Impact of COVID-19 on vaccine supplies

The COVID-19 pandemic is currently affecting over 200 countries and territories across all regions, including countries from which UNICEF procures essential commodities for children.

UNICEF is committed to advocate for the protection of children’s rights and help meet their basic needs and to expand their opportunities to reach their full potential. This includes the availability and accessibility of life-saving supplies such as medicines, vaccines, sanitation and education supplies.

The current COVID-19 outbreak is applying pressure on global manufacturer production capacities, supply availability and logistics. And it is putting at risk the continuation of immunization programmes in countries due to lockdowns and other measures to contain the spread of the virus, which also has an impact on supply. UNICEF is in ongoing dialogue with governments, vaccine manufacturers, partners and freight forwarders to assess the risk to vaccine availability and accessibility and which mitigating measures can be undertaken.

UNICEF vaccine procurement in numbers

In 2019, UNICEF procured an estimated 2.43 billion doses of vaccines to around 100 countries to reach approximately 45% of the world’s children under five. Vaccines were supplied in support of country programmes, in addition to outbreak and humanitarian response activities.

Current status of vaccine supplies - as of 10 June 2020

In week 13 (week of March 22), there was a collapse in the airline industry, where and shipments of vaccines were significantly impacted as a result. The dramatic decline in available flights, compounded by lockdowns of receiving countries where airports were closed impeded UNICEF’s ability to ship vaccines as per country and supplier shipment plans. Currently, the availability of commercial flights is improving. However, these improvements are limited. Some destinations remain difficult to access with limited flight and charter options, in addition to country lockdown and airport closures. Land-transit options are being used to ensure vaccines are delivered to countries, in addition to coordination with other aid agencies to consolidate shipments where feasible. Costs have increased significantly above the budgeted estimates funded by donors and countries for shipments, although they are starting to be more predictable to increase options to secure financing.  

As flight options are increasing, special charters are being arranged where vaccine shipments are being consolidated for multiple country delivery. This requires a high level of communication and coordination between UNICEF, Freight Forwarders, countries and suppliers to execute. Follow @UNICEF for updated tweets on deliveries.

As a consequence of the supply disruptions, Countries across West and Central Africa (WCARO), East and southern Africa (ESARO), East Asia (EAPRO), and South Asia (ROSA) have indicated vaccine stocks reaching critical levels, including for measles; Bacillus Calmette-Guérin (BCG); pentavalent (diphtheria, tetanus, pertussis (whooping cough), hepatitis B and haemophilus influenzae type b); human papillomavirus (HPV); hepatitis B; oral polio vaccine (OPV), rotavirus  and pneumococcal conjugate vaccine (PCV). The situation is changing daily as cargo or charter flight options are arranged to mitigate the risk of stock outs in country.  

WHO, UNICEF, and the Gavi, The Vaccine Alliance (Gavi) are conducting monthly pulse surveys to assess programmatic disruptions due to COVID-19 response measures. In the last cycle of the survey, a number of countries reported suspensions of their immunization programmes as well as disruptions. As a result of slowdown of consumption/demand, countries are experiencing a risk of vaccines reaching expiry before they can be used, and are delaying shipments of some vaccines, further putting stress on suppliers that have produced vaccine in accordance to planned forecasts. The resumption of programmes with the guidance of WHO and UNICEF to safety administer vaccines during COVID-19 outbreaks is necessary to protect populations, and ensure all children have access to life-saving vaccines.

In early May, a total of 99 countries reported the suspension of immunization campaigns for the following antigens: measles/measles rubella, polio (including for vaccine derived polio virus response activities), meningococcal A, yellow fever, typhoid, cholera and tetanus/diphtheria. Shipments of campaigns vaccines have largely been put on hold by countries. It is critical for countries as lockdowns lift and routine programmes resume to ensure there is a space available in their supply chains for vaccines to support campaigns activities that have been postponed.

Vaccine suppliers to UNICEF indicate that they are experiencing some disruption in production due to lockdown measures in countries where staff are not able to travel to work to support production. As there have been delays in shipments of vaccine to countries, other reported slowdowns have had a minimal impact at this date on supply availability. However, as programmes resume, UNICEF will closely monitor resumption of production to align with programme requirements.

Suppliers are indicating the following challenges to UNICEF due to the delays in shipments: 

• cash flow challenges as projected revenues are not materializing;  
• ticking shelf life on products that are pending shipment, and acceptance of country for reduced shelf life;  
• production challenges for 2021 supply as the requirements for the remainder of 2020 are unknown (i.e. impact of slowdown in demand on consumption in country, and if produced quantities will need to roll over to 2021);  
• implications for planned production of influenza and capacity assessment to support COVID-19 vaccine manufacturing.  

Actions to mitigate current and future risks

UNICEF has made provisions to expedite payments for all shipments (within 10 days) to address cash flow challenges.

UNICEF, in collaboration with WHO, will review minimum shelf life requirements at delivery and recommendations to countries for acceptance of shipments with less than 18 months shelf life, if deliveries are postponed during the pandemic period.  

UNICEF continues our close communication with suppliers as they review risks related to production and supply and risk mitigation strategies to ensure future production is not compromised.

UNICEF is in communication with countries in consultation with global partners such as PAHO, WHO and Gavi to review and assess stock levels in country and supply requirements to inform shipment plans and reduce impact on program delivery due to the disruptions in timely air shipments.