Another highly effective vaccine is poised to join the fight against COVID-19.  But its impact may be blunted by supply issues. The manufacturer expected to produce the bulk of the doses is in India, where the government has banned vaccine exports.  FILE – A car drives past the sign for vaccine developer Novavax at the company’s headquarters in Gaithersburg, Maryland, Nov. 30, 2020.”Many of our first doses will go to … low- and middle-income countries, and that was the goal to begin with,” Novavax CEO Stanley Erck told The Associated Press. The vaccine does not have the special cold storage requirements of the Pfizer-BioNTech or Moderna vaccines. That means low- and middle-income countries “can use the cold chain that they have already set up for routine childhood vaccines,” said William Moss, executive director of the Johns Hopkins University International Vaccine Access Center. “They don’t need to make modifications to handle the cold chain requirements” of the Pfizer and Moderna shots. Doses in limbo Novavax also has a deal with the Serum Institute of India (SII) to manufacture an additional 750 million doses of the vaccine.  SII is the world’s largest vaccine manufacturer and the main supplier of the Oxford-AstraZeneca vaccine to COVAX. But the Indian government has barred the company from exporting those doses as the country suffers through a devastating wave of COVID-19 infections.  People register their names to receive a coronavirus vaccine at a free camp in Kolkata, India, June 14, 2021.”Considering the situation in India, there are still a lot of questions about timing and volume (of Novavax vaccine) that would actually be available to the rest of the world,” said Kate Elder, senior vaccines policy adviser to the Doctors Without Borders Access Campaign. “It’s really just a testament to how poorly we as a global community have diversified production sites,” she added. “Whatever candidate produces successful vaccines, that technology (and) that know-how needs to be made available to whoever can produce it.” The company does have manufacturing capacity in other countries, Moss noted, and as regulators authorize the vaccine, there need to be “efforts to scale up manufacturing at those other sites outside of India so that we can get that vaccine to the populations that need them.” “It just shows the trouble with perhaps putting a lot of eggs in one basket,” he added. “For the next few months, we’re really short on vaccine globally,” said former U.S. Centers for Disease Control and Prevention chief Tom Frieden, who currently heads the global health nonprofit Resolve to Save Lives.  “Redistributing (vaccine doses), as the U.S. and others are doing, will be somewhat helpful, but not for many months,” he said. Over the weekend, the G-7 group of industrialized nations pledged 870 million vaccine doses to COVAX.  Questions about variants The results from the Novavax vaccine trial are impressive, but “what we still don’t have enough information on is how it will do against variants,” Frieden said.  Novavax reported that the vaccine was 93.2% effective against variants in the clinical trial, but it did not specify which variants.  The alpha variant, first identified in Britain and known to scientists as B.1.1.7, is the dominant viral strain in the United States. But in an earlier, smaller trial in South Africa, the vaccine was 51% effective against the dominant variant there, now known as beta.  
 
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