COVID-19 vaccine

Last updated

COVID-19 vaccine
Vaccine description
Target SARS-CoV-2
Vaccine type mRNA, viral, inactivated, protein
Clinical data
Routes of
administration
Intramuscular
ATC code
Identifiers
ChemSpider
  • none

How COVID19 vaccines work. The video shows the process of vaccination, from injection with RNA or viral vector vaccines, to uptake and translation, and on to immune system stimulation and effect.

A COVID19 vaccine is a vaccine intended to provide acquired immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID19).

Contents

Prior to the COVID‑19 pandemic, an established body of knowledge existed about the structure and function of coronaviruses causing diseases like severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). This knowledge accelerated the development of various vaccine platforms in early 2020. [1] The initial focus of SARS-CoV-2 vaccines was on preventing symptomatic, often severe, illness. [2] In 2020, the first COVID19 vaccines were developed and made available to the public through emergency authorizations [3] and conditional approvals. [4] [5] Initially, most COVID19 vaccines were two-dose vaccines, with the sole exception being the single-dose Janssen COVID‑19 vaccine. [3] However, immunity from the vaccines has been found to wane over time, requiring people to get booster doses of the vaccine to maintain protection against COVID19. [3]

The COVID19 vaccines are widely credited for their role in reducing the spread of COVID19 and reducing the severity and death caused by COVID19. [3] [6] According to a June 2022 study, COVID19 vaccines prevented an additional 14.4 to 19.8 million deaths in 185 countries and territories from 8 December 2020 to 8 December 2021. [7] [8] Many countries implemented phased distribution plans that prioritized those at highest risk of complications, such as the elderly, and those at high risk of exposure and transmission, such as healthcare workers. [9] [10]

Common side effects of COVID19 vaccines include soreness, redness, rash, inflammation at the injection site, fatigue, headache, myalgia (muscle pain), and arthralgia (joint pain), which resolve without medical treatment within a few days. [11] [12] COVID19 vaccination is safe for people who are pregnant or are breastfeeding. [13]

As of 27 December 2023, 13.53 billion doses of COVID19 vaccines have been administered worldwide, based on official reports from national public health agencies. [14] By December 2020, more than 10 billion vaccine doses had been preordered by countries, [15] with about half of the doses purchased by high-income countries comprising 14% of the world's population. [16]

Despite the extremely rapid development of effective mRNA and viral vector vaccines, worldwide vaccine equity has not been achieved. The development and use of whole inactivated virus (WIV) and protein-based vaccines have also been recommended, especially for use in developing countries. [17] [18]

The 2023 Nobel Prize in Physiology or Medicine was awarded to Katalin Karikó and Drew Weissman for the development of effective mRNA vaccines against COVID-19. [19] [20] [21]

Background

A US airman receiving a COVID-19 vaccine, December 2020 COVID Vaccine (50745583447).jpg
A US airman receiving a COVID19 vaccine, December 2020
Map of countries by approval status
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Approved for general use, mass vaccination underway
EUA (or equivalent) granted, mass vaccination underway
EUA granted, mass vaccination planned
No data available COVID-19 vaccine map.svg
Map of countries by approval status
  Approved for general use, mass vaccination underway
   EUA (or equivalent) granted, mass vaccination underway
  EUA granted, mass vaccination planned
  No data available

Prior to COVID19, a vaccine for an infectious disease had never been produced in less than several years and no vaccine existed for preventing a coronavirus infection in humans. [22] However, vaccines have been produced against several animal diseases caused by coronaviruses, including (as of 2003) infectious bronchitis virus in birds, canine coronavirus, and feline coronavirus. [23] Previous projects to develop vaccines for viruses in the family Coronaviridae that affect humans have been aimed at severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). Vaccines against SARS [24] and MERS [25] have been tested in non-human animals.

According to studies published in 2005 and 2006, the identification and development of novel vaccines and medicines to treat SARS was a priority for governments and public health agencies around the world at that time. [26] [27] [28] There is no cure or protective vaccine proven to be safe and effective against SARS in humans. [29] [30] There is also no proven vaccine against MERS. [31] When MERS became prevalent, it was believed that existing SARS research might provide a useful template for developing vaccines and therapeutics against a MERS-CoV infection. [29] [32] As of March 2020, there was one (DNA-based) MERS vaccine that completed Phase I clinical trials in humans, [33] and three others in progress, all being viral-vectored vaccines: two adenoviral-vectored (ChAdOx1-MERS, BVRS-GamVac) and one MVA-vectored (MVA-MERS-S). [34]

Vaccines that use an inactive or weakened virus that has been grown in eggs typically take more than a decade to develop. [35] [36] In contrast, mRNA is a molecule that can be made quickly, and research on mRNA to fight diseases was begun decades before the COVID19 pandemic by scientists such as Drew Weissman and Katalin Karikó, who tested on mice. Moderna began human testing of an mRNA vaccine in 2015. [35] Viral vector vaccines were also developed for the COVID19 pandemic after the technology was previously cleared for Ebola. [35]

As multiple COVID19 vaccines have been authorized or licensed for use, real-world vaccine effectiveness (RWE) is being assessed using case control and observational studies. [37] [38] A study is investigating the long-lasting protection against SARS-CoV-2 provided by the mRNA vaccines. [39] [40]

Vaccine technologies

A conceptual diagram showing three vaccine types for forming SARS-CoV-2 proteins to prompt an immune response: (1) RNA vaccine; (2) subunit vaccine; (3) viral vector vaccine Vaccine candidate mechanisms for SARS-CoV-2 (49948301838).jpg
A conceptual diagram showing three vaccine types for forming SARS‑CoV‑2 proteins to prompt an immune response: (1) RNA vaccine; (2) subunit vaccine; (3) viral vector vaccine
Vaccine platforms that are being employed for SARS-CoV-2. Whole-virus vaccines include both attenuated and inactivated forms of the virus. Protein and peptide subunit vaccines are usually combined with an adjuvant in order to enhance immunogenicity. The main emphasis in SARS-CoV-2 vaccine development has been on using the whole spike protein in its trimeric form, or components of it, such as the RBD region. Multiple non-replicating viral vector vaccines have been developed, particularly focused on adenovirus, while there has been less emphasis on the replicating viral vector constructs. Fimmu-11-579250-g004.jpg
Vaccine platforms that are being employed for SARS-CoV-2. Whole-virus vaccines include both attenuated and inactivated forms of the virus. Protein and peptide subunit vaccines are usually combined with an adjuvant in order to enhance immunogenicity. The main emphasis in SARS-CoV-2 vaccine development has been on using the whole spike protein in its trimeric form, or components of it, such as the RBD region. Multiple non-replicating viral vector vaccines have been developed, particularly focused on adenovirus, while there has been less emphasis on the replicating viral vector constructs.

As of July 2021, at least nine different technology platforms were under research and development to create an effective vaccine against COVID19. [42] [43] Most of the platforms of vaccine candidates in clinical trials are focused on the coronavirus spike protein (S protein) and its variants as the primary antigen of COVID19 infection, [42] since the S protein triggers strong B-cell and T-cell immune responses. [44] [45] However, other coronavirus proteins are also being investigated for vaccine development, like the nucleocapsid, because they also induce a robust T-cell response and their genes are more conserved and recombine less frequently (compared to Spike). [45] [46] [47] Future generations of COVID19 vaccines that may target more conserved genomic regions will also act as insurance against the manifestation of catastrophic scenarios concerning the future evolutionary path of SARS-CoV-2, or any similar coronavirus epidemic/pandemic. [48]

Platforms developed in 2020 involved nucleic acid technologies (nucleoside-modified messenger RNA and DNA), non-replicating viral vectors, peptides, recombinant proteins, live attenuated viruses, and inactivated viruses. [22] [42] [49] [50]

Many vaccine technologies being developed for COVID19 are not like influenza vaccines but rather use "next-generation" strategies for precise targeting of COVID19 infection mechanisms. [42] [49] [50] Several of the synthetic vaccines use a 2P mutation to lock the spike protein into its prefusion configuration, stimulating an adaptive immune response to the virus before it attaches to a human cell. [51] Vaccine platforms in development may improve flexibility for antigen manipulation and effectiveness for targeting mechanisms of COVID19 infection in susceptible population subgroups, such as healthcare workers, the elderly, children, pregnant women, and people with weakened immune systems. [42] [49]

mRNA vaccines

Diagram of the operation of an RNA vaccine. Messenger RNA contained in the vaccine enters cells and is translated into foreign proteins, which trigger an immune response. RNA vaccine illustration (en).jpg
Diagram of the operation of an RNA vaccine. Messenger RNA contained in the vaccine enters cells and is translated into foreign proteins, which trigger an immune response.

Several COVID19 vaccines, such as the Pfizer–BioNTech and Moderna vaccines, use RNA to stimulate an immune response. When introduced into human tissue, the vaccine contains either self-replicating RNA or messenger RNA (mRNA), which both cause cells to express the SARS-CoV-2 spike protein. This teaches the body how to identify and destroy the corresponding pathogen. RNA vaccines often use nucleoside-modified messenger RNA. The delivery of mRNA is achieved by a coformulation of the molecule into lipid nanoparticles, which protect the RNA strands and help their absorption into the cells. [52] [53] [54] [55]

RNA vaccines are the first COVID19 vaccines to be authorized in the United Kingdom, the United States, and the European Union. [56] [57] Authorized vaccines of this type are the Pfizer–BioNTech [58] [59] [60] and Moderna vaccines. [61] [62] The CVnCoV RNA vaccine from CureVac failed in clinical trials. [63]

Severe allergic reactions are rare. In December 2020, 1,893,360 first doses of Pfizer–BioNTech COVID19 vaccine administration resulted in 175 cases of severe allergic reactions, of which 21 were anaphylaxis. [64] For 4,041,396 Moderna COVID19 vaccine dose administrations in December 2020 and January 2021, only ten cases of anaphylaxis were reported. [64] Lipid nanoparticles (LNPs) were most likely responsible for the allergic reactions. [64]

Adenovirus vector vaccines

These vaccines are examples of non-replicating viral vector vaccines using an adenovirus shell containing DNA that encodes a SARS‑CoV‑2 protein. [65] [66] The viral vector-based vaccines against COVID19 are non-replicating, meaning that they do not make new virus particles but rather produce only the antigen that elicits a systemic immune response. [65]

