Table 1

R&D, launch and scale timelines by vaccine

VaccineR&D (years)#Launch (years) #Scale (years)#
COVID-19 vaccines
 Bharat Biotech_COVAXIN0.520.04NA*
 Gamaleya_Sputnik V0.410.14NA*
 Janssen (J&J)_Ad26.COV2.S0.92−0.030.25
 Oxford-AstraZeneca _AZD12220.900.05NA*
Median of COVID-19 vaccines (IQR)0.90 (0.41)0.05 (0.03)0.92 (0.97)
Other vaccines‡
 GSK_Bivalent oral polio3.990.186.38
 Merck_Gardasil (quadrivalent)12.671.3311.01
 Chengdu Institute of Biological Products_Japanese Encephalitis34.020.5018.01
 Serum Institute India_MenAfriVac8.420.750.83
 Merck Sharp & Dohme Corp _RotaTeq23.610.738.68
 Bharat Biotech, CDC, NIH, All India Institute of Medical Sciences, Stanford University, Indian Institute of Science, BMGF_Rotavac20.231.110.33
Median of other vaccines (IQR)14.16 (11.94)0.62 (0.84)7.53 (10.43)
  • 1. Milestones: according to the International Development Innovation Alliance’s ‘Insights on Scaling Innovation Framework, we simplified the end-to-end pathway into the following three stages. Two trained researchers collected the date of milestones through reviews of both peer-reviewed and grey literature (sources have been provided in online supplemental appendix 1). Dates were collected in the format day-month-year. For dates with only the year available, we assigned the milestone to be the midpoint of the year (ie, 1 July). For dates with the year and month available, but not the day, we assigned the milestone to be the midpoint of the month (ie, the 15th). If two milestones were reported in same year but without specific date, we assumed the difference to be 0.5 year.20 21

  • 1.1 R&D: the time from vaccine ideation to first approval of the vaccine by a national regulatory authority (in any LMIC).

  • 1.2 Launch: the time from first approval by a national regulatory authority to first introduction, commercialisation or procurement of the vaccine within any LMIC (outside of a research study).

  • 1.3 Scale: the time from first launch within any LMIC to at least 20% uptake of the vaccine across all LMICs. LMICs uptake at 20% was selected due to its availability of data for most interventions. For COVID-19 vaccines, the calculation is based on supply (procurement) data (based on the first time the coverage reached 20%); for other vaccines, calculation is based on demand (actual coverage or use) or supply (procurement) data whichever data are available. The denominator is the LMIC population with the VPD (‘target user’ of the vaccine).

  • *NA denotes data are unavailable or timeline is not yet complete

  • †Merck_Ervebo vaccine was used as an investigational vaccine under an expanded access programme to help mitigate Ebola outbreak in 2018.

  • ‡Selection of non-COVID-19 vaccines: For the non-COVID-19 vaccines, we referred to Luthra et al’s list of Gavi supported vaccines22 and purposively selected illustrative vaccines for different types of VPDs and manufactured by different types of developers. For vaccines with different manufacturers, we chose the first manufacturer that received WHO prequalification for better data availability. We have not included an exhausting list of vaccines, which is a limitation and our findings and implications should be interpreted with caution.

  • LMICs, low-income and middle-income countries; NA, not available; nOPV2, novel oral polio vaccine type 2; R&D, research and development; VPDs, vaccine-preventable diseases.