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Moderna is placing a big bet on vaccine production into 2022 by adding more production lines both for the US use and for export to other countries. From 1 billion doses it plans to triple production with partners around the world to 3 billion doses in 2022.

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The experience of J&J and Novavax in vaccine manufacturing shows the importance of vaccine manufacturing and of Quality Assurance in the production of vaccines for coronavirus. The success of Pfizer and Indian companies in vaccine manufacturing shows how important it is to think early and plan early for vaccine manufacturing technologies, personnel and quality assurance. This is also why the US effort, India's billion vaccine target in 6-12 months of planning, is a great effort in thinking ahead of every aspect of vaccines and vaccinating, planning of all details, hard work, by Pfizer, by Indian pharmaceutical companies, and by the Modi and Biden administrations. 

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India plans to vaccinate 300 million people in the first drive of the vaccination campaign. The two vaccines approved are the Covishield from Astra Zeneca partnership with Serum Institute of India, and the Bharat Biotech vaccine. India is the largest vaccine manufacturer in the world, and its vaccination production and campaign is being watched closely.  The largest maker of vaccines is Serum Institute of India based in Pune. Countries that are seeking India's help in vaccines are Brazil, South Africa, Morocco, Saudi Arabia, Bangladesh. Brazil has ordered 1.5 million vaccine doses. The Indian government has approved sending vaccines to other governments. Price of 100 million doses to be supplied by Serum Institute to the Indian government is 200 rupees a dose or about $2.73 a dose. Vaccine sold in private markets will be priced at 2000 rupees a dose. Serum Institute and Bharat Biotech have stockpiled 70 million doses. ...

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How do you setup a vaccine business. Consider Mr. Adar Poonavalla in the city of Pune in India. His company Serum Institute of India, remains family owned. Founded in 1966 by Cyrus Poonavalla, it produces billions of doses of vaccines for measles, polio and other diseases. It is expected to be one of the key sources of vaccines because of its expertise and the stocks of vials and other supplies that it has in stock for the next 2 years of vaccine production. It is working on a separate facility for coronavirus production that could turn out 800 million doses of vaccine at a price of about $13 a dose over 2 years. Serum Institute is working with 3 companies that are doing the research on the vaccine for coronavirus in the U.S. and Europe, and will play a key role in the manufacturing of vaccines. To respond to the question how do you setup a company to produce vaccines for the people of the world. This is what Mr. Poonavalla says- he will only work with ethical long term funds and sovereign funds because he does not want to be in the situation where he has to charge high prices to give them returns. Unlike most countries in the world, India is unique in making certain that most of the basic pharmaceutical drugs are available to over a billion people at a low cost. Serum's goal is low cost quality vaccine production so that over a billion people in Asia can be "protected from the birth onwards." As the U.S. and Europe and large parts of Asia, Africa and Latin America, face the second vaccine phase of the coronavirus response following difficulties in PPE, Ventilators, and Masks in the first phase, they can have confidence because of companies such as Serum and the research centers in U.S. and Europe like the one at Oxford University. ...

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Murali Krishnan of DW.com has this interview with Adar Poonavalla of Serum Institute of India the largest vaccine maker in the world that makes about 60% of all vaccines used in the world. It is beginning manufacturing of the Oxford vaccine so that the manufacturing process is ready to turn out a billion vaccine doses over a short period of 1 to 2 years. Serum's Oxford vaccine would be priced at $13 per dose for coronavirus. Serum is conducting its own trials for the vaccine. About 40 million doses would be ready by October. 

India's pioneering work in vaccine production on a large scale is one of the reasons the world can tackle the future with some confidence for the economy and the health of billions of people all over the world.