Authorized vaccines of this type are the Oxford–AstraZeneca COVID‑19 vaccine, [67] [68] [69] the Sputnik V COVID‑19 vaccine, [70] Convidecia, and the Janssen COVID‑19 vaccine. [71] [72]

Convidecia and Janssen are both one-shot vaccines that offer less complicated logistics and can be stored under ordinary refrigeration for several months. [73] [74]

Sputnik V uses Ad26 for its first dose, which is the same as Janssen's only dose, and Ad5 for the second dose, which is the same as Convidecia's only dose. [75]

In August 2021, the developers of Sputnik V proposed, in view of the Delta case surge, that Pfizer test the Ad26 component (termed its 'Light' version) [76] as a booster shot. [77]

Inactivated virus vaccines

Inactivated vaccines consist of virus particles that are grown in culture and then killed using a method such as heat or formaldehyde to lose disease-producing capacity while still stimulating an immune response. [78]

Inactivated virus vaccines authorized in China include the Chinese CoronaVac [79] [80] [81] and the Sinopharm BIBP [82] and WIBP vaccines; there is also the Indian Covaxin; later this year, the Russian CoviVac; [83] the Kazakh vaccine QazVac; [84] and the Iranian COVIran Barekat. [85] Vaccines in clinical trials include the Valneva COVID19 vaccine. [86] [ unreliable source? ] [87]

Subunit vaccines

Subunit vaccines present one or more antigens without introducing whole pathogen particles. The antigens involved are often protein subunits, but they can be any molecule fragment of the pathogen. [88]

The authorized vaccines of this type are the peptide vaccine EpiVacCorona, [89] ZF2001, [43] MVC-COV1901, [90] Corbevax, [91] [92] the Sanofi–GSK vaccine, [93] [94] and Soberana 02 (a conjugate vaccine). [95] Bimervax was approved for use as a booster vaccine in the European Union in March 2023. [96] [97]

The V451 vaccine was in clinical trials that were terminated after it was found that the vaccine may potentially cause incorrect results for subsequent HIV testing. [98] [99] [100]

Virus-like particle vaccines

The authorized vaccines of this type include the Novavax COVID‑19 vaccine. [17] [101]

Other types

Additional types of vaccines that are in clinical trials include multiple DNA plasmid vaccines, [102] [103] [104] [105] [106] [107] at least two lentivirus vector vaccines, [108] [109] a conjugate vaccine, and a vesicular stomatitis virus displaying the SARS‑CoV‑2 spike protein. [110]

Scientists investigated whether existing vaccines for unrelated conditions could prime the immune system and lessen the severity of COVID19 infections. [111] There is experimental evidence that the BCG vaccine for tuberculosis has non-specific effects on the immune system, but there is no evidence that this vaccine is effective against COVID19. [112]

List of authorized vaccines

COVID-19 vaccines authorized for emergency use or approved for full use
Common name Type (technology)Country of originFirst authorizationNotes
Authorized in more than 10 countries
Oxford–AstraZeneca Adenovirus vector United Kingdom, SwedenDecember 2020
Pfizer–BioNTech RNA Germany,
United States
December 2020Both original and Omicron variant versions
Janssen (Johnson & Johnson)Adenovirus vectorUnited States,
Netherlands
February 2021
Moderna RNAUnited StatesDecember 2020Both original and Omicron variant versions
Sinopharm BIBP Inactivated ChinaJuly 2020
Sputnik V Adenovirus vectorRussiaAugust 2020
CoronaVac InactivatedChinaAugust 2020Low efficacy in replication studies and with certain variants
Novavax Subunit/virus-like particle United StatesDecember 2021A "recombinant nanoparticle vaccine" [113]
Covaxin InactivatedIndiaJanuary 2021
Valneva InactivatedFrance, AustriaApril 2022
Sanofi–GSK SubunitFrance,
United Kingdom
November 2022Based on Beta variant
Sputnik Light Adenovirus vectorRussiaMay 2021
Authorized in 2–10 countries
Convidecia Adenovirus vectorChinaJune 2020
Sinopharm WIBP InactivatedChinaFebruary 2021Lower efficacy
Abdala SubunitCubaJuly 2021
EpiVacCorona SubunitRussiaOctober 2020
Zifivax SubunitChinaMarch 2021
Soberana 02 SubunitCuba, IranJune 2021
CoviVac InactivatedRussiaFebruary 2021
Medigen SubunitTaiwanJuly 2021
QazCovid-in InactivatedKazakhstanApril 2021
Minhai InactivatedChinaMay 2021Undergoing clinical trials
COVIran Barekat InactivatedIranJune 2021
Soberana Plus SubunitCubaAugust 2021
Corbevax SubunitIndia, United StatesDecember 2021
Authorized in 1 country
Chinese Academy of Medical Sciences InactivatedChinaJune 2021
ZyCoV-D DNA IndiaAugust 2021
FAKHRAVAC InactivatedIranSeptember 2021
COVAX-19 SubunitAustralia, IranOctober 2021
Razi Cov Pars SubunitIranOctober 2021
Turkovac InactivatedTurkeyDecember 2021
Sinopharm CNBG SubunitChinaDecember 2021Based on original, Beta, and Kappa variants
CoVLP Virus-like particleCanada,
United Kingdom
February 2022
Noora SubunitIranMarch 2022
Skycovione SubunitSouth KoreaJune 2022
Walvax RNAChinaSeptember 2022
iNCOVACC Adenovirus vectorIndiaSeptember 2022 Nasal vaccine
V-01 SubunitChinaSeptember 2022
Gemcovac RNAIndiaOctober 2022Self-amplifying RNA vaccine
IndoVac SubunitIndonesiaOctober 2022

Delivery methods

All coronavirus vaccines are administered by injection. However, various other types of vaccine delivery methods have been studied for future coronavirus vaccines.

Intranasal

Intranasal vaccines target mucosal immunity in the nasal mucosa, which is a portal for viral entry into the body. [114] [115] These vaccines are designed to stimulate nasal immune factors, such as IgA. [114] In addition to inhibiting the virus, nasal vaccines provide ease of administration because no needles (or needle phobia) are involved. [115] [116]

A variety of intranasal COVID19 vaccines are undergoing clinical trials. One is in use in China. [117] Examples include a vaccine candidate that uses a modified avian virus as a vector to target SARS-CoV-2 spike proteins and an mRNA vaccine delivered via a nasal nanoparticle spray. [118] In September 2022, India and China approved the two first nasal COVID19 vaccines (iNCOVACC and Convidecia), which may (as boosters) [119] also reduce transmission [120] [121] (potentially via sterilizing immunity). [120]

Autologous

Aivita Biomedical is developing an experimental autologous dendritic cell COVID19 vaccine kit where the vaccine is prepared and incubated at the point-of-care using cells from the intended recipient. [122] The vaccine is undergoing small phase I and phase II clinical studies. [122] [123] [124]

Universal vaccine

A universal coronavirus vaccine would be effective against all coronaviruses and possibly other viruses. [125] [126] The concept was publicly endorsed by NIAID director Anthony Fauci, virologist Jeffery K. Taubenberger, and David M. Morens. [127] In March 2022, the White House released the "National COVID19 Preparedness Plan", which recommended accelerating the development of a universal coronavirus vaccine. [128]

One attempt at such a vaccine is being developed at the Walter Reed Army Institute of Research. It uses a spike ferritin-based nanoparticle (SpFN). This vaccine began a Phase I clinical trial in April 2022. [129]

Another strategy is to attach vaccine fragments from multiple strains to a nanoparticle scaffold. One theory is that a broader range of strains can be vaccinated against by targeting the receptor-binding domain, rather than the whole spike protein. [130]

Formulation

As of September 2020, eleven of the vaccine candidates in clinical development use adjuvants to enhance immunogenicity. [42] An immunological adjuvant is a substance formulated with a vaccine to elevate the immune response to an antigen, such as the COVID19 virus or influenza virus. [131] Specifically, an adjuvant may be used in formulating a COVID19 vaccine candidate to boost its immunogenicity and efficacy to reduce or prevent COVID19 infection in vaccinated individuals. [131] [132] Adjuvants used in COVID19 vaccine formulation may be particularly effective for technologies using the inactivated COVID19 virus and recombinant protein-based or vector-based vaccines. [132] Aluminum salts, known as "alum", were the first adjuvant used for licensed vaccines and are the adjuvant of choice in some 80% of adjuvanted vaccines. [132] The alum adjuvant initiates diverse molecular and cellular mechanisms to enhance immunogenicity, including the release of proinflammatory cytokines. [131] [132]

Planning and development

Since January 2020, vaccine development has been expedited via unprecedented collaboration in the multinational pharmaceutical industry and between governments. [42]

Multiple steps along the entire development path are evaluated, including: [22] [133]

Challenges

There have been several unique challenges with COVID19 vaccine development.

