By Francesco Guarascio

BRUSSELS, (Reuters) – Pfizer AstraZeneca (NASDAQ) and BioNtech will be the major suppliers of COVID-19 vaccinations for the global COVAX program at the beginning of 2022. This shift demonstrates the importance of the shot to poorer countries.

This expected shift will cause headaches in countries receiving the vaccine. They may not have enough cold storage to store it properly, as well as shortages of needles to administer the shot.

According to Gavi data, AstraZeneca currently is the most widely distributed vaccine under COVAX. Gavi co-manages this programme with the World Health Organization.

This programme has delivered over 600 million shots in nearly 150 countries. Of these, more than 220 millions are AstraZeneca and 160 million Pfizer.

Gavi and WHO estimates that Pfizer would take over the business in the first three months of the next year.

Another 150 million Pfizer tablets will be available by COVAX at the end of March according to a WHO document.

Gavi spokesperson confirmed that Pfizer has far more “allocated jabs” than AstraZeneca, which only 350 million, and about 470 millions doses in stock.

Pfizer was the first to provide COVID-19 vaccinations for the European Union, USA and Japan.

According to UNICEF data, it has bilateral agreements covering more than 6 Billion doses. This makes it the biggest supplier of COVID-19 vaccinations.

AstraZeneca is a key supplier for less-developed countries because it’s shot is more affordable and simpler to ship.

COVAX had a lot of faith in AstraZeneca when the pandemic began, but India’s supply issues and restrictions on exports from India led to COVAX reducing its dependence on AstraZeneca.

In the face of difficulties in procuring vaccines directly from the manufacturers, the program began to need donations from rich countries. Pfizer became the largest supplier of COVAX. Pfizer is the main donor of shots to this programme.

COLD CHAIN AND HYDRATES

Gavi was forced to make a rush investment in cold chain capability in countries receiving the Pfizer shot. This cold chain equipment is needed to transport the vaccine to the cold locations.

According to an internal report that was submitted by Gavi to its board in December, and seen by Reuters, the organization raised concerns about cold chain capability in certain countries.

Gavi stated in the document that the problem could be exacerbated by the shortage of special syringes required to administer Pfizer’s vaccine.

Gavi claims that Pfizer’s jab was “the most difficult to deliver, given the ultra-cold chain requirements and special needle requirements”, in its internal document.

The document also states that it is “the most difficult thing to plan for because these (donated vaccinations) are frequently delivered in short quantities, with limited shelf lives and require little notice” and requires earmarking.

COVID-19 vaccines donated by wealthy countries with short shelf lives have proved to be a problem for COVAX. Last week, WHO officials stated that many COVID-19 doses had been wasted because of this.

Last week, an EU official stated that the EU had stopped donating Pfizer vaccines from COVAX due to a shortage of syringes. A second person familiar with this issue said to Reuters that Gavi had delayed the shipping of Pfizer doses from Europe as a result of a lack of syringes.

Pfizer did not comment because they do not manufacture or purchase syringes directly.

UNICEF, WHO, and other organizations have warned for years about the shortage of auto-disable needles. These are essential to inoculating poorer countries.

To prevent the spread of disease, auto-disable Syringes automatically lock to stop re-use. This is common in countries with poorer infrastructures. UNICEF stated that auto-disable Syringes are required for Pfizer’s vaccine. They differ from regular syringes.