What Would It Take to Vaccinate the Whole World? Let’s Take a Look.

Big-power muscle flexing helps explain much of the world’s vaccine inequities, but there's another reason behind insufficient doses: The challenge of making them is unprecedented.

By Richard Pérez-Peña

More than 600 million people worldwide have been at least partially vaccinated against Covid-19 — meaning that more than seven billion still have not. It is a striking achievement in the shadow of a staggering challenge.

Half of all the doses delivered so far have gone into the arms of people in countries with one-seventh of the world’s people, primarily the United States and European nations. Dozens of countries, particularly in Africa, have barely started their inoculation campaigns.

As wealthy countries envision the pandemic retreating within months — while poorer ones face the prospect of years of suffering — frustration has people around the world asking why more vaccine isn’t available.

Nationalism and government actions do much to help explain the stark inequity between the world's haves and have-nots. So, for that matter, does government inaction. And the power of the pharmaceutical companies, which at times seem to hold all the cards, cannot be ignored.

But much of it comes down to sheer logistics.

Immunizing most of humanity in short order is a monumental task, one never attempted before, and one that experts say the world wasn’t ready to confront. They note that things have already moved with unprecedented speed: A year and a half ago, the disease was unknown, and the first vaccine authorizations came less than six months ago.

But there is a long way to go. Here is a look at the reasons for the vaccine shortfall.

Global capacity is limited.

There are only so many factories around the world that make vaccines and only so many people trained in making them — and they were busy before the pandemic. Likewise, production capacity for biological raw materials, cell culture media, specialized filters, pumps, tubing, preservatives, glass vials and rubber stoppers is also limited.

“We’re not suddenly stopping making every other vaccine,” said Sarah Schiffling, an expert on pharmaceutical supply chains and humanitarian relief at Liverpool John Moores University in Britain. “We’re adding this on top. We’re basically doubling output. Supply chains of this magnitude usually take years to accomplish.”

The world’s largest vaccine maker, the Serum Institute of India, is making the Covid-19 vaccine developed by AstraZeneca and the University of Oxford, and projects output of one billion doses this year, in addition to the roughly 1.5 billion doses it makes annually for other diseases. But it has taken months to ramp up to that pace.

With heavy investment from governments, businesses have overhauled factories, built new ones from the ground up and trained new employees, an effort that started last year and is still far from complete.

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