Public health programs[ who? ] have been described as "[a] race to vaccinate individuals" with the early wave vaccines. [134]

Timelines for conducting clinical research normally a sequential process requiring years are being compressed into safety, efficacy, and dosing trials running simultaneously over months, potentially compromising safety assurance. [135] [136] For example, Chinese vaccine developers and the Chinese Center for Disease Control and Prevention began their efforts in January 2020, [137] and by March they were pursuing numerous candidates on short timelines. [135] [138]

The rapid development and urgency of producing a vaccine for the COVID19 pandemic were expected to increase the risks and failure rate of delivering a safe, effective vaccine. [49] [50] [139] Additionally, research at universities is obstructed by physical distancing and the closing of laboratories. [140] [141]

Vaccines must progress through several phases of clinical trials to test for safety, immunogenicity, effectiveness, dose levels, and adverse effects of the candidate vaccine. [142] [143] Vaccine developers have to invest resources internationally to find enough participants for Phase II–III clinical trials when the virus has proved to be a "moving target" of changing transmission rates across and within countries, forcing companies to compete for trial participants. [144]

Clinical trial organizers may also encounter people unwilling to be vaccinated due to vaccine hesitancy [145] or disbelief in the science of the vaccine technology and its ability to prevent infection. [146] As new vaccines are developed during the COVID19 pandemic, licensure of COVID19 vaccine candidates[ who? ] requires submission of a full dossier of information on development and manufacturing quality. [147] [148] [149]

Organizations

Internationally, the Access to COVID‑19 Tools Accelerator is a G20 and World Health Organization (WHO) initiative announced in April 2020. [150] [151] It is a cross-discipline support structure to enable partners to share resources and knowledge. It comprises four pillars, each managed by two to three collaborating partners: Vaccines (also called "COVAX"), Diagnostics, Therapeutics, and Health Systems Connector. [152] The WHO's April 2020 "R&D Blueprint (for the) novel Coronavirus" documented a "large, international, multi-site, individually randomized controlled clinical trial" to allow "the concurrent evaluation of the benefits and risks of each promising candidate vaccine within 3–6 months of it being made available for the trial." The WHO vaccine coalition will prioritize which vaccines should go into Phase II and III clinical trials and determine harmonized Phase III protocols for all vaccines achieving the pivotal trial stage. [153]

National governments have also been involved in vaccine development. Canada announced funding for 96 projects for the development and production of vaccines at Canadian companies and universities, with plans to establish a "vaccine bank" that could be used if another coronavirus outbreak occurs, [154] support clinical trials, and develop manufacturing and supply chains for vaccines. [155]

China provided low-rate loans to one vaccine developer through its central bank and "quickly made land available for the company" to build production plants. [136] Three Chinese vaccine companies and research institutes are supported by the government for financing research, conducting clinical trials, and manufacturing. [156]

The United Kingdom government formed a COVID19 vaccine task force in April 2020 to stimulate local efforts for accelerated development of a vaccine through collaborations between industries, universities, and government agencies. The UK's Vaccine Taskforce contributed to every phase of development, from research to manufacturing. [157]

In the United States, the Biomedical Advanced Research and Development Authority (BARDA), a federal agency funding disease-fighting technology, announced investments to support American COVID19 vaccine development and the manufacturing of the most promising candidates. [136] [158] In May 2020, the government announced funding for a fast-track program called Operation Warp Speed. [159] [160] By March 2021, BARDA had funded an estimated $19.3 billion in COVID19 vaccine development. [161]

Large pharmaceutical companies with experience in making vaccines at scale, including Johnson & Johnson, AstraZeneca, and GlaxoSmithKline (GSK), formed alliances with biotechnology companies, governments, and universities to accelerate progress toward effective vaccines. [136] [135]

Clinical research


COVID-19 vaccine clinical research uses clinical research to establish the characteristics of COVID-19 vaccines. These characteristics include efficacy, effectiveness, and safety. As of November 2022, 40 vaccines are authorized by at least one national regulatory authority for public use: [162] [163]

As of June 2022, 353 vaccine candidates are in various stages of development, with 135 in clinical research, including 38 in phase I trials, 32 in phase I–II trials, 39 in phase III trials, and 9 in phase IV development. [162]

Post-vaccination complications

Post-vaccination embolic and thrombotic events, termed vaccine-induced immune thrombotic thrombocytopenia (VITT), [164] [165] [166] [167] [168] vaccine-induced prothrombotic immune thrombocytopenia (VIPIT), [169] thrombosis with thrombocytopenia syndrome (TTS), [170] [167] [168] vaccine-induced immune thrombocytopenia and thrombosis (VITT), [168] or vaccine-associated thrombotic thrombocytopenia (VATT), [168] are rare types of blood clotting syndromes that were initially observed in a number of people who had previously received the Oxford–AstraZeneca COVID‑19 vaccine (AZD1222) [lower-alpha 1] during the COVID‑19 pandemic. [169] [175] It was subsequently also described in the Janssen COVID‑19 vaccine (Johnson & Johnson), leading to the suspension of its use until its safety had been reassessed. [176] On 5 May 2022 the FDA posted a bulletin limiting the use of the Janssen Vaccine to very specific cases due to further reassessment of the risks of TTS, although the FDA also stated in the same bulletin that the benefits of the vaccine outweigh the risks. [177]

In April 2021, AstraZeneca and the European Medicines Agency (EMA) updated their information for healthcare professionals about AZD1222, saying it is "considered plausible" that there is a causal relationship between the vaccination and the occurrence of thrombosis in combination with thrombocytopenia and that, "although such adverse reactions are very rare, they exceeded what would be expected in the general population". [175] [178] [179] [180]

History


COVID-19 vaccine research samples in a NIAID lab freezer (30 January 2020) COVID-19 vaccine in NIAID lab freezer.jpg
COVID‑19 vaccine research samples in a NIAID lab freezer (30 January 2020)

SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), the virus that causes COVID-19, was isolated in late 2019. [181] Its genetic sequence was published on 11 January 2020, triggering an urgent international response to prepare for an outbreak and hasten the development of a preventive COVID-19 vaccine. [182] [183] [184] Since 2020, vaccine development has been expedited via unprecedented collaboration in the multinational pharmaceutical industry and between governments. [185] By June 2020, tens of billions of dollars were invested by corporations, governments, international health organizations, and university research groups to develop dozens of vaccine candidates and prepare for global vaccination programs to immunize against COVID‑19 infection. [183] [186] [187] [188] According to the Coalition for Epidemic Preparedness Innovations (CEPI), the geographic distribution of COVID‑19 vaccine development shows North American entities to have about 40% of the activity, compared to 30% in Asia and Australia, 26% in Europe, and a few projects in South America and Africa. [182] [185]

In February 2020, the World Health Organization (WHO) said it did not expect a vaccine against SARS‑CoV‑2 to become available in less than 18 months. [189] Virologist Paul Offit commented that, in hindsight, the development of a safe and effective vaccine within 11 months was a remarkable feat. [190] The rapidly growing infection rate of COVID‑19 worldwide during 2020 stimulated international alliances and government efforts to urgently organize resources to make multiple vaccines on shortened timelines, [191] with four vaccine candidates entering human evaluation in March (see COVID-19 vaccine § Trial and authorization status). [182] [192]

On 24 June 2020, China approved the CanSino vaccine for limited use in the military and two inactivated virus vaccines for emergency use in high-risk occupations. [193] On 11 August 2020, Russia announced the approval of its Sputnik V vaccine for emergency use, though one month later only small amounts of the vaccine had been distributed for use outside of the phase 3 trial. [194]

The Pfizer–BioNTech partnership submitted an Emergency Use Authorization (EUA) request to the U.S. Food and Drug Administration (FDA) for the mRNA vaccine BNT162b2 (active ingredient tozinameran) on 20 November 2020. [195] [196] On 2 December 2020, the United Kingdom's Medicines and Healthcare products Regulatory Agency (MHRA) gave temporary regulatory approval for the Pfizer–BioNTech vaccine, [197] [198] becoming the first country to approve the vaccine and the first country in the Western world to approve the use of any COVID‑19 vaccine. [199] [200] [201] As of 21 December 2020, many countries and the European Union [202] had authorized or approved the Pfizer–BioNTech COVID‑19 vaccine. Bahrain and the United Arab Emirates granted emergency marketing authorization for the Sinopharm BIBP vaccine. [203] [204] On 11 December 2020, the FDA granted an EUA for the Pfizer–BioNTech COVID‑19 vaccine. [205] A week later, they granted an EUA for mRNA-1273 (active ingredient elasomeran), the Moderna vaccine. [206] [207] [208] [209]

On 31 March 2021, the Russian government announced that they had registered the first COVID‑19 vaccine for animals. [210] Named Carnivac-Cov, it is an inactivated vaccine for carnivorous animals, including pets, aimed at preventing mutations that occur during the interspecies transmission of SARS-CoV-2. [211]

In October 2022, China began administering an oral vaccine developed by CanSino Biologics using its adenovirus model. [212]

Despite the availability of mRNA and viral vector vaccines, worldwide vaccine equity has not been achieved. The ongoing development and use of whole inactivated virus (WIV) and protein-based vaccines has been recommended, especially for use in developing countries, to dampen further waves of the pandemic. [213] [214]

In November 2021, the full nucleotide sequences of the AstraZeneca and Pfizer/BioNTech vaccines were released by the UK Medicines and Healthcare products Regulatory Agency in response to a freedom of information request. [215] [216]

Effectiveness

Death rates from COVID-19 for unvaccinated Americans substantially exceeded those who were vaccinated, with bivalent boosters further reducing the death rate. 2021- COVID-19 death rates by vaccination status - US.svg
Death rates from COVID-19 for unvaccinated Americans substantially exceeded those who were vaccinated, with bivalent boosters further reducing the death rate.

Evidence from vaccine use during the pandemic shows vaccination can reduce infection and is most effective at preventing severe COVID-19 symptoms and death, but is less good at preventing mild COVID-19. Efficacy wanes over time but can be maintained with boosters. [218] In 2021, the CDC reported that unvaccinated people were 10 times more likely to be hospitalized and 11 times more likely to die than fully vaccinated people. [219] [220]

The CDC reported that vaccine effectiveness fell from 91% against Alpha to 66% against Delta. [221] One expert stated that "those who are infected following vaccination are still not getting sick and not dying like was happening before vaccination." [222] By late August 2021, the Delta variant accounted for 99 percent of U.S. cases and was found to double the risk of severe illness and hospitalization for those not yet vaccinated. [223]

In November 2021, a study by the ECDC estimated that 470,000 lives over the age of 60 had been saved since the start of the vaccination roll-out in the European region. [224]

On 10 December 2021, the UK Health Security Agency reported that early data indicated a 20- to 40-fold reduction in neutralizing activity for Omicron by sera from Pfizer 2-dose vaccinees relative to earlier strains. After a booster dose (usually with an mRNA vaccine), [225] vaccine effectiveness against symptomatic disease was at 70%–75%, and the effectiveness against severe disease was expected to be higher. [226]

According to early December 2021 CDC data, "unvaccinated adults were about 97 times more likely to die from COVID-19 than fully vaccinated people who had received boosters". [227]

A meta-analysis looking into COVID-19 vaccine differences in immunosuppressed individuals found that people with a weakened immune system are less able to produce neutralizing antibodies. For example, organ transplant recipients need three vaccines to achieve seroconversion. [228] A study on the serologic response to mRNA vaccines among patients with lymphoma, leukemia, and myeloma found that one-quarter of patients did not produce measurable antibodies, varying by cancer type. [229]

