Mapping global trends in vaccine sales before and during the first wave of the COVID-19 pandemic: a cross-sectional time-series analysis

BACKGROUND: While the COVID-19 pandemic may have substantially hindered the provision of routine immunisation services worldwide, we have little data on the impact of the pandemic on vaccine supply chains. METHODS: We used time-series analysis to examine global trends in vaccine sales for a total of 34 vaccines and combination vaccines using data from the IQVIA MIDAS Database between August 2014 and August 2020 across 84 countries. We grouped countries into three income-level categories, and we modelled the changes in vaccine sales from April to August 2020 versus April to August 2019 using autoregressive integrated moving average models. RESULTS: In March 2020, global sales of vaccines dropped from 1211.1 per 100 000 to 806.2 per 100 000 population in April 2020, an overall decrease of 33.4%; however, the vaccine sales interruptions recovered disproportionately across economies. Between April 2020 and August 2020, we found a significant decrease of 20.6% (p<0.001) in vaccine sales across high-income countries (HICs), in contrast with a significant increase of 10.7% (p<0.001) across lower middle-income countries (LMICs), relative to the same period in 2019. From August 2014 through August 2020, monthly per capita vaccine sales across HICs remained, on average, at least four times higher than in LMICs and nearly three times higher than in upper middle-income countries. CONCLUSION: Our study revealed the heterogeneous impact of COVID-19 on vaccine sales across economies while underlining the substantial consistent disparities in per capita vaccine sales before and during the first wave of the COVID-19 pandemic. Action to ensure equitable distribution of vaccines is needed.