WHO Introduces 2-Phase Plan For COVID-19 Vaccine Distribution

The World Health Organization (WHO) recently revealed a plan for rolling out a COVID-19 vaccine once it’s available. The plan was shared during a media briefing with WHO Director-General Tedros Adhanom Ghebreyesus on August 18.

“Since May, WHO has been in extensive consultations to develop a new framework to guide fair and equitable access to diagnostics, therapeutics, and vaccines, for COVID-19 across all countries,” Ghebreyesus said. “These cross-cutting principles are key to the promotion of equitable access and fair allocation of these essential health products for the greatest impact globally.”

While there is currently no vaccine for SARS-CoV-2, the virus that causes COVID-19, there are currently more than 125 vaccines for the virus in development around the world, according to The New York Times. Nine of those vaccines are in large-scale efficacy tests, and two have been approved for early or limited use.

Once a successful vaccine is identified, WHO’s advisory group will provide recommendations for the “appropriate and fair use” of the vaccine, Ghebreyesus said.

WHO plans to roll out the vaccine in two phases:

• Phase 1: Doses will be given proportionally to all participating countries at once to “reduce overall risk.”
• Phase 2: “Consideration” will be given to countries “in relation to threat and vulnerability.”

WHO will implement this plan with the help of the COVAX Global Vaccines Facility, an alliance co-led by international vaccine organization Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI), and WHO. The goal of the COVAX Global Vaccines Facility is to speed up the development and manufacturing process of COVID-19 vaccines, and to guarantee fair and equitable access for every country in the world. Ghebreyesus said he sent a letter to every WHO member country, encouraging them to join the alliance.

Will the U.S. Be Involved?

In July, the U.S. sent a letter to WHO that officially notified the United Nations that it planned to leave the organization. The U.S. will officially leave the WHO on July 6, 2021, according to Reuters.

That raises a lot of questions about what will happen to vaccine access in the U.S. if a member of the COVAX Global Vaccines Facility—which the U.S. is not a part of—develops a vaccine first. Here’s what you need to know.

When Will a Vaccine Be Ready?

It’s hard to know for sure, Maria Elena Bottazzi, PhD, associate dean of the National School of Tropical Medicine and co-director of the Texas Children's Hospital Center for Vaccine Development, tells Verywell. While there are several vaccines in later stages of clinical trials, it’s hard to know which ones—if any—will be OK for public use in a certain time period, she says.

However, many experts are hopeful. “I’m pretty certain we will have a vaccine before July 2021,” Rajeev Fernando, MD, an infectious disease expert in Southampton, New York, tells Verywell. “The big question is who gets there first.”

In the U.S., there are several vaccines in phase 3 of clinical trials, which is when the vaccine is tested on large groups of people. But typically, that phase lasts about six months, Fernando says.

In general, he anticipates that a vaccine will be ready in the winter, if everything goes according to plan.

What Is the U.S. Doing to Develop a Vaccine?

The U.S. has created Operation Warp Speed, an initiative that aims to deliver 300 million doses of a safe, effective vaccines for COVID-19 by January 2021, as part of a larger strategy to “accelerate the development, manufacturing, and distribution of COVID-19 vaccines, therapeutics, and diagnostics,” per the U.S. Department of Health and Human Services (HHS).

Under this initiative, the U.S. has given billions of dollars to select companies, including Johnson & Johnson, Moderna, AstraZeneca, and Pfizer to help fund the development of a COVID-19 vaccine.

If one of these vaccines is successful, it will be distributed to Americans under a “tiered” approach, using data from the first wave of COVID-19 data, the HHS says.

Will the U.S. Have Access to a Vaccine Developed Outside the Country?

It’s likely, Bottazzi says. “There are some players within the COVAX Global Vaccines Facility and Operation Warp Speed,” she says. “They’ve already committed to the U.S. and the global access system. If any of those vaccines are selected, then certainly the U.S. will be covered.”

Bottazzi points out that “the reverse is also true,” meaning that countries outside the U.S. who are not also involved in Operation Warp Speed may be concerned about accessing a vaccine that is developed as part of the initiative.

If a vaccine is developed outside the U.S. after the summer of 2021 that is not part of Operation Warp Speed, the U.S. may not have early access to it, Bottazzi says. However, she’s not worried about Americans getting access to a vaccine at some point.

Bottazzi is more concerned about lower income countries having access to a future vaccine.

“I think there are more problems in countries outside of high income countries in getting access to the vaccine,” she says. “I doubt high income countries like the U.S. will have as much trouble getting access.”

Ultimately, Bottazzi says, “it’s really going to depend on which vaccines get approval. As long as the U.S. is investing in top-tier vaccines, we at least may have some vaccines that will partially solve the problem.”

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