In February 2023, a systematic review in The Lancet said that the protection afforded by infection was comparable to that from vaccination, albeit with an increased risk of severe illness and death from the disease of an initial infection. [230]

A January 2024 study by the CDC found that staying up to date on the vaccines could reduce the risk of strokes, blood clots and heart attacks related to COVID-19 in people aged 65 years or older or with a condition that makes them more vulnerable to said conditions. [231] [232]

Duration of immunity

As of 2021, available evidence shows that fully vaccinated individuals and those previously infected with SARS-CoV-2 have a low risk of subsequent infection for at least six months. [233] [234] [235] There is insufficient data to determine an antibody titer threshold that indicates when an individual is protected from infection. [233] Multiple studies show that antibody titers are associated with protection at the population level, but individual protection titers remain unknown. [233] For some populations, such as the elderly and the immunocompromised, protection levels may be reduced after both vaccination and infection. [233] Available evidence indicates that the level of protection may not be the same for all variants of the virus. [233]

As of December 2021, there are no FDA-authorized or approved tests that providers or the public can use to determine if a person is protected from infection reliably. [233]

As of March 2022, elderly residents' protection against severe illness, hospitalization, and death in English care homes was high immediately after vaccination, but protection declined significantly in the months following vaccination. [236] Protection among care home staff, who were younger, declined much more slowly. [236] Regular boosters are recommended for older people, and boosters for care home residents every six months appear reasonable. [236]

The US Centers for Disease Control and Prevention (CDC) recommends a fourth dose of the Pfizer mRNA vaccine as of March 2022 for "certain immunocompromised individuals and people over the age of 50". [237] [238]

Immune evasion by variants

In contrast to other investigated prior variants, the SARS-CoV-2 Omicron variant [239] [240] [241] [242] [243] and its BA.4/5 subvariants [244] have evaded immunity induced by vaccines, which may lead to breakthrough infections despite recent vaccination. Nevertheless, vaccines are thought to provide protection against severe illness, hospitalizations, and deaths due to Omicron. [245]

Vaccine adjustments

In June 2022, Pfizer and Moderna developed bivalent vaccines to protect against the SARS-CoV-2 wild-type and the Omicron variant. The bivalent vaccines are well-tolerated and offer immunity to Omicron superior to previous mRNA vaccines. [246] In September 2022, the United States Food and Drug Administration (FDA) authorized the bivalent vaccines for use in the US. [247] [248] [249]

In June 2023, the FDA advised manufacturers that the 2023–2024 formulation of the COVID-19 vaccines for use in the US be updated to be a monovalent COVID-19 vaccine using the XBB.1.5 lineage of the Omicron variant. [250] [251]

Effectiveness against transmission

As of 2022, fully vaccinated individuals with breakthrough infections with the SARS-CoV-2 delta (B.1.617.2) variant have a peak viral load similar to unvaccinated cases and can transmit infection in household settings. [252]

Mix and match

According to studies, the combination of two different COVID19 vaccines, also called cross-vaccination or the mix-and-match method, provides protection equivalent to that of mRNA vaccines, including protection against the Delta variant. Individuals who receive the combination of two different vaccines produce strong immune responses, with side effects no worse than those caused by standard regimens. [253] [254]

Adverse events

For most people, the side effects, also called adverse effects , from COVID19 vaccines are mild and can be managed at home. The adverse effects of the COVID19 vaccination are similar to those of other vaccines, and severe adverse effects are rare. [255] [256] Adverse effects from the vaccine are higher than placebo, but placebo arms of vaccine trials still reported adverse effects that can be attributed to the nocebo effect. [257]

All vaccines that are administered via intramuscular injection, including COVID19 vaccines, have side effects related to the mild trauma associated with the procedure and the introduction of a foreign substance into the body. [258] These include soreness, redness, rash, and inflammation at the injection site. Other common side effects include fatigue, headache, myalgia (muscle pain), and arthralgia (joint pain), all of which generally resolve without medical treatment within a few days. [11] [12] Like any other vaccine, some people are allergic to one or more ingredients in COVID19 vaccines. Typical side effects are stronger and more common in younger people and in subsequent doses, and up to 20% of people report a disruptive level of side effects after the second dose of an mRNA vaccine. [259] These side effects are less common or weaker in inactivated vaccines. [259] COVID19 vaccination-related enlargement of lymph nodes happens in 11.6% of those who received one dose of the vaccine and in 16% of those who received two doses. [260]

Experiments in mice show that intramuscular injections of lipid excipient nanoparticles (an inactive substance that serves as the vehicle or medium) cause particles to enter the blood plasma and many organs, with higher concentrations found in the liver and lower concentrations in the spleen, adrenal glands, and ovaries. The highest concentration of nanoparticles was found at the injection site itself. [261]

COVID19 vaccination is safe for breastfeeding people. [13] Temporary changes to the menstrual cycle in young women have been reported. However, these changes are "small compared with natural variation and quickly reverse." [262] In one study, women who received both doses of a two-dose vaccine during the same menstrual cycle (an atypical situation) may see their next period begin a couple of days late. They have about twice the usual risk of a clinically significant delay (about 10% of these women, compared to about 4% of unvaccinated women). [262] Cycle lengths return to normal after two menstrual cycles post-vaccination. [262] Women who received doses in separate cycles had approximately the same natural variation in cycle lengths as unvaccinated women. [262] Other temporary menstrual effects have been reported, such as heavier than normal menstrual bleeding after vaccination. [262]

Serious adverse events associated COVID19 vaccines are generally rare but of high interest to the public. [263] The official databases of reported adverse events include

Increased public awareness of these reporting systems and the extra reporting requirements under US FDA Emergency Use Authorization rules have increased reported adverse events. [265] Serious side effects are an ongoing area of study, and resources have been allocated to try and better understand them. [266] [267] [268] Research currently indicates that the rate and type of side effects are lower-risk than infection. For example, although vaccination may trigger some side effects, the effects experienced from an infection could be worse. Neurological side effects from getting COVID19 are hundreds of times more likely than from vaccination. [269]

Documented rare serious effects include:

There are rare reports of subjective hearing changes, including tinnitus, after vaccination. [271] [276] [277] [278]

Society and culture

Distribution

Note about the table in this section: number and percentage of people who have received at least one dose of a COVID19 vaccine (unless noted otherwise). May include vaccination of non-citizens, which can push totals beyond 100% of the local population. The table is updated daily by a bot. [note 2]

