COVID-19 vaccine
A COVID‑19 vaccine is a vaccine intended to provide acquired immunity against severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2), the virus that causes coronavirus disease 2019 (COVID‑19).
Prior to the COVID‑19 pandemic, an established body of knowledge existed about the structure and function of coronaviruses causing diseases like severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). This knowledge accelerated the development of various vaccine platforms during early 2020.[1] The initial focus of SARS-CoV-2 vaccines was on preventing symptomatic, often severe illness.[2] On 10 January 2020, the SARS-CoV-2 genetic sequence data was shared through GISAID, and by 19 March, the global pharmaceutical industry announced a major commitment to address COVID‑19.[3]
The COVID‑19 vaccines are widely credited for their role in reducing the severity and death caused by COVID‑19.[4][5] Many countries have implemented phased distribution plans that prioritize those at highest risk of complications, such as the elderly, and those at high risk of exposure and transmission, such as healthcare workers.[6]
As of 21 February 2022, 10.57 billion doses of COVID‑19 vaccines have been administered worldwide based on official reports from national public health agencies.[7] By December 2020, more than 10 billion vaccine doses had been preordered by countries,[8] with about half of the doses purchased by high-income countries comprising 14% of the world's population.[9]
Background
COVID‑19 vaccine doses administered by continent as of Oct 11, 2021. For vaccines that require multiple doses, each individual dose is counted. As the same person may receive more than one dose, the number of doses can be higher than the number of people in the population.
Map showing share of population fully vaccinated against COVID-19 relative to a country's total population[note 1]
.svg)
| Part of a series on the |
| COVID-19 pandemic |
|---|
 |
|
 COVID-19 portal |
.jpg)
Prior to COVID‑19, a vaccine for an infectious disease had never been produced in less than several years – and no vaccine existed for preventing a coronavirus infection in humans.[10] However, vaccines have been produced against several animal diseases caused by coronaviruses, including (as of 2003) infectious bronchitis virus in birds, canine coronavirus, and feline coronavirus.[11] Previous projects to develop vaccines for viruses in the family Coronaviridae that affect humans have been aimed at severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). Vaccines against SARS[12] and MERS[13] have been tested in non-human animals.
According to studies published in 2005 and 2006, the identification and development of novel vaccines and medicines to treat SARS was a priority for governments and public health agencies around the world at that time.[14][15][16] There is no cure or protective vaccine proven to be safe and effective against SARS in humans.[17][18] There is also no proven vaccine against MERS.[19] When MERS became prevalent, it was believed that existing SARS research might provide a useful template for developing vaccines and therapeutics against a MERS-CoV infection.[17][20] As of March 2020, there was one (DNA-based) MERS vaccine which completed Phase I clinical trials in humans,[21] and three others in progress, all being viral-vectored vaccines: two adenoviral-vectored (ChAdOx1-MERS, BVRS-GamVac) and one MVA-vectored (MVA-MERS-S).[22]
Vaccines that use an inactive or weakened virus that has been grown in eggs typically take more than a decade to develop.[23][24] In contrast, mRNA is a molecule that can be made quickly, and research on mRNA to fight diseases was begun decades before the COVID‑19 pandemic by scientists such as Drew Weissman and Katalin Karikó, who tested on mice. Moderna began human testing of an mRNA vaccine in 2015.[23] Viral vector vaccines were also developed for the COVID‑19 pandemic after the technology was previously cleared for Ebola.[23]
As multiple COVID‑19 vaccines have been authorized or licensed for use, real-world vaccine effectiveness (RWE) is being assessed using case control and observational studies.[25] A study is investigating the long-lasting protection against SARS-CoV-2 provided by the mRNA vaccines.[26][27]
Formulation
As of September 2020, eleven of the vaccine candidates in clinical development use adjuvants to enhance immunogenicity.[28] An immunological adjuvant is a substance formulated with a vaccine to elevate the immune response to an antigen, such as the COVID‑19 virus or influenza virus.[29] Specifically, an adjuvant may be used in formulating a COVID‑19 vaccine candidate to boost its immunogenicity and efficacy to reduce or prevent COVID‑19 infection in vaccinated individuals.[29][30] Adjuvants used in COVID‑19 vaccine formulation may be particularly effective for technologies using the inactivated COVID‑19 virus and recombinant protein-based or vector-based vaccines.[30] Aluminum salts, known as "alum", were the first adjuvant used for licensed vaccines, and are the adjuvant of choice in some 80% of adjuvanted vaccines.[30] The alum adjuvant initiates diverse molecular and cellular mechanisms to enhance immunogenicity, including release of proinflammatory cytokines.[29][30]
Sequencing
In November 2021, the full nucleotide sequences of the AstraZeneca and Pfizer/BioNTech vaccines were released by the UK Medicines and Healthcare Products Regulatory Agency, in response to a freedom of information request.[31][32]
Clinical research
COVID-19 vaccine clinical research uses clinical research to establish the characteristics of COVID-19 vaccines. These characteristics include efficacy, effectiveness and safety. Thirty vaccines are authorized for use by national governments, including eight approved for emergency or full use by at least one WHO-recognised stringent regulatory authority; while five are in Phase IV. 204 vaccines are undergoing clinical trials that have yet to be authorized. Nine clinical trials consider heterologous vaccination courses.
