Changes in per capita vaccine sales between April and August 2020 when compared with the same period in 2019, by countryincome level category
| Age group | Vaccine | All regions and countries | Lower middle-income countries | Upper middle-income countries | High-income countries | ||||||||||||
| Units per 100 000 pop | % change | P value* | Units per 100 000 pop | % change | P value* | Units per 100 000 pop | % change | P value* | Units per 100 000 pop | % change | P value* | ||||||
| April–August 2019 | April–August 2020 | April–August 2019 | April–August 2020 | April–August 2019 | April–August 2020 | April–August 2019 | April–August 2020 | ||||||||||
| All vaccines (excluding influenza) | 5206.0 | 4712.7 | (9.5) | <0.001 | 3237.5 | 3582.9 | 10.7 | <0.001 | 4569.2 | 4143.0 | (9.3) | 0.74 | 11156.9 | 8863.5 | (20.6) | <0.001 | |
| Infants† | BCG | 29.2 | 20.0 | (31.6) | 0.04 | 11.6 | 13.2 | 13.9 | 0.02 | 40.4 | 16.9 | (58.1) | 0.42 | 43.1 | 43.5 | 1.1 | 0.48 |
| Diphtheria, tetanus, polio | 18.0 | 11.7 | (35.2) | <0.001 | 0.4 | 0.3 | (28.9) | <0.001 | 0.0 | 0.0 | (36.5) | 0.22 | 92.2 | 60.5 | (34.4) | <0.001 | |
| Diphtheria | 15.7 | 5.8 | (63.1) | 0.02 | 0.0 | 0.0 | 7.8 | 0.18 | 0.0 | 0.3 | 16.2 | 0.48 | 82.1 | 29.7 | (63.8) | 0.02 | |
| Diphtheria, tetanus | 142.5 | 109.9 | (22.8) | 0.30 | 43.9 | 26.1 | (40.5) | 0.13 | 194.6 | 156.6 | (19.5) | 0.48 | 237.4 | 184.7 | (22.2) | <0.001 | |
| DTP | 277.3 | 178.1 | (35.8) | 0.01 | 14.4 | 10.9 | (24.1) | 0.07 | 191.1 | 73.8 | (61.4) | 0.37 | 1003.5 | 752.3 | (25.0) | <0.001 | |
| DTP, hepatitis B | 0.4 | 0.5 | 23.5 | <0.001 | 1.2 | 0.9 | (25.5) | 0.12 | — | 0.5 | — | — | — | — | — | — | |
| DTP, Hib | 4.5 | 3.6 | (18.9) | 0.44 | 12.4 | 9.7 | (22.0) | 0.31 | — | 0.4 | — | 0.64 | 0.8 | 0.4 | (53.8) | 0.89 | |
| DTP, polio | 117.8 | 107.0 | (9.2) | 0.07 | 1.1 | 2.3 | 105.7 | 0.94 | 5.9 | 4.0 | (32.5) | 0.56 | 600.6 | 248.5 | (8.7) | 0.07 | |
| DTP, polio, Hib | 142.7 | 142.8 | 0.1 | 0.75 | 24.7 | 26.6 | 7.8 | 0.23 | 114.0 | 115.2 | 1.1 | 0.80 | 449.3 | 446.8 | (0.6) | 0.28 | |
| Hepatitis B‡ | 263.2 | 218.7 | (16.9) | 0.44 | 43.8 | 34.4 | (21.6) | <0.001 | 270.3 | 273.2 | 1.0 | 0.07 | 693.0 | 477.7 | (31.1) | <0.001 | |
| Hib | 816.0 | 832.0 | 2.0 | 0.88 | 111.1 | 115.1 | 3.6 | 0.30 | 974.5 | 1119.3 | 14.9 | 0.37 | 1837.3 | 1572.6 | (14.4) | 0.42 | |
| Japanese encephalitis ‡ | 39.5 | 35.9 | (9.1) | <0.001 | 3.1 | 2.3 | (25.8) | <0.001 | 5.8 | 5.9 | 2.1 | 0.82 | 188.5 | 171.6 | (9.0) | <0.001 | |
| Measles | 58.2 | 53.7 | (7.7) | 0.87 | 0.1 | — | — | — | 136.7 | 126.9 | (7.1) | 0.90 | 3.4 | 2.6 | (24.1) | 0.31 | |
| Measles, mumps | 0.4 | 0.5 | 14.7 | 0.64 | — | — | — | — | 0.9 | 1.1 | 15.0 | 0.33 | — | — | — | — | |
| Measles, rubella | 21.1 | 20.4 | (3.4) | 0.71 | — | — | — | — | 0.1 | 0.8 | 815.0 | 1.00 | 110.8 | 105.9 | (4.4) | 0.65 | |
| Meningococcal‡ | 220.2 | 258.0 | 17.2 | 0.59 | 3.9 | 2.4 | (39.4) | <0.001 | 218.1 | 370.5 | 69.8 | 0.26 | 662.2 | 533.5 | (19.4) | <0.001 | |
| Meningococcal, Hib | 0.6 | 0.6 | (9.6) | 0.88 | — | — | — | — | — | — | — | — | 3.4 | 3.1 | (9.3) | 0.88 | |
| MMR | 324.7 | 256.6 | (21.0) | 0.68 | 23.1 | 18.2 | (21.4) | <0.001 | 433.7 | 370.6 | (14.6) | 0.38 | 701.8 | 498.0 | (29.0) | <0.001 | |
