World cannot count on a COVID-19 vaccine by early 2021

Outlook

According to the London School of Hygiene and Tropical Medicine, there are 239 vaccine candidates for COVID-19 in development throughout the world. Eight of these are in the last stage (Phase III) of trials and one in combined Phase II/III trials before approval and licensing. Most trials do not expect results before the first half of 2021 apart from the United Kingdom’s Oxford University-AstraZeneca team, which expects some results towards the end of 2020.

A particularly effective vaccine would show results earlier as the difference with the control group would be greater. That could allow trials to end faster, but is unlikely to happen with first vaccines, which are not as fine-tuned as later ones would be. Furthermore, challenges in distributing a vaccine -- logistical or political -- will mean a longer wait for a global end to the pandemic.

Impacts

• The countries where the vaccines are developed are likely to keep the bulk of the supply for their own populations first.
• Bilateral deals and relations between countries will determine vaccine access, giving rise to regional vaccine blocs.
• Governments rushing to announce that vaccines are ready for political wins risks undermining uptake.
• An approved vaccine that first emerges in China could be a political blow to the US government.