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The Oxford vaccine is shown to be effective for older adults over 70 years in age. One of the key features of the Oxford vaccine is that it is designed to be accessible in cost for not just high income countries but across all parts of the world including the countries in Asia, Africa and Latin America where some of the poorest people live. The cost will be a fraction of the cost of the Moderna and Pfizer vaccine. Results for regulatory approval are expected by Christmas. This vaccine is expected to cost about $4 a dose compared to $25 for the Pfizer or Moderna vaccines. Oxford also uses a technology for the vaccine that has already been proved effective with least side effects fr other virus such as Ebola virus. Oxford researchers took the existing vaccine technology and modified it to tackle coronavirus in a way that proves effective for this virus also. Countries such as South Korea say they will not rush into the first vaccine that is available and have not responded to requests for sale from Moderna or Pfizer. India's Serum Institute is the leading manufacturer of vaccines in the world. It is preparing for production of the Oxford vaccine. India's vaccine effort includes other vaccines developed by its research institutes. The focus of India is for a vaccine that is effective as well as meet cost so that it can be used to vaccinate over 1.3 billion people. Because India has strong already established manufacturing capabilities for vaccines and is collaborating with Oxford and Astra Zeneca for a low cost vaccine it is in a position to drive the campaign for an effective plus low cost 100% accessible vaccine for people around the world. Another aspect of the Astra Zeneca partnership with Oxford is that it has committed not to make a profit from the vaccine. This is important for Oxford researchers and its organizational goals. ...

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Mr. Pascal Soriot of Astra Zeneca says his company has signed agreements for production of 2 billion doses of the coronavirus vaccine being developed by Oxford University. He says manufacturing is starting now because "we want it to be as fast as possible." One of the deals is with Serum Institute of India, the other is with Bill Gates of the Bill and Melinda Gates Foundation for $750 million for CEPI and GAVI organizations which he supports. Mr. Soriot says the licensing agreement with Serum Institute is to supply one billion doses for low and middle income countries, with 400 million doses ready by end of 2020. He says Astra Zeneca is building supply chains across the world and so far has secured manufacturing capacity for 2 billion doses of the vaccine. Mr Soriot tells BBC that manufacturing vaccines on this scale is not an easy thing to do. He says that Astra Zeneca will not make a profit in production of these Oxford University developed vaccines. The U.S. has secured 300 million doses of the Oxford vaccine, and the UK 100 million doses.   ...

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The world's larges vaccine supplier Serum Institute of India syas it will not be able to meet its target production of 2 billion doses for 2021. It says vaccines will not be available for export from the Institute till the end of the year. The Indian government has initiated an effort to diversify its vaccine production by distributing it among many suppliers in India's large pharmaceutical industry so that constraints at any one supplier would not affect the overall supply for use inside India and the production that can be sent overseas.

Another setback was seen in the US as 100 million doses of J&J one dose vaccine at a Baltimore plant are being checked for contamination.

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The Hindu data team looks at the Indian vaccination drive with graphs by state and progress by dates. During the first 10 days of June the vaccination drive has been stepped up. It is now over 3 million a day and at this rate should reach 400 million vaccinated by the end of July, 100 million below target. For the remainder of the year vaccine supplies have to be pushed up so that 8 million doses can be given each day. This would get India to where everyone in the country of 1.2 billion has been vaccinated by Dec 31, 2021. This would make it possible for India to then use its technology and large manufacturing capacity to help other nations in Asia, Africa and Latin America in 2022. This is the first time in history that India has taken on a challenge of this size and complexity. The vaccine strategy has changed to where the federal government is taking over the overall responsibility of coordinating the production of vaccines in the country and providing access to vaccines from other countries. Federal government is also taking on overall responsibility for distribution of vaccines and setting up the logistical effort. Vaccine supply is being opened up by opening India to multiple vaccines including Pfizer, Moderna, and other vaccines. Production of Covaxin is being stepped up. This strategy is designed to get India to somewhere closer to the 8 million doses a day needed and to ensure distribution and logistical efforts are in place. More resources are put into the effort. The speed of economic recovery also depends on the vaccination drive. Lessons were learned during the second wave in May 2021 and the government is better prepared for the hard work ahead. ...

