The first doses of Australia’s COVID-19 vaccination program have at last been administered, but concerns have been expressed that the rollout will be slowed by supply constraints.
In announcing Australia’s November deal with Pfizer to supply 10 million doses of its vaccine, Prime Minister Scott Morrison claimed the agreement, along with another deal signed with Novavax for 50 million doses, had put Australia at “the front of the queue”.
But, in January, the Opposition accused the Government of being slow to make deals, and that this would affect supply of the drug.
“[B]y the time the Morrison Government did a deal with Pfizer, a billion doses had already been accounted for around the world. Australia wasn’t at the front of the queue — we’re at the back,” then opposition spokesman for health Chris Bowen said.
Were 1 billion doses of Pfizer’s vaccine already accounted for in deals with other countries before the Government made its deal in November? RMIT ABC Fact Check investigates.
Mr Bowen’s claim is drawing a long bow.
A definitive list of the deals made between Pfizer and various countries for its vaccine is not publicly available.
But a tally compiled from government and corporate media releases suggests around 350 million doses of the Pfizer vaccine were accounted for in pre-purchase agreements before Australia announced its deal on November 5.
Mr Bowen’s suggested tally of 1 billion doses would only be reached if so-called “optional” doses were included, as well as a deal with the European Union for 200 million pre-purchased doses and 100 million optional doses.
But the inclusion of these numbers comes with significant caveats, and experts contacted by Fact Check expressed mixed views about whether or not they should be included.
They said the EU deal should only be included in the overall tally if it had been finalised on September 9, when the bloc and Pfizer “concluded exploratory talks”, rather than on November 11, when the contract was finally approved.
A larger issue is the inclusion of optional doses, which some experts said were different to pre-purchased doses and could not be relied upon as being “accounted for”.
These optional doses make up over half of the tally to November 5, even when the EU deal is included.
Thus, Mr Bowen’s claim lacked the necessary context to allow audiences to understand the true status of more than half the doses in his count of 1 billion.
Background on Pfizer’s vaccine
A multitude of vaccines seeking to curb the prevalence of COVID-19 disease in humans are at various stages of development, but few have received the kind of attention as that of Pfizer’s candidate.
As the first wave of the pandemic swept the world, the pharmaceutical giant announced it was teaming up with German biotech firm BioNTech to develop and manufacture a vaccine candidate “based on BioNTech’s proprietary mRNA vaccine platforms, with the objective of ensuring rapid worldwide access to the vaccine, if approved”.
In November, Pfizer announced that results from its phase 3 trial of the drug showed a 95 per cent success rate in preventing COVID-19 disease in people seven days after they were given two doses of the drug.
This was followed by the issuing of an emergency use authorisation in December in the UK, a world first for a COVID-19 vaccine candidate. Further authorisations followed quickly in a slew of other countries.
Australia’s Therapeutic Goods Administration (TGA) provisionally approved Pfizer’s vaccine for use on January 25, 2021, meaning it can now be legally supplied in Australia “to prevent coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, in individuals 16 years of age and older”.
Australia’s deal with Pfizer
On November 5, 2020, the Government announced it had reached a deal with Pfizer/BioNTech for the supply of 10 million doses of its vaccine to Australia, subject to regulatory approval.
As previously mentioned, the vaccine requires two doses, spread out over a number of weeks, to be effective, meaning the deal would provide enough vaccine to inoculate 5 million Australians.
At the time of the deal, no mention was made of any option being included in the contract to purchase further doses.
Mr Bowen made his claim on January 23.
The Government has since secured a further 10 million doses of the vaccine, bringing the total to 20 million.
Context of the claim
Mr Bowen is not the only Labor figure to have made this claim.
During a press conference two days after Mr Bowen’s, Opposition Leader Anthony Albanese criticised the speed of the Government’s Pfizer vaccine rollout, attributing it to the timing of the deal.
“If the Morrison Government had secured the Pfizer deal before other countries had secured 1 billion doses of their own, maybe the Government would have more than one in five Australians being looked after by this vaccine,” he said.
And in a Senate inquiry into the Government’s response to COVID-19 several days later, Deputy Leader of the Opposition in the Senate, Kristina Keneally, asked Pfizer’s director of market access, Louise Graham:
“Let me then ask you the question this way: my understanding is that by the point the deal was announced on 5 November, Pfizer had already done deals for around one billion doses with 34 countries; is that correct?”
Ms Graham stopped short of confirming Senator Keneally’s figure, stating:
“By that point, yes, there were a range of deals and contracts already in place. Australia came online in November.”
Fact Check contacted Mr Bowen’s office to ask for the source of his claim.
A spokeswoman confirmed that his reference to 1 billion doses pertained to the Pfizer vaccine alone, and provided a chronology of vaccine deals made between countries and various vaccine manufacturers, sourced from an article on pharmaceutical industry website Bio Pharma Dispatch.