Updated January 26, 2024.
COVID-19 vaccine distribution by country [279]
LocationVaccinated [lower-alpha 2] Percent [lower-alpha 3]
OOjs UI icon globe.svg World [lower-alpha 4] [lower-alpha 5] 5,630,599,59770.60%
Flag of the People's Republic of China.svg China [lower-alpha 6] 1,310,292,00091.89%
Flag of India.svg India 1,027,420,52972.50%
Flag of Europe.svg European Union [lower-alpha 7] 338,058,29275.10%
Flag of the United States.svg United States [lower-alpha 8] 270,227,18181.39%
Flag of Indonesia.svg Indonesia 203,878,47374.00%
Flag of Brazil.svg Brazil 189,643,43188.08%
Flag of Pakistan.svg Pakistan 165,567,89070.21%
Flag of Bangladesh.svg Bangladesh 151,504,40388.50%
Flag of Japan.svg Japan 104,705,13384.47%
Flag of Mexico.svg Mexico 97,179,49376.22%
Flag of Nigeria.svg Nigeria 92,261,51042.22%
Flag of Vietnam.svg Vietnam 90,272,85391.94%
Flag of Russia.svg Russia 89,081,59661.56%
Flag of the Philippines.svg Philippines 78,484,84867.92%
Flag of Iran.svg Iran 65,199,83173.63%
Flag of Germany.svg Germany 64,876,29977.82%
Flag of Turkey.svg Turkey 57,941,05167.89%
Flag of Thailand.svg Thailand 57,005,49779.62%
Flag of Egypt.svg Egypt 56,907,31951.27%
Flag of France.svg France 54,677,67880.63%
Flag of the United Kingdom.svg United Kingdom 53,806,96379.97%
Flag of Italy.svg Italy [lower-alpha 9] 50,936,71986.28%
Flag of South Korea.svg South Korea 44,784,49986.43%
Flag of Ethiopia.svg Ethiopia 44,073,76635.72%
Flag of Colombia.svg Colombia 43,012,17482.92%
Flag of Argentina.svg Argentina 41,527,80591.25%
Flag of Spain.svg Spain 41,351,23486.95%
Flag of Myanmar.svg Myanmar 34,777,31464.64%
Flag of Canada (Pantone).svg Canada 34,763,19490.40%
Flag of Tanzania.svg Tanzania 34,434,93352.57%
Flag of Peru.svg Peru 30,563,70889.76%
Flag of Malaysia.svg Malaysia 28,137,86382.91%
Flag of Nepal.svg Nepal 27,883,19691.28%
Flag of Saudi Arabia.svg Saudi Arabia 27,041,36474.27%
Flag of Morocco.svg Morocco 25,020,16866.80%
Flag of South Africa.svg South Africa 24,209,93840.42%
Flag of Poland.svg Poland 22,877,47257.40%
Flag of Mozambique.svg Mozambique 22,869,64669.37%
Flag of Australia (converted).svg Australia 22,236,69884.95%
Flag of Venezuela.svg Venezuela 22,157,23278.29%
Flag of the Republic of China.svg Taiwan 21,899,24091.65%
Flag of Uzbekistan.svg Uzbekistan 21,674,82362.59%
Flag of Uganda.svg Uganda 19,488,10441.25%
Flag of the Taliban.svg Afghanistan 18,896,99945.95%
Flag of Chile.svg Chile 18,088,51792.27%
Flag of Sri Lanka.svg Sri Lanka 17,143,76178.53%
Flag of Angola.svg Angola 16,522,93246.43%
Flag of Ukraine.svg Ukraine 15,729,61736.19%
Flag of the Democratic Republic of the Congo.svg Democratic Republic of the Congo 15,388,88915.54%
Flag of Ecuador.svg Ecuador 15,333,87385.18%
Flag of Cambodia.svg Cambodia 15,315,25191.34%
Flag of Sudan.svg Sudan 15,207,45232.44%
Flag of Kenya.svg Kenya 14,494,37226.83%
Flag of Cote d'Ivoire.svg Ivory Coast 13,568,37248.18%
Flag of Ghana.svg Ghana 13,221,42139.50%
Flag of the Netherlands.svg Netherlands 12,596,44671.72%
Flag of Zambia.svg Zambia 11,637,73058.14%
Flag of Iraq.svg Iraq 11,332,92525.47%
Flag of Kazakhstan.svg Kazakhstan 10,858,10155.98%
Flag of Cuba.svg Cuba 10,768,78896.05%
Flag of Rwanda.svg Rwanda 10,572,98176.75%
Flag of the United Arab Emirates.svg United Arab Emirates 9,991,089100.00%
Flag of Portugal.svg Portugal 9,791,34195.33%
Flag of Belgium (civil).svg Belgium 9,267,47979.51%
Flag of Somalia.svg Somalia 8,972,16750.99%
Flag of Guatemala.svg Guatemala 8,933,62350.07%
Flag of Romania.svg Romania 8,187,97641.65%
Flag of Greece.svg Greece 7,937,42576.43%
Flag of Algeria.svg Algeria 7,840,13117.75%
Flag of Sweden.svg Sweden 7,775,72673.71%
Flag of Guinea.svg Guinea 7,679,91855.41%
Flag of the Dominican Republic.svg Dominican Republic 7,367,19365.61%
Bandera de Bolivia (Estado).svg Bolivia 7,361,00860.94%
Flag of Tunisia.svg Tunisia 7,218,87158.42%
Flag of the Czech Republic.svg Czech Republic 6,976,65966.48%
Flag of Hong Kong.svg Hong Kong 6,917,35592.37%
Flag of Austria.svg Austria 6,899,87377.18%
Flag of Israel.svg Israel 6,723,11971.15%
Flag of Honduras.svg Honduras 6,596,21363.23%
Flag of Belarus.svg Belarus 6,527,59168.46%
Flag of Zimbabwe.svg Zimbabwe 6,437,80840.25%
Flag of Hungary.svg Hungary 6,420,81364.42%
Flag of Nicaragua.svg Nicaragua 6,260,82390.10%
Flag of Chad.svg Chad 6,254,72935.29%
Flag of Niger.svg Niger 6,217,50823.72%
Flag of Switzerland (Pantone).svg Switzerland 6,096,91169.75%
Flag of Burkina Faso.svg Burkina Faso 6,089,08926.86%
Flag of Laos.svg Laos 5,888,64979.31%
Flag of Azerbaijan.svg Azerbaijan 5,373,25352.10%
Flag of Malawi.svg Malawi 5,343,85826.19%
Flag of Tajikistan.svg Tajikistan 5,282,86354.18%
Flag of Sierra Leone.svg Sierra Leone 5,252,12761.03%
Flag of Singapore.svg Singapore 5,160,55191.55%
Flag of Jordan.svg Jordan 4,821,57943.25%
Flag of Denmark.svg Denmark 4,752,10180.79%
Flag of El Salvador.svg El Salvador 4,652,59773.69%
Flag of Costa Rica.svg Costa Rica 4,641,89989.60%
Flag of Finland.svg Finland 4,524,24981.65%
Flag of Mali.svg Mali 4,354,29219.27%
Flag of Norway.svg Norway 4,346,99579.99%
Flag of New Zealand.svg New Zealand 4,301,60582.96%
Flag of South Sudan.svg South Sudan 4,287,16039.28%
Flag of Ireland.svg Republic of Ireland 4,108,86881.80%
Flag of Paraguay.svg Paraguay 3,993,93858.90%
Flag of Liberia.svg Liberia 3,825,38172.14%
Flag of Cameroon.svg Cameroon 3,753,73313.45%
Flag of Benin.svg Benin 3,697,19027.69%
Flag of Panama.svg Panama 3,533,47780.15%
Flag of Kuwait.svg Kuwait 3,457,49880.99%
Flag of Serbia.svg Serbia 3,354,07548.81%
Flag of Syria.svg Syria 3,295,63014.90%
Flag of Oman.svg Oman 3,257,36571.18%
Flag of Uruguay.svg Uruguay 3,010,45187.95%
Flag of Qatar.svg Qatar 2,852,178105.83%
Flag of Slovakia.svg Slovakia 2,822,91951.82%
Flag of Lebanon.svg Lebanon 2,740,22749.92%
Flag of Madagascar.svg Madagascar 2,700,3919.12%
Flag of Senegal.svg Senegal 2,684,69615.50%
Flag of the Central African Republic.svg Central African Republic 2,600,38946.61%
Flag of Croatia.svg Croatia 2,323,02557.64%
Flag of Libya.svg Libya 2,316,32734.00%
Flag of Mongolia.svg Mongolia 2,272,96568.27%
Flag of Togo.svg Togo 2,255,57925.49%
Flag of Bulgaria.svg Bulgaria 2,108,37731.09%
Flag of Mauritania.svg Mauritania 2,103,75444.42%
Flag of Palestine.svg Palestine 2,012,76738.34%
Flag of Lithuania.svg Lithuania 1,958,22171.21%
Flag of Botswana.svg Botswana 1,951,05474.18%
Flag of Kyrgyzstan (2023).svg Kyrgyzstan 1,736,54126.19%
Flag of Georgia.svg Georgia 1,654,50444.03%
Flag of Albania.svg Albania 1,348,39647.44%
Flag of Latvia.svg Latvia 1,346,18471.84%
Flag of Slovenia.svg Slovenia 1,265,80259.72%
Flag of Bahrain.svg Bahrain 1,241,17484.31%
Flag of Mauritius.svg Mauritius 1,123,77386.48%
Flag of Armenia.svg Armenia 1,122,04040.35%
Flag of Moldova.svg Moldova 1,108,87933.88%
Flag of Yemen.svg Yemen 1,050,1123.12%
Flag of Lesotho.svg Lesotho 1,014,07343.98%
Flag of Bosnia and Herzegovina.svg Bosnia and Herzegovina 943,39428.91%
Flag of The Gambia.svg Gambia 934,79934.55%
Flag of Kosovo.svg Kosovo 906,85850.89%
Flag of East Timor.svg Timor-Leste 886,83866.12%
Flag of Estonia.svg Estonia 870,12365.62%
Flag of Jamaica.svg Jamaica 859,77330.41%
Flag of North Macedonia.svg North Macedonia 854,57040.82%
Flag of Trinidad and Tobago.svg Trinidad and Tobago 753,58849.39%
Flag of Guinea-Bissau.svg Guinea-Bissau 747,05735.48%
Flag of Fiji.svg Fiji 712,02576.58%
Flag of Bhutan.svg Bhutan 699,11689.35%
Flag of the Republic of the Congo.svg Republic of the Congo 695,76011.92%
Flag of Macau.svg Macau 679,70397.77%
Flag of Cyprus.svg Cyprus 670,96974.88%
Flag of Namibia.svg Namibia 629,76724.53%
Flag of Eswatini.svg Eswatini 526,05043.78%
Flag of Haiti.svg Haiti 521,3964.50%
Flag of Guyana.svg Guyana 495,28561.24%
Flag of Luxembourg.svg Luxembourg 481,95774.42%
Flag of Malta.svg Malta 478,81489.78%
Flag of Brunei.svg Brunei 451,149100.48%
Flag of the Comoros.svg Comoros 438,82553.41%
Flag of Djibouti.svg Djibouti 421,57337.61%
Flag of Maldives.svg Maldives 399,30876.23%
Flag of Papua New Guinea.svg Papua New Guinea 382,0203.77%
Flag of Cape Verde.svg Cabo Verde 356,73460.68%
Flag of the Solomon Islands.svg Solomon Islands 343,82147.47%
Flag of Gabon.svg Gabon 311,04013.02%
Flag of Iceland.svg Iceland 309,77084.00%
Flag of the Turkish Republic of Northern Cyprus.svg Northern Cyprus 301,67378.80%
Flag of Montenegro.svg Montenegro 292,78346.63%
Flag of Equatorial Guinea.svg Equatorial Guinea 270,10916.53%
Flag of Suriname.svg Suriname 267,82045.26%
Flag of Belize.svg Belize 258,47363.78%
New Caledonia flags merged (2017).svg New Caledonia 192,37566.35%
Flag of Samoa.svg Samoa 191,40386.07%
Flag of French Polynesia.svg French Polynesia 190,90862.33%
Flag of Vanuatu.svg Vanuatu 176,62454.06%
Flag of the Bahamas.svg Bahamas 174,81042.64%
Flag of Barbados.svg Barbados 163,84658.17%
Flag of Sao Tome and Principe.svg Sao Tome and Principe 140,25661.68%
Flag of Curacao.svg Curaçao 108,60156.81%
Flag of Kiribati.svg Kiribati 100,90076.88%
Flag of Aruba.svg Aruba 90,54585.05%
Flag of Seychelles.svg Seychelles 88,52082.62%
Flag of Tonga.svg Tonga 87,34281.73%
Flag of Jersey.svg Jersey 84,36576.14%
Flag of the Isle of Man.svg Isle of Man 69,56081.44%
Flag of Antigua and Barbuda.svg Antigua and Barbuda 64,29068.97%
Flag of the Cayman Islands.svg Cayman Islands 62,02390.25%
Flag of Saint Lucia.svg Saint Lucia 60,14033.43%
Flag of Andorra.svg Andorra 57,90172.52%
Flag of Guernsey.svg Guernsey 54,22385.62%
Flag of Bermuda.svg Bermuda 48,55475.65%
Flag of Grenada.svg Grenada 44,24135.26%
Flag of Gibraltar.svg Gibraltar 42,175129.07%
Flag of the Faroe Islands.svg Faroe Islands 41,71585.04%
Flag of Greenland.svg Greenland 41,24372.52%
Flag of Saint Vincent and the Grenadines.svg Saint Vincent and the Grenadines 37,52736.10%
Flag of Burundi.svg Burundi 36,9090.29%
Flag of Saint Kitts and Nevis.svg Saint Kitts and Nevis 33,79470.88%
Flag of Dominica.svg Dominica 32,99545.57%
Flag of the Turks and Caicos Islands.svg Turks and Caicos Islands 32,81571.76%
Flag of Turkmenistan.svg Turkmenistan 32,2400.53%
Flag of Sint Maarten.svg Sint Maarten 29,78867.41%
Flag of Liechtenstein.svg Liechtenstein 26,77168.02%
Flag of Monaco.svg Monaco 26,67267.49%
Flag of San Marino.svg San Marino 26,35777.50%
Flag of the British Virgin Islands.svg British Virgin Islands 19,46662.55%
Flag of the Netherlands.svg Caribbean Netherlands 19,10972.26%
Flag of the Cook Islands.svg Cook Islands 15,11288.73%
Flag of Nauru.svg Nauru 13,106103.27%
Flag of Anguilla.svg Anguilla 10,85468.36%
Flag of France.svg Wallis and Futuna 7,15061.66%
Flag of Tuvalu.svg Tuvalu 6,36853.40%
Flag of the United Kingdom.svg Saint Helena, Ascension and Tristan da Cunha 4,36171.83%
Flag of the Falkland Islands.svg Falkland Islands 2,63275.57%
Flag of Tokelau.svg Tokelau 2,203116.38%
Flag of Montserrat.svg Montserrat 2,10447.68%
Flag of Niue.svg Niue 1,650102.23%
Flag of the Pitcairn Islands.svg Pitcairn Islands 47100.00%
Flag of North Korea.svg North Korea 00.00%
  1. The Oxford–AstraZeneca COVID‑19 vaccine is codenamed AZD1222, [171] and later supplied under brand names, including Vaxzevria [172] and Covishield. [173] [174]
  2. Number of people who have received at least one dose of a COVID-19 vaccine (unless noted otherwise).
  3. Percentage of population that has received at least one dose of a COVID-19 vaccine. May include vaccination of non-citizens, which can push totals beyond 100% of the local population.
  4. Countries which do not report data for a column are not included in that column's world total.
  5. Vaccination note: Countries which do not report the number of people who have received at least one dose are not included in the world total.
  6. Does not include special administrative regions (Hong Kong and Macau) or Taiwan.
  7. Data on member states of the European Union are individually listed, but are also summed here for convenience. They are not double-counted in world totals.
  8. Vaccination note: Includes Freely Associated States
  9. Vaccination note: Includes Vatican City