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Anthony Blinken says on his visit to New Delhi that shared values and democracy bind India and the US. Blinken also discussed ideas of providing Indian made vaccines in the Indo-Pacific region, and promised to strengthen vaccine supply chains to increase production.

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A conflict is developing between Britain and the European Union over vaccine supplies as both sides try to get access to limited supplies. Britain and the US have moved ahead with their vaccination drives, causing alarm in Europe as Germany, France, member states of the EU lag behind. The problem comes from the delay in approving the vaccine by Astra Zeneca and Oxford University by the European Union. European Union prestige is at stake because its slower process of approving vaccine has led to a delay of 1 month in approving the Astra Zeneca vaccine. The Oxford vaccine is only now approved in Europe. Other problems have emerged. Astra Zeneca has announced that its vaccines made in Britain are now running short of supply and it can only provide 39 million doses to the EU instead of the 80 million originally arranged by EU. Soon after this announcement Pfizer said its factory in Puurs, Belgium, near Antwerp, is running into production issues. This would reduce supplies to the EU.  The EU has responded to this situation by saying it was being treated unfairly by Astra Zeneca. In response it has introduced new paperwork that would limit supply of Pfizer vaccines to Britain from the Belgian plant. Other countries are watching this situation with dismay as richer countries are fighting for the vaccine supplies. ...

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Germany's chancellor Angela Merkel says she will not support the moves by the EU commission to impose export bans on export of Astra Zeneca vaccines made in EU countries to Britain. A Dutch factory has 4 million doses of this vaccine ready for shipment.  Merkel says, "there are a huge range of international interdependencies when it comes to vaccine production. You have to be very careful when it comes to imposing export bans. You have to take a close look at supply chains."  Merkel's action comes as Britain makes an effort to talk to German and French leaders for a fair way to allocate supplies of vaccine. France and Germany see the need for the principles of "reciprocity" and "equivalence" to be covered in settling the differences on vaccine supplies. Equivalence refers to the sense that there should not be a big gap between EU and non EU countries in vaccine access. On March 24, Britain had vaccinated 45 of 100 people in the country, and EU had vaccinated only 13 people in a hundred. ...

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France and Britain support president Biden in removing vaccine patent barriers so that vaccine production can be ramped up.

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In Britain, in India and in the EU, the race is between the vaccination drive and the infection case growth, as each country and region takes steps to accelerate and organize production, distribution and administering of the vaccine to all parts of the population.

The latest late stage trial for Astra Zeneca vaccine in US, Chile and Peru, offers new hope. It is shown in that trial that it is 100% effective in prevention of hospitalization and deaths, and 79% effective in prevention of symptomatic illness from the coronavirus. It is also seen as safe by experts as it goes for FDA regulatory approval in the US. It is provided at cost, and storage is in ordinary refrigerators for long periods, with production in India of large quantities of the vaccine, making it a vaccine that could reach large parts of the world's population.

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India is providing additional financing to Serum Institute of India and vaccine manufacturers to increase vaccine supplies. It is also importing Sputnik vaccine from Russia and approving production within India of Sputnik vaccine. These steps are being taken to accelerate vaccinations. By early May vaccination will be open to anyone over 18 years.

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As Pfizer prepares shipments of 25 million doses of vaccine in the U.S. this WSJ report looks at how Pfizer CEO Albert Bourla pushed his manufacturing managers to the limit to increase production. He wanted 100 million doses for 50 million people by the end of 2020, production would have to be ten fold what the initial targets were. Pfizer will achieve half that which is an achievement considering how much had to be done. This report looks at the development of the vaccine at Pfizer since the early days in March when the collaboration with BoNTech in Germany began.

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The Novavax vaccine to be manufactured in Britain faces a shortage of 2000 litre bags, bags in which the vaccine cells are grown. The first of 60 million doses ordered by the British government are already in production in Teeside, a factory in Britain.

