COVAX, a multilateral initiative aimed at fostering global access to covid-19 vaccines, cut the forecast for the availability of doses for 2021 by 25% citing export restrictions on Serum Institute of India (SII).

COVAX expects to have access to 1.425 billion doses of vaccine in 2021 in the most likely scenario and in the absence of urgent action by producers and high-coverage countries to prioritize COVAX, according to the latest supply forecast issued on Wednesday. Of these doses, approximately 1.2 billion will be available for lower-income countries participating in the COVAX advance market commitment (AMC).

The major reasons for the reduction in the number of doses that COVAX expected to receive in 2021 are export restrictions and uncertainty around the resumption of exports from SII, a key COVAX supplier, and increased challenges at manufacturing sites that supply COVAX, it said.

Another reason for the reduction in expected doses is the timing and likelihood of filing and regulatory approval for candidates produced by Novavax, SII-Novavax and Clover, with WHO emergency use listing (EUL) or approval by a stringent regulatory authority (SRA) required for supply to COVAX participants, said COVAX further.

It said these issues particularly affect the supply of Johnson & Johnson and AstraZeneca vaccine, which is being manufactured by SII in India under the brand name Covishield.

There are 11 vaccines in the COVAX portfolio, including Covishield. “The evolving supply landscape has led to a reduction of 25% in anticipated volumes available for supply in 2021 through COVAX. For SII-AstraZeneca and SII-Novavax, continued export restrictions from India are leading to further supply delays, with the most likely scenario assuming no SII supply to COVAX in 2021," according to the joint COVAX statement on supply forecast for 2021 and early 2022.

The Indian government has clarified time and again that it has not banned the export of covid-19 vaccines but has calibrated shipments keeping in mind domestic requirements.

India has not imposed any export ban on covid-19 vaccines, external affairs ministry spokesperson Arindam Bagchi said during a media interaction in April.

“Till now, we have supplied vaccines to more than 80 countries across the world. We have already stated that our external supplies would be done keeping in mind our domestic requirements," he said.

A query sent to the commerce ministry remained unanswered till press time. SII did not comment on the issue.

The COVAX forecast further said that by the end of August, 330 million doses had been released for delivery, with 230 having been delivered to 139 participating economies.

“According to the most likely scenario in our supply forecast, a further 1.1 billion doses are expected to become available for delivery between September and the end of 2021," the statement said further.

“This amounts to approximately 1.4 billion doses available for 2021. Of these, approximately 1.2 billion will be available for AMC participants. This is equivalent to 20% of the population coverage, or 40% of the adult population in all 92 AMC economies, barring India," it added.

COVAX’s supply will continue to expand in the first quarter of 2022, reaching a total of 2.6 billion doses available for supply by the end of March.

“Yet the global picture of access to covid-19 vaccines is unacceptable. Only 20% of people in low- and lower-middle-income countries have received the first dose of vaccine compared to 80% in high- and upper-middle income countries," it said.

COVAX, the vaccines pillar of the Access to COVID-19 Tools Accelerator, is co-convened by the Coalition for Epidemic Preparedness Innovations, Gavi, the Vaccine Alliance and World Health Organization, working in partnership with Unicef, vaccine manufacturers across developed and developing countries and World Bank, among others.