As of 3 January 2024, 13.53 billion COVID-19 vaccine doses have been administered worldwide, with 70.6 percent of the global population having received at least one dose. [280] [281] While 4.19 million vaccines were then being administered daily, only 22.3 percent of people in low-income countries had received at least a first vaccine by September 2022, according to official reports from national health agencies, which are collated by Our World in Data. [282]

During a pandemic on the rapid timeline and scale of COVID-19 cases in 2020, international organizations like the World Health Organization (WHO) and Coalition for Epidemic Preparedness Innovations (CEPI), vaccine developers, governments, and industry evaluated the distribution of the eventual vaccine(s). [283] Individual countries producing a vaccine may be persuaded to favor the highest bidder for manufacturing or provide first-class service to their own country. [284] [285] [286] Experts emphasize that licensed vaccines should be available and affordable for people at the frontlines of healthcare and in most need. [284] [286]

In April 2020, it was reported that the UK agreed to work with 20 other countries and global organizations, including France, Germany, and Italy, to find a vaccine and share the results, and that UK citizens would not get preferential access to any new COVID‑19 vaccines developed by taxpayer-funded UK universities. [287] Several companies planned to initially manufacture a vaccine at artificially low prices, then increase prices for profitability later if annual vaccinations are needed and as countries build stock for future needs. [286]

The WHO had set out the target to vaccinate 40% of the population of all countries by the end of 2021 and 70% by mid-2022, [288] but many countries missed the 40% target at the end of 2021. [289] [290]

Access

Countries have extremely unequal access to the COVID19 vaccine. Vaccine equity has not been achieved or even approximated. The inequity has harmed both countries with poor access and countries with good access. [17] [18] [291]

Nations pledged to buy doses of the COVID19 vaccines before the doses were available. Though high-income nations represent only 14% of the global population, as of 15 November 2020, they had contracted to buy 51% of all pre-sold doses. Some high-income nations bought more doses than would be necessary to vaccinate their entire populations. [16]

Production of the Sputnik V vaccine in Brazil, January 2021 Fabrica do DF produz vacina Sputnik V (50874839072).jpg
Production of the Sputnik V vaccine in Brazil, January 2021

In January 2021, WHO Director-General Tedros Adhanom Ghebreyesus warned of problems with equitable distribution: "More than 39 million doses of vaccine have now been administered in at least 49 higher-income countries. Just 25 doses have been given in one lowest-income country. Not 25 million; not 25 thousand; just 25." [292]

Inside of a vaccination center in Brussels, Belgium, February 2021 Inside view of the vaccination centre 2.jpg
Inside of a vaccination center in Brussels, Belgium, February 2021

In March 2021, it was revealed that the US attempted to convince Brazil not to purchase the Sputnik V COVID19 vaccine, fearing "Russian influence" in Latin America. [293] Some nations involved in long-standing territorial disputes have reportedly had their access to vaccines blocked by competing nations; Palestine has accused Israel of blocking vaccine delivery to Gaza, while Taiwan has suggested that China has hampered its efforts to procure vaccine doses. [294] [295] [296]

A single dose of the COVID19 vaccines by AstraZeneca would cost 47 Egyptian pounds (EGP), and the authorities are selling them for between 100 and 200 EGP. A report by the Carnegie Endowment for International Peace cited the poverty rate in Egypt as around 29.7 percent, which constitutes approximately 30.5 million people, and claimed that about 15 million Egyptians would be unable to gain access to the luxury of vaccination. A human rights lawyer, Khaled Ali, launched a lawsuit against the government, forcing them to provide vaccinations free of charge to all members of the public. [297]

COVID-19 vaccination for children aged 12-14 in Bhopal, India Covid vaccination for children aged 12-14 in India 03cropped.jpg
COVID19 vaccination for children aged 12–14 in Bhopal, India

According to immunologist Anthony Fauci, mutant strains of the virus and limited vaccine distribution pose continuing risks, and he said, "we have to get the entire world vaccinated, not just our own country." [298] Edward Bergmark and Arick Wierson are calling for a global vaccination effort and wrote that the wealthier nations' "me-first" mentality could ultimately backfire because the spread of the virus in poorer countries would lead to more variants, against which the vaccines could be less effective. [299]

In March 2021, the United States, Britain, European Union member states, and some other members of the World Trade Organization (WTO) blocked a push by more than eighty developing countries to waive COVID19 vaccine patent rights in an effort to boost production of vaccines for poor nations. [300] On 5 May 2021, the US government under President Joe Biden announced that it supports waiving intellectual property protections for COVID19 vaccines. [301] The Members of the European Parliament have backed a motion demanding the temporary lifting of intellectual property rights for COVID19 vaccines. [302]

An elderly man receiving a second dose of the CoronaVac vaccine in Brazil in April 2021 Brasileiro tomando vacina contra o COVID-19.jpg
An elderly man receiving a second dose of the CoronaVac vaccine in Brazil in April 2021

In a meeting in April 2021, the World Health Organization's emergency committee addressed concerns of persistent inequity in global vaccine distribution. [303] Although 9 percent of the world's population lives in the 29 poorest countries, these countries had received only 0.3% of all vaccines administered as of May 2021. [304] In March 2021, Brazilian journalism agency Agência Pública reported that the country vaccinated about twice as many people who declare themselves white than black and noted that mortality from COVID19 is higher in the black population. [305]

In May 2021, UNICEF made an urgent appeal to industrialized nations to pool their excess COVID19 vaccine capacity to make up for a 125-million-dose gap in the COVAX program. The program mostly relied on the Oxford–AstraZeneca COVID‑19 vaccine produced by the Serum Institute of India, which faced serious supply problems due to increased domestic vaccine needs in India from March to June 2021. Only a limited amount of vaccines can be distributed efficiently, and the shortfall of vaccines in South America and parts of Asia is due to a lack of expedient donations by richer nations. International aid organizations have pointed at Nepal, Sri Lanka, and the Maldives, as well as Argentina, Brazil, and some parts of the Caribbean, as problem areas where vaccines are in short supply. In mid-May 2021, UNICEF was also critical of the fact that most proposed donations of Moderna and Pfizer vaccines were not slated for delivery until the second half of 2021 or early in 2022. [306]

COVID-19 mass vaccination queue in Finland, June 2021 COVID-19 mass vaccination in Ratina, Tampere, Finland.jpg
COVID19 mass vaccination queue in Finland, June 2021

In July 2021, the heads of the World Bank Group, the International Monetary Fund, the World Health Organization, and the World Trade Organization said in a joint statement: "As many countries are struggling with new variants and a third wave of COVID19 infections, accelerating access to vaccines becomes even more critical to ending the pandemic everywhere and achieving broad-based growth. We are deeply concerned about the limited vaccines, therapeutics, diagnostics, and support for deliveries available to developing countries." [307] [308] In July 2021, The BMJ reported that countries had thrown out over 250,000 vaccine doses as supply exceeded demand and strict laws prevented the sharing of vaccines. [309] A survey by The New York Times found that over a million doses of vaccine had been thrown away in ten U.S. states because federal regulations prohibit recalling them, preventing their redistribution abroad. [310] Furthermore, doses donated close to expiration often cannot be administered quickly enough by recipient countries and end up having to be discarded. [311] To help overcome this problem, the Prime Minister of India, Narendra Modi, announced that they would make their digital vaccination management platform, CoWIN, open to the global community. He also announced that India would also release the source code for the contact tracing app Aarogya Setu for developers around the world. Around 142 countries, including Afghanistan, Bangladesh, Bhutan, the Maldives, Guyana, Antigua and Barbuda, St. Kitts and Nevis, and Zambia, expressed their interest in the application for COVID management. [312] [313]

Amnesty International and Oxfam International have criticized the support of vaccine monopolies by the governments of producing countries, noting that this is dramatically increasing the dose price by five times and often much more, creating an economic barrier to access for poor countries. [314] [315] Médecins Sans Frontières (Doctors without Borders) has also criticized vaccine monopolies and repeatedly called for their suspension, supporting the TRIPS waiver. The waiver was first proposed in October 2020 and has support from most countries, but was delayed by opposition from the EU (especially Germany; major EU countries such as France, Italy, and Spain support the exemption), [316] the UK, Norway, and Switzerland, among others. MSF called for a Day of Action in September 2021 to put pressure on the WTO Minister's meeting in November, which was expected to discuss the TRIPS IP waiver. [317] [318] [319]

