccination can be reached. The world’s adult population, depending on definitions of adult, is around 5.8 billion to 6 billion. Between the single and double dose vaccines, that requires something in the region of 10 billion doses. Clearly, this is before reckoning on vaccinations for children, or booster shots to deal with variant strains.

The third conclusion, then, is that although this is a very stretching target, those states able to provide extra financing to aid the scaling up of production should do so as a matter of urgency, following the lead given by such investments already made in the United States and the UK.

Fourth, finally, and far from least, further obstacles of politics and cost need to be surmounted. By politics is principally meant vaccine nationalism in the form of export controls on vaccines and ingredients but also in some countries trust in the Chinese and Russian vaccines. Then there is cost, which is tied to political unwillingness to contribute sufficient funds to the collective buying mechanism for poor countries of COVAX. There is also the issue of the difficulty in transporting and administering vaccines such as Pfizer-BioNTech and Moderna which require ultra-cold temperatures, and the issue of some emerging markets being charged more for vaccines than richer nations.

For the poorest countries, COVAX is the solution but currently its inadequate funding represents the problem. A subsequent Policy Monitor will take a close look at the actual and potential funding for COVAX, and how the programme is working.