Entries relating to the Pfizer vaccine on or before November 5 were:
|July 20, 2020||UK secures 40 million doses of Pfizer-BioNTech (financial terms undisclosed)|
|July 22, 2020||US commits US$1.95 billion to Pfizer-BioNTech for 600 million doses|
|July 31, 2020||Japan deal with Pfizer-BioNTech for 120 million doses|
|August 31, 2020||Canada … 20 million Pfizer [doses]|
|September 9, 2020||Pfizer and BioNTech close to finalising 200 million dose deal with the European Union|
|September 15, 2020||Germany invests US$445 million in the development of Pfizer-BioNTech|
|September 18, 2020||BioNTech acquires manufacturing facility from Novartis to produce 750 million doses per year|
|October 10, 2020||New Zealand secures 1.5 million doses of Pfizer|
|October 18, 2020||Mexico secures 90 million doses of three vaccines, [including] Pfizer|
|November 5, 2020||Australia secures 10 million doses of Pfizer and 40 million doses of Novavax|
While the doses mentioned in these entries do indeed total almost 1 billion, the status of the deals listed remains unclear without the confirmation of primary sources.
Deal or no deal?
Fact Check contacted Pfizer seeking a list of vaccine deals by country, but a spokeswoman declined to provide details, citing confidentiality.
Further, there appears to be no publicly available, definitive source for vaccine deals made between countries and pharmaceutical companies, including the number of doses secured and the date of such agreements.
Nonetheless, there are some groups which have sought to track and quantify these measures using a variety of sources.
UNICEF’s COVID-19 Vaccine Market Dashboard relies principally on media reports for its database, which is updated regularly.
Elsewhere, a study published in the British Medical Journal attempted to collate and quantify all advance purchase agreements made by governments up to November 15, 2020, using the “World Health Organisation’s draft landscape of covid-19 candidate vaccines, along with company disclosures to the US Securities and Exchange Commission, company and foundation press releases, government press releases, and media reports”.
That study had a cut-off date of November 15. Its supporting material listed deals made by 11 countries plus the European Union for a total of 512.4 million doses, excluding Australia’s November 5 deal for 10 million doses.
Meanwhile, researchers at Duke University’s Global Health Innovation Center, which runs Launch and Scale Speedometer, supplied Fact Check with its database of vaccine deals, which is based on publicly available information.
These sources would obviously not include deals that had been kept secret.
However, Adam Kamradt-Scott, a global health security expert at Sydney University, told Fact Check that while some governments considered agreements such as these to be an issue of national security, there was a powerful incentive to publicise them during a global pandemic.
“In the current pandemic there is an obvious incentive for governments to announce they’ve made an agreement, which is why we have lists being composed by organisations … as it reinforces the message that governments are concerned for the wellbeing of their citizens,” he told Fact Check in an email.
“But it is rare for much more information to come to light about the nature of these deals because governments get concerned that after signing the agreement, another country might come in over the top and offer more money to get ahead of the queue.”
Keeping options open
Another complicating factor in calculating and aggregating various vaccine deals is the existence of clauses in contracts allowing countries to purchase further doses in the future.
When the United States signed its initial deal with Pfizer, for example, it was for the purchase of 100 million doses, according to a press release. But the deal included an option to purchase up to 500 million additional doses.
This provides context for the 600 million doses listed in the Bio Pharma Dispatch article referred to by Mr Bowen’s spokeswoman.
The US took up part of this option in December, purchasing an additional 100 million doses.
The Australian Government appears to have exercised a similar option when it purchased an additional 10 million doses of the Pfizer vaccine in January, although the option to do so was not public knowledge when the deal was first announced in November.
“As part of that vaccine strategy, we have followed the advice on purchasing from the scientific and technical advisory group, or SCITAG, led by Professor Brendan Murphy … they advised from the outset that we should build an option, subject to the determination by the TGA, into our contract to purchase additional doses if the TGA were to approve the use of Pfizer,” Health Minister Greg Hunt said at a news conference.
“We did that, we did that quietly behind the scenes. Once the TGA approved the Pfizer vaccine, we triggered that option.”
However, the question of whether to include these optional doses in a stocktake of vaccine deals is a vexed one, and experts contacted by Fact Check offered mixed opinions on the subject.
Associate Professor Kamradt-Scott said it was “reasonable” to include them as “they are part of the original agreement and there are clauses included describing under what circumstances those supplementary purchase options will be enacted”.
“The agreement will likely already include stipulations around price per unit as well as clauses stipulating that these supplementary purchases would be fulfilled ahead of other orders,” he said.
But Andrea Taylor, assistant director of programs at the Duke Global Health Institute, told Fact Check that “the options are not the same status as confirmed doses”.
“With optioned doses, you still have to negotiate the delivery schedule if and when you exercise the options. So, you can’t just decide you want those doses and click your fingers and have them arrive next week.”
She noted that the US ran into this problem with its option to purchase an additional 500 million doses which accompanied its original deal for 100 million doses in July.
“But then, in late 2020, the US government decided that they wanted more doses by Q2 2021 and Pfizer said it was too late to exercise the options for that delivery timeline, as they had already committed their manufacturing slots for Q2,” Ms Taylor wrote in an email.
The US recently negotiated the purchase of a further 100 million doses from Pfizer, which reportedly won’t be delivered until the end of July.
