Over the last week the COVID-19 vaccine landscape has once again changed drastically, with the use of J&J’s Janssen suspended in many countries and new players attracting more attention.


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As viral vector vaccines, AstraZeneca’s Vaxzevria and J&J’s Janssen, are facing suspensions around the world, the demand for mRNA shots from Pfizer-BioNTech and Moderna keeps surging.

Denmark last week became the first European country to drop AZ’s vaccine altogether immediately attracting interest from several other countries, such as the Czech Republic or Lithuania, to buy out the remaining doses from Denmark. Since then, however, it has been reported that the AZ vaccination in the country might resume on a voluntary basis. Norway public health regulator has recommended against the use of the vaccine, while some other countries, including France and Spain, are limiting it to certain age groups. At the same time, numerous countries across the world are on the contrary lifting the AZ suspensions and the blood clots phenomenon is being investigated.

J&J found itself in a situation similar to AZ when several cases of blood clotting had been reported. The U.S. administration has halted the use of Janssen for the time being citing the “abundance of caution”, while the European Medicines Agency is currently reviewing the thrombosis reports and is expected to make an announcement later this week. Until then, several countries including Greece and Norway, have put the vaccine rollout on hold. In the meantime, Emergent BioSolutions plant in Baltimore, U.S., taken over by J&J for the vaccine manufacturing has been ordered to suspend its operations by the FDA.

Moderna has announced that it is cutting deliveries across the world including to the EU, the UK and Canada. This, combined with the pause of the J&J vaccine, led to Pfizer having agreed to increase deliveries to the U.S. and Europe with the latter expecting to receive 100 million additional doses in 2021.

Russia meanwhile continues the expansion of its Sputnik V vaccine deliveries across the world despite the recent highly politicised incidents in Europe. The first doses are expected to soon arrive to India with the country lifting up its import duties; Turkey and South Korea are reported to have approved the manufacturing of the jab; while the production is already being launched in Serbia. The vaccine is currently under the EMA rolling review. Several European countries such as Hungary have granted it the emergency use authorisation while others like Austria refuse to do so prior to the EMA’s decision.

India, the world’s largest vaccine manufacturer is prioritising inoculations domestically, while the Serum Institute of India that was licensed to manufacture AstraZeneca’s and Novavax’s vaccines is facing shortages with raw materials partly because of the U.S. administration’s banning the exports back in late March. The launch of the Novavax vaccine (Coronavax), initially planned in June, has been delayed till September. Serum Institute has agreed to manufacture about 1 billion Novavax doses in 2021. Meanwhile, J&J is reported to have applied for permission to conduct phase-3 clinical trial of its vaccine in India as well as import licence.

In China, Gao Fu, head of the Chinese Centres for Disease Control and Prevention, first admitted the efficacy of the country's Covid vaccines was low, noting a possibility of mixing vaccines to boost efficacy. He later, however, said his comments had been misinterpreted.

Chinese vaccine CoronaVac by Sinovac jab has only been fully authorised for use by China, but the doses are being shipped around the world to countries such as Indonesia, Malaysia, Pakistan, Brazil, Mexico, Turkey and Ukraine as well as to Africa. Recently, Egypt has agreed with Sinovac to manufacture up to 80 million doses a year domestically to be distributed in Egypt and other African countries.

According to the Financial Times vaccination tracker, as of 18 April 906,560,829 vaccination have been given based on the data from 212 locations. This is equal to 12 doses for every 100 people. Israel, Bahrain, Chile and the U.S. are the leaders, having vaccinated from 55% (Israel) to 25.7% (USA) of their populations. In absolute terms, the US and China have administered the highest number of doses, 209 million and 193 million respectively. India ranks third, with more than 123 million.

Image credit: Kirill Reznichenko via iStock

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AstraZeneca, Johnson & Johnson, COVID-19, Moderna, Pfizer/BioNTech, COVID-19 vaccination, Sputnik V, vaccine supply, SinoVac Vaccine Rollout: Implications of “Abundance of Caution”