science.org SCIENCEPHOTO: ZAKIR HOSSAIN CHOWDHURY/NURPHOTO/GETTY IMAGES1438 17 DECEMBER 2021 • VOL 374 ISSUE 6574I
mmunization prevents 4 to 5 million
deaths annually, primarily among chil-
dren, but each year 20 million infants
do not receive a full course of the most
essential basic vaccines. COVID-19 has
underscored the importance of vac-cines to public health, but immunization
coverage dropped in 2020 as a result of
the pandemic, leaving even more infants
un- or underimmunized ( 1 ). The push to
manufacture COVID-19 vaccines has raised
concerns that supplies of other essentialvaccines may be compromised, which
could erode the gains achieved by immu-
nization and delay access for underserved
populations. Drawing on data assembled
by the World Health Organization (WHO)
and on the advice of technical experts (see
supplementary materials), we describe
how COVID-19 is affecting the global sup-
ply of key infant and adolescent vaccines
(see the table). We assess the risks to those
essential vaccines, identify mitigations,
and explore how emerging innovations can
help improve market health.ISSUES AFFECTING VACCINE SUPPLIES
Prior to the pandemic, approximately 5
billion doses of vaccines were manufac-
tured globally each year. In 2022, COVID-19
vaccine production is projected to reach
at least 14 billion doses per year ( 2 ). This
unprecedented fourfold increase in overallINSIGHTS
POLICY FORUM
Vaccine production is quadrupling rapidly,
creating supply chain challenges
GLOBAL HEALTHCOVID-19 impact on infant and
adolescent vaccine supplies
By Tania Cernuschi^1 , Stefano Malvolti^2 , Matthew Downham^3 , Dominique Maugeais^4 ,
David Robinson^5 , Alejandro Cravioto^6