One of the authors of the BMJ study, Anthony So, a professor and founding director of the Innovation+Design Enabling Access (IDEA) initiative based at the Johns Hopkins Bloomberg School of Public Health, said the choice about whether to include optional doses in the statistics depended on what exactly was being measured.
Professor So told Fact Check that he declined to include such options in his paper, because “there was limited transparency of the option to purchase in available public records” and “it was not possible to ascertain whether those options to scale up could be exercised by the end of 2021, the period over which we sought to confirm pre-market purchase commitments”.
He also noted that, in some cases, the sum of pre-purchased and option-to-purchase vaccine doses signed in deals around the world exceeded the number of doses that manufacturers said they could deliver by the end of 2021.
Given all of the above caveats, Fact Check decided to separate tallies into secured doses and future optional doses.
So how many doses were accounted for before Australia signed its deal?
Using the databases mentioned earlier as a starting point, Fact Check sought to calculate the number of Pfizer doses accounted for in purchase agreements around the world before Australia announced its deal with the company on November 5.
Fact Check has only included deals which were announced or confirmed through official government sources, or through Pfizer itself.
Canada, Chile, Costa Rica, Ecuador, Hong Kong and Macau, Japan, Peru, Mexico, New Zealand, the UK and the US all made deals with Pfizer before November 5.
In the case of the UK, the country made an initial deal with Pfizer in July for 30 million doses. A media release from Pfizer later confirmed that this had been increased to 40 million doses in early October, though it did not provide an exact date.
Fact Check confirmed that Qatar also clinched a deal, but the number of doses was not publicly announced, so it has not been included in the calculations.
A deal was also reportedly made by Germany, separate to negotiations between the European Union and Pfizer, for 30 million doses. While the existence of the deal was confirmed by a spokesman for Germany’s Health Ministry in January, details were sparse with Reuters suggesting it was secretly signed in September.
However, as this date is not supported by official sources, Fact Check has not included Germany’s deal in the tally.
Excluding options, the final tally of doses included in global agreements struck before Australia’s deal was signed was 350.8 million.
This would rise to 850.8 million doses if the option for the US to purchase an additional 500 million doses is included.
The EU deal
For completeness, Fact Check also investigated the European Union’s deal with Pfizer for 200 million doses, which was signed on November 11 and contained an option to purchase a further 100 million doses.
Although the media release issued on that day announced that the multi-nation bloc had approved a contract with Pfizer, it appears the doses listed in the deal may have been “accounted for” by the EU long before this date.
Another announcement, dated September 9, which accords with the article cited by Mr Bowen’s spokeswoman, suggested the bloc had “concluded exploratory talks with BioNTech-Pfizer to purchase a potential vaccine against COVID-19”.
Professor So told Fact Check: “It certainly appears that the two parties reached this pre-market purchase commitment in September and then formalised it on November 11th.”
Associate Professor Kamradt-Scott agreed. “To my mind, it is hard to imagine any circumstance in which a pharmaceutical manufacturer would not factor in potential sales to one of the world’s largest markets (the European Union) when finalising negotiations with other potential buyers.”
For this reason, Associate Professor Kamradt-Scott said it seemed likely that Pfizer would have factored in its deal with the EU prior to finalising its agreement with Australia.
“Given the size of the EU market, it would make prudent business sense,” he said. “It is entirely conceivable that Pfizer would prioritise the EU over Australia, even if the ink had not dried on the EU agreement.”
But Ms Taylor said the EU doses were not included as “confirmed” in her database until the final deal was signed.
“The ‘exploratory talks’ in September may have resulted in a non-binding or even a binding agreement, but we wouldn’t have counted it as confirmed until it was a definitive agreement.”
If the EU deal is included in calculations, excluding options, the tally of doses accounted for globally ahead of Australia’s deal rises to 550.8 million doses.
Including options, the total would be around 1.2 billion.
Is Australia at the back of the queue?
While a number of mostly wealthy countries made a deal with Pfizer before Australia, it’s clear that many more countries, most of which are less wealthy, did not.
Associate Professor Kamradt-Scott said Australia was “far from [being at] the back of the queue”, noting that those that were at the back of the queue were “countries that can’t afford to make these deals, and are reliant on either donations of vaccines or the new COVAX initiative developed by the World Health Organisation, GAVI and CEPI”.
Ms Taylor said it was more likely that the timing of Australia’s order would affect the timing of delivery of the vaccine doses, rather than the size of the order itself.
“It is certainly possible that the purchase coming after the relatively large orders from the US, Japan, UK … may have put Australia at a disadvantage in terms of delivery schedule,” she said, noting that larger orders had still been placed by other countries after Australia’s deal was signed.
Professor So told Fact Check that because of the limited transparency of vaccine agreements around the world, it was difficult to know whether or not Australia would have secured more doses or received priority in the delivery of those doses, had a deal been made earlier.
“… publicly available information on the queuing of vaccine doses coming off the production line for different countries is hard to know (and may, in fact, be changing dynamically), until vaccine doses near the time of delivery and administration,” he said.
Principal researcher: Matt Martino, online editor
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