A drive-through COVID-19 vaccination center in Iran, August 2021 Iran COVID19-Vaccination center.jpg
A drive-through COVID19 vaccination center in Iran, August 2021

In August 2021, to reduce unequal distribution between rich and poor countries, the WHO called for a moratorium on booster doses at least until the end of September. However, in August, the United States government announced plans to offer booster doses eight months after the initial course to the general population, starting with priority groups. Before the announcement, the WHO harshly criticized this type of decision, citing the lack of evidence for the need for boosters, except for patients with specific conditions. At this time, vaccine coverage of at least one dose was 58% in high-income countries and only 1.3% in low-income countries, and 1.14 million Americans had already received an unauthorized booster dose. US officials argued that waning efficacy against mild and moderate disease might indicate reduced protection against severe disease in the coming months. Israel, France, Germany, and the United Kingdom have also started planning boosters for specific groups. [320] [321] [322] In September 2021, more than 140 former world leaders and Nobel laureates, including former President of France François Hollande, former Prime Minister of the United Kingdom Gordon Brown, former Prime Minister of New Zealand Helen Clark, and Professor Joseph Stiglitz, called on the candidates to be the next German chancellor to declare themselves in favor of waiving intellectual property rules for COVID19 vaccines and transferring vaccine technologies. [323] In November 2021, nursing unions in 28 countries filed a formal appeal with the United Nations over the refusal of the UK, EU, Norway, Switzerland, and Singapore to temporarily waive patents for COVID19 vaccines. [324]

During his first international trip, the President of Peru, Pedro Castillo, spoke at the seventy-sixth session of the United Nations General Assembly on 21 September 2021, proposing the creation of an international treaty signed by world leaders and pharmaceutical companies to guarantee universal vaccine access, arguing that "The battle against the pandemic has shown us the failure of the international community to cooperate under the principle of solidarity." [325] [326]

Optimizing the societal benefit of vaccination may benefit from a strategy that is tailored to the state of the pandemic, the demographics of a country, the age of the recipients, the availability of vaccines, and the individual risk for severe disease. [10] In the UK, the interval between prime and booster doses was extended to vaccinate as many people as early as possible. [327] Many countries are starting to give an additional booster shot to the immunosuppressed [328] [329] and the elderly, [330] and research predicts an additional benefit of personalizing vaccine doses in the setting of limited vaccine availability when a wave of virus Variants of Concern hits a country. [331]

Despite the extremely rapid development of effective mRNA and viral vector vaccines, vaccine equity has not been achieved. [17] The World Health Organization called for 70 percent of the global population to be vaccinated by mid-2022, but as of March 2022, it was estimated that only one percent of the 10 billion doses given worldwide had been administered in low-income countries. [332] An additional 6 billion vaccinations may be needed to fill vaccine access gaps, particularly in developing countries. Given the projected availability of newer vaccines, the development and use of whole inactivated virus (WIV) and protein-based vaccines are also recommended. Organizations such as the Developing Countries Vaccine Manufacturers Network could help to support the production of such vaccines in developing countries, with lower production costs and greater ease of deployment. [17] [333]

While vaccines substantially reduce the probability and severity of infection, it is still possible for fully vaccinated people to contract and spread COVID19. [334] Public health agencies have recommended that vaccinated people continue using preventive measures (wear face masks, social distance, wash hands) to avoid infecting others, especially vulnerable people, particularly in areas with high community spread. Governments have indicated that such recommendations will be reduced as vaccination rates increase and community spread declines. [335]

Economics

Moreover, an unequal distribution of vaccines will deepen inequality and exaggerate the gap between rich and poor and will reverse decades of hard-won progress on human development.
United Nations, COVID vaccines: Widening inequality and millions vulnerable [336]

Vaccine inequity damages the global economy, disrupting the global supply chain. [291] Most vaccines were reserved for wealthy countries; as of September 2021, [336] some countries have more vaccines than are needed to fully vaccinate their populations. [16] When people are under-vaccinated, needlessly die, experience disability, and live under lockdown restrictions, they cannot supply the same goods and services. This harms the economies of under-vaccinated and over-vaccinated countries alike. Since rich countries have larger economies, rich countries may lose more money to vaccine inequity than poor ones, [291] though the poor ones will lose a higher percentage of GDP and experience longer-term effects. [337] High-income countries would profit an estimated US$4.80 for every $1 spent on giving vaccines to lower-income countries. [291]

The International Monetary Fund sees the vaccine divide between rich and poor nations as a serious obstacle to a global economic recovery. [338] Vaccine inequity disproportionately affects refuge-providing states, as they tend to be poorer, and refugees and displaced people are economically more vulnerable even within those low-income states, so they have suffered more economically from vaccine inequity. [339] [17]

Liability

Several governments agreed to shield pharmaceutical companies like Pfizer and Moderna from negligence claims related to COVID19 vaccines (and treatments), as in previous pandemics, when governments also took on liability for such claims.

In the US, these liability shields took effect on 4 February 2020, when the US Secretary of Health and Human Services, Alex Azar, published a notice of declaration under the Public Readiness and Emergency Preparedness Act (PREP Act) for medical countermeasures against COVID19, covering "any vaccine, used to treat, diagnose, cure, prevent, or mitigate COVID19, or the transmission of SARS-CoV-2 or a virus mutating therefrom". The declaration precludes "liability claims alleging negligence by a manufacturer in creating a vaccine, or negligence by a health care provider in prescribing the wrong dose, absent willful misconduct." In other words, absent "willful misconduct", these companies cannot be sued for money damages for any injuries that occur between 2020 and 2024 from the administration of vaccines and treatments related to COVID19. [340] The declaration is effective in the United States through 1 October 2024. [340]

In December 2020, the UK government granted Pfizer legal indemnity for its COVID19 vaccine. [341]

In the European Union, the COVID19 vaccines were granted a conditional marketing authorization, which does not exempt manufacturers from civil and administrative liability claims. [342] The EU conditional marketing authorizations were changed to standard authorizations in September 2022. [343] While the purchasing contracts with vaccine manufacturers remain secret, they do not contain liability exemptions, even for side effects not known at the time of licensure. [344]

The Bureau of Investigative Journalism, a nonprofit news organization, reported in an investigation that unnamed officials in some countries, such as Argentina and Brazil, said that Pfizer demanded guarantees against costs of legal cases due to adverse effects in the form of liability waivers and sovereign assets such as federal bank reserves, embassy buildings, or military bases, going beyond what was expected from other countries, such as the US. [345] During the pandemic parliamentary inquiry in Brazil, Pfizer's representative said that its terms for Brazil are the same as for all other countries with which it has signed deals. [346]

On 13 December 2022, the governor of Florida, Ron DeSantis, said that he would petition the state supreme court to convene a grand jury to investigate possible violations in respect to COVID19 vaccines, [347] and declared that his government would be able to get "the data whether they [the companies] want to give it or not". [348]

Controversy

In June 2021, a report revealed that the UB-612 vaccine, developed by the US-based Covaxx, was a for-profit venture initiated by Blackwater founder Erik Prince. In a series of text messages to Paul Behrends, the close associate recruited for the Covaxx project, Prince described the profit-making possibilities of selling the COVID19 vaccines. Covaxx provided no data from the clinical trials on safety or efficacy it conducted in Taiwan. The responsibility of creating distribution networks was assigned to an Abu Dhabi-based entity, which was mentioned as "Windward Capital" on the Covaxx letterhead but was actually Windward Holdings. The firm's sole shareholder, who handled "professional, scientific and technical activities", was Erik Prince. In March 2021, Covaxx raised $1.35 billion in a private placement. [349]

Misinformation and hesitancy


A protest against COVID-19 vaccination in London, United Kingdom Antivax protest in London 2.jpg
A protest against COVID-19 vaccination in London, United Kingdom

Anti-vaccination activists and other people in many countries have spread a variety of unfounded conspiracy theories and other misinformation about COVID-19 vaccines based on misunderstood or misrepresented science, religion, and law. These have included exaggerated claims about side effects, misrepresentations about how the immune system works and when and how COVID-19 vaccines are made, a story about COVID-19 being spread by 5G, and other false or distorted information. This misinformation has proliferated and may have made many people averse to vaccination. [350] This has led to governments and private organizations around the world introducing measures to incentivize or coerce vaccination, such as lotteries, [351] mandates, [352] and free entry to events, [353] which has in turn led to further misinformation about the legality and effect of these measures themselves. [354]

In the US, some prominent biomedical scientists who publicly advocate vaccination have been attacked and threatened in emails and on social media by anti-vaccination activists. [355]

See also

Notes

  1. Our World in Data (OWID) vaccination maps. Data is from public sources (Archived 21 December 2021 at the Wayback Machine ). Data FAQ (Archived 10 March 2021 at the Wayback Machine ).
  2. The table data is automatically updated daily by a bot; see Template:COVID-19 data for more information. Scroll down past the table to find the documentation and the main reference. See also: Category:Automatically updated COVID-19 pandemic table templates.

Related Research Articles

mRNA vaccine Type of vaccine

An mRNAvaccine is a type of vaccine that uses a copy of a molecule called messenger RNA (mRNA) to produce an immune response. The vaccine delivers molecules of antigen-encoding mRNA into immune cells, which use the designed mRNA as a blueprint to build foreign protein that would normally be produced by a pathogen or by a cancer cell. These protein molecules stimulate an adaptive immune response that teaches the body to identify and destroy the corresponding pathogen or cancer cells. The mRNA is delivered by a co-formulation of the RNA encapsulated in lipid nanoparticles that protect the RNA strands and help their absorption into the cells.

<span class="mw-page-title-main">Moderna COVID-19 vaccine</span> RNA COVID-19 vaccine

The Moderna COVID‑19 vaccine, sold under the brand name Spikevax, is a COVID-19 vaccine developed by the American company Moderna, the United States National Institute of Allergy and Infectious Diseases (NIAID), and the Biomedical Advanced Research and Development Authority (BARDA). Depending on the jurisdiction, it is authorized for use in humans aged six months, twelve years, or eighteen years and older. It provides protection against COVID-19, which is caused by infection by the SARS-CoV-2 virus. It is designed to be administered in two or three 0.5-mL doses given by intramuscular injection at an interval of at least 28 days apart.