| Mumps | 12.5 | 13.5 | 8.6 | 0.87 | — | — | — | — | 3.0 | 3.3 | 7.1 | 0.41 | 58.5 | 63.9 | 9.3 | 0.42 | |
| Pneumococcal | 379.1 | 319.2 | (15.8) | 0.35 | 47.8 | 40.3 | (15.8) | <0.001 | 361.5 | 208.3 | (42.4) | 0.51 | 1110.5 | 1143.2 | 3.9 | <0.001 | |
| Polio‡ | 261.3 | 217.7 | (16.9) | 0.88 | 5.2 | 6.3 | 20.5 | 0.06 | 607.3 | 505.6 | (16.8) | 0.88 | 22.2 | 15.7 | (29.5) | 0.94 | |
| Rotavirus | 119.1 | 110.7 | (7.1) | 0.62 | 29.9 | 23.5 | (21.5) | 0.02 | 99.4 | 83.8 | (15.7) | 0.85 | 350.0 | 353.4 | 1.0 | 0.04 | |
| Tetanus | 689.4 | 905.2 | 31.3 | 0.05 | 1839.9 | 2454.6 | 33.4 | 0.07 | 54.1 | 48.6 | (10.2) | 0.63 | 118.5 | 91.8 | (22.6) | <0.001 | |
| Varicella | 287.6 | 132.6 | (53.9) | <0.001 | 14.5 | 8.9 | (38.8) | <0.001 | 236.4 | 24.9 | (89.5) | 0.95 | 958.0 | 624.9 | (34.8) | <0.001 | |
| Yellow fever§ | 5.7 | 1.2 | (79.1) | <0.001 | 0.2 | 0.2 | (14.9) | 0.14 | 2.3 | 0.9 | (61.6) | 0.21 | 23.3 | 3.6 | (84.7) | <0.001 | |
| Adolescents | HPV | 146.4 | 151.3 | 3.3 | 0.40 | 3.7 | 2.1 | (44.6) | <0.001 | 147.4 | 198.8 | 34.9 | 0.31 | 433.4 | 352.2 | (18.7) | 0.22 |
| Adults | Anthrax¶ | 0.1 | 0.0 | (54.4) | 0.22 | — | — | — | — | 0.1 | 0.1 | (54.2) | 0.22 | — | — | — | — |
| Typhoid‡ | 48.1 | 8.4 | (82.5) | <0.001 | 26.2 | 15.4 | (41.3) | <0.001 | 2.1 | 1.2 | (42.5) | 0.82 | 197.6 | 12.1 | (93.9) | <0.001 | |
| All age groups | Dengue | 0.1 | 0.1 | 22.7 | 0.68 | — | — | — | — | 0.18 | 0.22 | 23.0 | 0.68 | — | — | — | — |
| Hepatitis A‡ | 421.4 | 298.8 | (29.1) | <0.001 | 871.9 | 656.5 | (24.7) | <0.001 | 29.8 | 42.6 | 43.2 | 0.31 | 552.5 | 272.4 | (50.7) | <0.001 | |
| Rabies‡ | 150.4 | 138.3 | (8.1) | 0.84 | 100.2 | 110.9 | 10.7 | 0.48 | 241.5 | 224.6 | (7.0) | 0.22 | 64.6 | 20.9 | (67.7) | <0.001 | |
| Rubella | 40.4 | 35.4 | (12.5) | 0.21 | 2.6 | 1.8 | (29.2) | 0.01 | 92.2 | 81.4 | (11.7) | 0.20 | 4.1 | 3.3 | (19.1) | 0.29 | |
| Seasonal influenza | 1030.9 | 1326.5 | 28.7 | 0.30 | 74.3 | 72.6 | (2.3) | 0.56 | 1243.6 | 1915.2 | 54.0 | 0.72 | 2537.1 | 2639.5 | 4.0 | 0.29 | |
| Tickborne encephalitis‡ | 131.9 | 114.3 | (13.3) | <0.001 | 0.0 | 0.0 | (50.6) | <0.001 | 69.4 | 57.6 | (16.9) | 0.11 | 537.3 | 473.4 | (11.9) | <0.001 | |
| Other | 15.1 | 10.3 | (31.8) | 0.14 | — | — | — | — | 35.9 | 24.6 | (31.6) | 0.13 | 0.1 | 0.1 | (41.6) | 0.02 | |
Source: author’s analysis of MIDAS Monthly Sales Vaccine Data, August 2014–August 2020.
*Reported p values are for an ARIMA ramp intervention in April–August 2020.
†Catch-up vaccination is recommended for interrupted or delayed childhood routine immunisation.
‡If not previously immunised or if a booster dose is needed, these vaccines are among the most common travel-recommended vaccines depending on age, health and destination.
§Yellow fever vaccine is required for international travel to areas at risk of yellow fever virus.
¶Anthrax is recommended for high-risk adults as per CDC.
—, not applicable; ARIMA, autoregressive integrated moving average; CDC, Centers for Disease Control and Prevention; DTP, diphtheria, tetanus, pertussis; Hib, Haemophilus influenzae type b; HPV, human papillomavirus; MMR, measles, mumps and rubella; pop, population.