Pfizer made a commitment on more equitable access last year, following criticism that it prioritized wealthy nations for doses of its COVID-19 shot early in the pandemic. The company says it wants to shorten a timeline in which poorer countries often get vaccines many years after they are available elsewhere.
The drugmaker received a $28 million grant from the Bill and Melinda Gates Foundation in September to support the launch of the respiratory syncytial virus (RSV) vaccine in poorer countries, where RSV — a common cold-like virus — is much more likely to be lethal for very young children.
Pfizer's maternal RSV vaccine is expected to be approved for use in pregnant women in May in the United States and several months later in Europe, and the company plans to launch the product in both markets in the fall. Its peak sales forecast is of more than $2 billion annually together from the maternal vaccine and an RSV shot for older adults.
But the vaccine will need a different delivery system to be used in developing countries in Africa and Asia, including alternative packaging and syringes. Preparations for those modifications are just beginning, according to the World Health Organization and the company — which is likely to push back delivery by several years.
The case highlights how equitable global access will require better advance planning by drugmakers, governments and health organizations, health officials say.
"They could have tried sooner," said Erin Sparrow, WHO's technical officer for the RSV vaccine, referring to Pfizer. "It's a little bit disappointing, but they are doing the right thing now."
Pfizer says it is committed to a faster timeline for rolling out medicines to poor nations but acknowledges that there are challenges in meeting such goals.
"We are committed to working with the appropriate organizations, including regulatory authorities and other global health partners, to help ensure the vaccine candidate, once approved, is available in lower- and middle-income countries as quickly as possible," a Pfizer spokesperson said when asked about the timeline for the RSV shot.
In an interview last month, Pfizer's head of vaccines research and development Annaliesa Anderson said the company still aimed to make its vaccine – the first of its kind – available for pregnant women in low-income countries more or less in the "same time frame" as in wealthy countries.
It had pledged last May to offer its existing portfolio, as well as newly developed drugs and vaccines, at a not-for-profit basis to 45 lower-income countries on a faster timeline than in the past.
The company had learned during the COVID-19 pandemic that "parallel development" to meet the needs of different regions was possible, Anderson said.