More than 85 poor countries will not have widespread access to coronavirus vaccines before 2023

• The rollout of Covid-19 vaccines has started in developed countries, but mass immunisation will take time. 

• Production represents the main hurdle, as many developed countries have pre-ordered a larger number of vaccines than they need. 

• The costs associated with mass immunisation programmes will be significant, especially for less-developed countries that have limited fiscal resources. 

• Vaccine diplomacy will play a role in determining which countries get access to a covid vaccine in the coming months. 

• Russia and China will use the rollout of their own coronavirus shots to advance their interests. 

• With priority groups vaccinated in rich economies by end-March, The EIU expects global economic prospects to brighten from mid-2021. 

• For most middle-income countries, including China and India, the vaccination timeline will stretch to late 2022. 

• In poorer economies, a widespread rate of vaccination will not be achieved before 2023, if at all.

In early 2021 three covid-19 vaccines, from Pfizer (US)-BioNTech (Germany), Moderna (US) and AstraZeneca-Oxford University (UK), will be rolled out on a massive scale in developed countries. Meanwhile, Chinese and Russian vaccines are being rolled out both domestically and to emerging countries such as Egypt, via diplomatic bilateral deals. This will foster so-called vaccine diplomacy—with Russia and China trying to bolster their global status via the delivery of vaccines—this year and beyond. 

Countries at the front of the queue with high coronavirus vaccine numbers—including the UK, the US and most countries in the EU—are expected to have immunised their priority groups by end-March, with other wealthy countries catching up by end-June. We therefore expect that global economic prospects will brighten from mid-2021, with the global economic rebound gaining speed in the third and fourth quarters. However, life will not be back to normal by then, as immunisation programmes for the bulk of the population will continue until mid-2022. 

Among middle-income countries, Russia, which has developed its own covid vaccines, could be on a similar schedule to richer economies, with mass immunisation completed by mid-2022. Other middle-income countries, including Mexico and Brazil, have been promised supplies in return for running clinical trials or housing production factories. This should give them early access to doses for priority groups, although their ability to achieve mass rates of vaccination will depend on other factors including fiscal space, population size, number of healthcare workers, infrastructure and political will. China and India represent special cases; both countries have developed their own shots and are pressing ahead with rollout plans, but the sheer size of their population means that mass immunisation programmes will stretch until late 2022, in line with the expected timeline for most middle-income countries.

Finally, some other middle-income countries and most low-income countries will be relying on COVAX, an initiative led by the WHO that aims to secure 6bn doses of covid-19 vaccines for poorer countries. The first 2bn of these will be given in 2021, mainly to healthcare workers (COVAX doses will cover only up to 20% of the population of each country). However, COVAX supplies may be slow to arrive, especially if delays in the production for and delivery to richer countries push back delivery dates for poorer nations. In these developing countries, large coronavirus vaccine numbers will not be achieved before 2023, if it happens at all. 

Methodology:

This map depicts the latest forecasts from The EIU for the rollout of coronavirus vaccines, reflecting the time when countries may expect to have vaccinated the majority (60-70%) of their adult population. Criteria taken into account include supply deals, production constraints, vaccine hesitancy, the size of the population, and the availability of healthcare workers. The data are also adjusted by analysts to reflect specific conditions on the ground.

“The contrast between rich countries and poorer ones is stark. Most developing countries will not have widespread access to the shots before 2023 at the earliest. Some of these countries—particularly poorer ones with a young demographic profile—may well lose the motivation to distribute vaccines, especially if the disease has spread widely or if the associated costs prove too high.” 

AGATHE DEMARAIS, THE ECONOMIST INTELLIGENCE UNIT GLOBAL FORECASTING DIRECTOR

Ms Demarais adds that “Vaccine diplomacy will also be an important trend to keep an eye on. Both Russia and China will seek to adopt a transactional approach to the delivery of vaccines, using coronavirus shots as a bargaining chip to advance long-standing interests.”

Finally, Ms Demarais adds that “Vaccines against many diseases, such as polio or tuberculosis, have been available for decades. However, many people in poorer countries remain unable to get access to them. What was termed a “novel coronavirus” only one year ago will be with us for the long term, alongside the many other diseases that have shaped life over the centuries.”

Download our report “Coronavirus vaccines: expect delays” to find out more and contact The EIU for more information.