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A Phase 1 trial of over a thousand volunteers shows the Oxford vaccine works well with minimum side effects that can be handled with acetaminophen. Phase 2 trial is underway with volunteers in UK, Brazil and South Africa. Participants given the vaccine had significant increase in antibodies to neutralize the disease, and T cells for long term protection. About 70% reported fatigue or headaches which can be handled with acetaminophen. After the Ebola crisis of 2014 in West Africa the British government invested 120 million pounds to form a group to develop vaccines for top 10 likely threats dubbed "Disease X." On this list was the coronavirus. Scientists at the Jenner Institute at Oxford formed a team as part of this effort. Sarah Gilbert and Adrian Hill led the scientists at Jenner and pioneered research for  a new way to do this- to first replace a part of the virus with a component of the new virus. Then to remove the part of the virus that allows it to replicate in humans. This method is called recombinant adenovirus vector. The Oxford scientists used existing technology in new ways to increase the chances of getting a good vaccine early.  The first vaccine could be developed and tested for mass production by September. A 30,000 participant trial begins in U.S. in August. About 1 billion doses could be manufactured by end of 2020. India's Serum Institute has the manufacturing facilities to do this near Pune, India.  ...

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The U.S. is moving quickly to gain access to an effective vaccine by September or October 2020. It is doing this by providing the money for companies to conduct trials and ramp up manufacturing in a big way. The U.S. government has agreed to give Astra Zeneca upto $1.2 billion to secure supply of a Oxford University developed vaccine which could be ready by October. Astra Zeneca has agreed to make the vaccine under a licensing deal with Oxford University's Jenner Institute and promised it will not make a profit on this. U.S. has also given $483 million to Moderna in Cambridge, Massachusetts, for making the vaccine. Both Oxford and Moderna are testing the vaccine on humans. Oxford uses a tested older technology, Moderna a new technology. UK has given Astra Zeneca $79 million to secure 100 million doses of the vaccine, with 30 million ready by September. Oxford is also in negotiations with Gavi the international vaccine alliance, and Coalition for Epidemic Preparedness Innovations on further deals to boost production. Oxford began a 1100 person study in April, and is  doing a 5000 person trial in late May.  ...

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After a sudden surge in the beginning of May the coronavirus wave in India, its second wave, is decreasing. It is 186,000 new coronavirus cases on May 27, down from over 350,000 at the peak. In India's largest state Uttar Pradesh with a population of 210 million the coronavirus cases have dropped sharply to 4000 a day. New coronavirus cases in Delhi and Bombay are around 1000 a day. The Indian government has moved quickly to tackle this wave with decisive action to meet the sudden surge in May 2021. For the rest of 2021 and into 2022 the most important action by the Indian government has been to create a government sponsored effort of India's entire pharmaceutical company sector to reunite in production of over 2 billion vaccine doses by December 2021. After independence in 1947 one of the steps taken by India with great foresight was to create a strong pharmaceutical sector with fair and transparent pricing of basic drugs and vaccines. Something that does not exist in this manner and scale anywhere else in the world. Today this is giving India a tremendous asset in the fight against coronavirus. India is already the largest producer of vaccines in the world, the new effort will make give it a decisive advantage in meeting not only India's but the world's need for new vaccines. ...

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The UK and the European Union compete for limited vaccine supplies as a plant in Belgium has production problems and Astra Zeneca says it can only supply half of what it promised to Europe.

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The mRNA vaccine production is running into bottlenecks because the mRNA derived from DNA, needs to be encapsulated in lipids. Lipids supply is limited. The detailed production process is described here in the WSJ. 

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When regulators told J&J that tens of millions of doses at a Baltimore plant had to be discarded for contamination, the initial enthusiasm for a one dose vaccine began to fade. Production problems and the pause in the vaccine J&J as problems are sorted out, is making the J&J vaccine less effective in this crisis. Only 11.4 million doses have been adminstered of J&J vaccine says the NYT, making its role less significant.