<span class="mw-page-title-main">Oxford–AstraZeneca COVID-19 vaccine</span> Viral vector vaccine for prevention of COVID-19 by Oxford University and AstraZeneca

The Oxford–AstraZeneca COVID‑19 vaccine, sold under the brand names Covishield and Vaxzevria among others, is a viral vector vaccine for the prevention of COVID-19. It was developed in the United Kingdom by Oxford University and British-Swedish company AstraZeneca, using as a vector the modified chimpanzee adenovirus ChAdOx1. The vaccine is given by intramuscular injection. Studies carried out in 2020 showed that the efficacy of the vaccine is 76.0% at preventing symptomatic COVID-19 beginning at 22 days following the first dose and 81.3% after the second dose. A study in Scotland found that, for symptomatic COVID-19 infection after the second dose, the vaccine is 81% effective against the Alpha variant and 61% against the Delta variant.

<span class="mw-page-title-main">BioNTech</span> German biotechnology company

BioNTech SE is a German biotechnology company based in Mainz that develops and manufactures active immunotherapies for patient-specific approaches to the treatment of diseases. It develops pharmaceutical candidates based on messenger ribonucleic acid (mRNA) for use as individualized cancer immunotherapies, as vaccines against infectious diseases and as protein replacement therapies for rare diseases, and also engineered cell therapy, novel antibodies and small molecule immunomodulators as treatment options for cancer.

<span class="mw-page-title-main">CoronaVac</span> Vaccine against COVID-19

CoronaVac, also known as the Sinovac COVID-19 vaccine, is a whole inactivated virus COVID-19 vaccine developed by the Chinese company Sinovac Biotech. It was phase III clinically trialled in Brazil, Chile, Indonesia, the Philippines, and Turkey and relies on traditional technology similar to other inactivated-virus COVID-19 vaccines, such as the Sinopharm BIBP vaccine, another Chinese vaccine, and Covaxin, an Indian vaccine. CoronaVac does not need to be frozen, and both the final product and the raw material for formulating CoronaVac can be transported refrigerated at 2–8 °C (36–46 °F), the temperatures at which flu vaccines are kept.

<span class="mw-page-title-main">Pfizer–BioNTech COVID-19 vaccine</span> Type of vaccine for humans

The Pfizer–BioNTech COVID-19 vaccine, sold under the brand name Comirnaty, is an mRNA-based COVID-19 vaccine developed by the German biotechnology company BioNTech. For its development, BioNTech collaborated with the American company Pfizer to carry out clinical trials, logistics, and manufacturing. It is authorized for use in humans to provide protection against COVID-19, caused by infection with the SARS-CoV-2 virus. The vaccine is given by intramuscular injection. It is composed of nucleoside-modified mRNA (modRNA) encoding a mutated form of the full-length spike protein of SARS-CoV-2, which is encapsulated in lipid nanoparticles. Initial advice indicated that vaccination required two doses given 21 days apart, but the interval was later extended to up to 42 days in the US, and up to four months in Canada.

<span class="mw-page-title-main">Sinopharm BIBP COVID-19 vaccine</span> Vaccine against COVID-19

The Sinopharm BIBP COVID-19 vaccine, also known as BBIBP-CorV, the Sinopharm COVID-19 vaccine, or BIBP vaccine, is one of two whole inactivated virus COVID-19 vaccines developed by Sinopharm's Beijing Institute of Biological Products. It completed Phase III trials in Argentina, Bahrain, Egypt, Morocco, Pakistan, Peru, and the United Arab Emirates (UAE) with over 60,000 participants. BBIBP-CorV shares similar technology with CoronaVac and Covaxin, other inactivated virus vaccines for COVID-19. Its product name is SARS-CoV-2 Vaccine, not to be confused with the similar product name of CoronaVac.

<span class="mw-page-title-main">COVID-19 vaccination in the United Kingdom</span> Immunisation against COVID-19

The COVID-19 vaccination programme in the United Kingdom is an ongoing mass immunisation campaign for coronavirus disease 2019 (COVID-19) during the COVID-19 pandemic in the United Kingdom.

<span class="mw-page-title-main">Novavax COVID-19 vaccine</span> Vaccine against COVID-19

The Novavax COVID-19 vaccine, sold under the brand names Nuvaxovid and Covovax, among others, is a subunit COVID-19 vaccine developed by Novavax and the Coalition for Epidemic Preparedness Innovations (CEPI).

<span class="mw-page-title-main">COVID-19 vaccination in Israel</span> Plan to immunize against COVID-19

Israel's COVID-19 vaccination programme, officially named "Give a Shoulder", began on 19 December 2020, and has been praised for its speed, having given twenty percent of the Israeli population the first dose of the vaccines' two dose regimen in the span of three weeks.

<span class="mw-page-title-main">Deployment of COVID-19 vaccines</span> Distribution and administration of COVID-19 vaccinations

As of 3 January 2024, 13.53 billion COVID-19 vaccine doses have been administered worldwide, with 70.6 percent of the global population having received at least one dose. While 4.19 million vaccines were then being administered daily, only 22.3 percent of people in low-income countries had received at least a first vaccine by September 2022, according to official reports from national health agencies, which are collated by Our World in Data.

<span class="mw-page-title-main">History of COVID-19 vaccine development</span> Scientific work to develop a vaccine for COVID-19

SARS-CoV-2, the virus that causes COVID-19, was isolated in late 2019. Its genetic sequence was published on 11 January 2020, triggering an urgent international response to prepare for an outbreak and hasten the development of a preventive COVID-19 vaccine. Since 2020, vaccine development has been expedited via unprecedented collaboration in the multinational pharmaceutical industry and between governments. By June 2020, tens of billions of dollars were invested by corporations, governments, international health organizations, and university research groups to develop dozens of vaccine candidates and prepare for global vaccination programs to immunize against COVID‑19 infection. According to the Coalition for Epidemic Preparedness Innovations (CEPI), the geographic distribution of COVID‑19 vaccine development shows North American entities to have about 40% of the activity, compared to 30% in Asia and Australia, 26% in Europe, and a few projects in South America and Africa.

<span class="mw-page-title-main">CureVac COVID-19 vaccine</span> Vaccine candidate against COVID-19

The CureVac COVID-19 vaccine was a COVID-19 vaccine candidate developed by CureVac N.V. and the Coalition for Epidemic Preparedness Innovations (CEPI). The vaccine showed inadequate results in its Phase III trials with only 47% efficacy. In October 2021 CureVac abandoned further development and production plans for CVnCoV and refocused efforts on a cooperation with GlaxoSmithKline.

<span class="mw-page-title-main">SCB-2019</span> Vaccine candidate against COVID-19

SCB-2019 is a protein subunit COVID-19 vaccine developed by Clover Biopharmaceuticals using an adjuvant from Dynavax technologies. Positive results of Phase I trials for the vaccine were published in The Lancet and the vaccine completed enrollment of 29,000 participants in Phase II/III trials in July 2021. In September 2021, SCB-2019 announced Phase III results showing 67% efficacy against all cases of COVID-19 and 79% efficacy against all cases of the Delta variant. Additionally, the vaccine was 84% effective against moderate cases and 100% effective against hospitalization.

<span class="mw-page-title-main">Viral vector vaccine</span> Type of vaccine

A viral vector vaccine is a vaccine that uses a viral vector to deliver genetic material (DNA) that can be transcribed by the recipient's host cells as mRNA coding for a desired protein, or antigen, to elicit an immune response. As of April 2021, six viral vector vaccines, four COVID-19 vaccines and two Ebola vaccines, have been authorized for use in humans.

<span class="mw-page-title-main">Walvax COVID-19 vaccine</span> Vaccine candidate against COVID-19

AWcorna, originally termed ARCoV and also known as the Walvax COVID-19 vaccine, is an mRNA COVID-19 vaccine developed by Walvax Biotechnology, Suzhou Abogen Biosciences, and the PLA Academy of Military Science. In contrast to other mRNA COVID vaccines, such as those by Pfizer-BioNtech and Moderna, this vaccine primarily targets the Sars-CoV-2 receptor-binding domain of the spike protein, rather than the entire spike protein. It is approved for Phase III trials in China, Mexico, Indonesia, and Nepal.

<span class="mw-page-title-main">COVID-19 vaccination in Japan</span> Plan to immunize against COVID-19 in Japan

COVID-19 vaccination in Japan started later than in most other major economies. The country has frequently been regarded as "slow" in its vaccination efforts.

<span class="mw-page-title-main">COVID-19 vaccine clinical research</span> Clinical research to establish the characteristics of COVID-19 vaccines

COVID-19 vaccine clinical research uses clinical research to establish the characteristics of COVID-19 vaccines. These characteristics include efficacy, effectiveness, and safety. As of November 2022, 40 vaccines are authorized by at least one national regulatory authority for public use:

<span class="mw-page-title-main">COVID-19 vaccine misinformation and hesitancy</span> Misinformation regarding the SARS-CoV-2 vaccine and the resulting hesitancy towards it

Anti-vaccination activists and other people in many countries have spread a variety of unfounded conspiracy theories and other misinformation about COVID-19 vaccines based on misunderstood or misrepresented science, religion, and law. These have included exaggerated claims about side effects, misrepresentations about how the immune system works and when and how COVID-19 vaccines are made, a story about COVID-19 being spread by 5G, and other false or distorted information. This misinformation has proliferated and may have made many people averse to vaccination. This has led to governments and private organizations around the world introducing measures to incentivize or coerce vaccination, such as lotteries, mandates, and free entry to events, which has in turn led to further misinformation about the legality and effect of these measures themselves.

<span class="mw-page-title-main">Susanna Dunachie</span> British microbiologist

Susanna Jane Dunachie is a British microbiologist who is Professor of Infectious Diseases at the University of Oxford. Her work considers microbiology and immunology to better understand bacterial infection and accelerate the development of vaccines. She has focused on melioidosis, scrub typhus and tuberculosis. During the COVID-19 pandemic, she studied T cell immunity to severe acute respiratory syndrome coronavirus 2.

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Further reading

Vaccine protocols