Covax Cuts Its 2021 Forecast for Available Doses by Quarter

The United Nations-backed program to vaccinate the world against the coronavirus slashed its forecast for doses available in 2021 by roughly a quarter on Wednesday, another setback for an effort that has been hampered by production problems, export bans and vaccine hoarding by wealthy nations.

Shortly after the forecast was released, the World Health Organization asked wealthy countries to hold off on administering booster shots for healthy patients until at least the end of the year as a way of enabling every country to vaccinate at least 40 percent of their populations. The organization had previously called for a booster shot moratorium until the end of September.

“I will not stay silent when the companies and countries that control the global supply of vaccines think the world’s poor should be satisfied with leftovers,” Dr. Tedros Adhanom Ghebreyesus, the W.H.O.’s director general, told reporters on Wednesday.

In its latest projection, the global immunization program, known as Covax, said that it expected to have a total of 1.4 billion doses available by the end of 2021. In June, the program had said that it expected to have access to 1.9 billion doses this year. Experts have said 11 billion are needed to slow the spread of the virus.

Covax blamed uncertainty around when vaccine exports would resume from a major manufacturing site in India, along with problems scaling up production of the AstraZeneca and Johnson & Johnson vaccines and a delay in the clearance of the Novavax shot.

“Covax is making strenuous efforts to address and mitigate these risks,” the program said, citing negotiations with the Indian government, whose decision to halt vaccine exports this spring rattled the program, as well as efforts to convince manufacturers to stop prioritizing individual countries over Covax.

The program was beset by difficulties last year as rich nations became rivals in a vaccine-buying race, paying premiums to secure their own shots while slow-walking financial pledges that Covax needed to sign deals. More recently, it has also struggled with the financing needed to get doses into people’s arms, even as the Biden administration pledged hundreds of millions of doses. Last week, the White House, which is under pressure to do more to address the pandemic, said it would invest $2.7 billion to ramp up domestic production of critical vaccine components as part of President Biden’s push to make the United States the “arsenal of vaccines for the world.”

Understand Vaccine and Mask Mandates in the U.S.

    • Vaccine rules. On Aug. 23, the Food and Drug Administration granted full approval to Pfizer-BioNTech’s coronavirus vaccine for people 16 and up, paving the way for an increase in mandates in both the public and private sectors. Private companies have been increasingly mandating vaccines for employees. Such mandates are legally allowed and have been upheld in court challenges.
    • Mask rules. The Centers for Disease Control and Prevention in July recommended that all Americans, regardless of vaccination status, wear masks in indoor public places within areas experiencing outbreaks, a reversal of the guidance it offered in May. See where the C.D.C. guidance would apply, and where states have instituted their own mask policies. The battle over masks has become contentious in some states, with some local leaders defying state bans.
    • College and universities. More than 400 colleges and universities are requiring students to be vaccinated against Covid-19. Almost all are in states that voted for President Biden.
    • Schools. Both California and New York City have introduced vaccine mandates for education staff. A survey released in August found that many American parents of school-age children are opposed to mandated vaccines for students, but were more supportive of mask mandates for students, teachers and staff members who do not have their shots.  
    • Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get a Covid-19 vaccine, citing rising caseloads fueled by the Delta variant and stubbornly low vaccination rates in their communities, even within their work force.
    • New York City. Proof of vaccination is required of workers and customers for indoor dining, gyms, performances and other indoor situations, although enforcement does not begin until Sept. 13. Teachers and other education workers in the city’s vast school system will need to have at least one vaccine dose by Sept. 27, without the option of weekly testing. City hospital workers must also get a vaccine or be subjected to weekly testing. Similar rules are in place for New York State employees.
    • At the federal level. The Pentagon announced that it would seek to make coronavirus vaccinations mandatory for the country’s 1.3 million active-duty troops “no later” than the middle of September. President Biden announced that all civilian federal employees would have to be vaccinated against the coronavirus or submit to regular testing, social distancing, mask requirements and restrictions on most travel.

Dr. Tedros said on Wednesday that some vaccine makers and wealthy nations were using distribution problems as an excuse not to make deliveries. But health officials and people involved in Covax have said that those very delivery delays are contributing to distribution problems by making it impossible for poorer countries to plan their inoculation campaigns.

So far, Covax has delivered 245 million doses — most free to poorer nations, with the rest to countries like Canada that paid their own way. In January, the program had planned to have at least 785 million doses available by now.

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