Thirty vaccines are authorized by at least one national regulatory authority for public use:[33][34]
As of July 2021, 330 vaccine candidates were in various stages of development, with 102 in clinical research, including 30 in Phase I trials, 30 in Phase I–II trials, 25 in Phase III trials, and 8 in Phase IV development.[33]Post-vaccination complications
Post-vaccination embolic and thrombotic events, termed vaccine-induced immune thrombotic thrombocytopenia (VITT),[35][36][37][38][39] vaccine-induced prothrombotic immune thrombocytopenia (VIPIT),[40] thrombosis with thrombocytopenia syndrome (TTS),[41][38][39] vaccine-induced immune thrombocytopenia and thrombosis (VITT),[39] or vaccine-associated thrombotic thrombocytopenia (VATT),[39] are rare types of blood clotting syndromes that were initially observed in a number of people who had previously received the Oxford–AstraZeneca COVID‑19 vaccine (AZD1222)[a] during the COVID‑19 pandemic.[40][46] It was subsequently also described in the Janssen COVID‑19 vaccine (Johnson & Johnson) leading to suspension of its use until its safety had been reassessed.[47]
In April 2021, AstraZeneca and the European Medicines Agency (EMA) updated their information for healthcare professionals about AZD1222, saying it is "considered plausible" that there is a causal relationship between the vaccination and the occurrence of thrombosis in combination with thrombocytopenia and that, "although such adverse reactions are very rare, they exceeded what would be expected in the general population".[46][48][49][50]Vaccine types
.jpg)
At least nine different technology platforms are under research and development to create an effective vaccine against COVID‑19.[28][52] Most of the platforms of vaccine candidates in clinical trials are focused on the coronavirus spike protein (S protein) and its variants as the primary antigen of COVID‑19 infection,[28] since the S protein triggers strong B-cell and T-cell immune responses.[53][54] However, other coronavirus proteins are also being investigated for vaccine development, like the nucleocapsid, because they also induce a robust T-cell response and their genes are more conserved and recombine less frequently (compared to Spike).[54][55][56] Future generations of COVID-19 vaccines that may target more and conserved genomic regions will also act as an insurance against the manifestation of catastrophic scenarios concerning the future evolutionary path of SARS-CoV-2, or any similar Coronavirus epidemic/pandemic.[57]
Platforms developed in 2020 involved nucleic acid technologies (nucleoside-modified messenger RNA and DNA), non-replicating viral vectors, peptides, recombinant proteins, live attenuated viruses, and inactivated viruses.[10][28][58][59]
Many vaccine technologies being developed for COVID‑19 are not like vaccines already in use to prevent influenza, but rather are using "next-generation" strategies for precise targeting of COVID‑19 infection mechanisms.[28][58][59] Several of the synthetic vaccines use a 2P mutation to lock the spike protein into its prefusion configuration, stimulating an adaptive immune response to the virus before it attaches to a human cell.[60] Vaccine platforms in development may improve flexibility for antigen manipulation, and effectiveness for targeting mechanisms of COVID‑19 infection in susceptible population subgroups, such as healthcare workers, the elderly, children, pregnant women, and people with weakened immune systems.[28][58]
mRNA vaccines
.jpg)
Several COVID‑19 vaccines, including the Pfizer–BioNTech and Moderna vaccines, have been developed to use RNA to stimulate an immune response. When introduced into human tissue, the vaccine contains either self-replicating RNA or messenger RNA (mRNA), which both cause cells to express the SARS-CoV-2 spike protein. This teaches the body how to identify and destroy the corresponding pathogen. RNA vaccines often, but not always, use nucleoside-modified messenger RNA. The delivery of mRNA is achieved by a coformulation of the molecule into lipid nanoparticles which protect the RNA strands and help their absorption into the cells.[61][62][63][64]
RNA vaccines were the first COVID‑19 vaccines to be authorized in the United Kingdom, the United States and the European Union.[65][66] Authorized vaccines of this type are the Pfizer–BioNTech Severe allergic reactions are rare. In December 2020, 1,893,360 first doses of Pfizer–BioNTech COVID‑19 vaccine administration resulted in 175 cases of severe allergic reaction, of which 21 were anaphylaxis.[73] For 4,041,396 Moderna COVID‑19 vaccine dose administrations in December 2020 and January 2021, only ten cases of anaphylaxis were reported.[73] Lipid nanoparticles (LNPs) were most likely responsible for the allergic reactions.[73] These vaccines are examples of non-replicating viral vector vaccines, using an adenovirus shell containing DNA that encodes a SARS‑CoV‑2 protein.[74][75] The viral vector-based vaccines against COVID‑19 are non-replicating, meaning that they do not make new virus particles, but rather produce only the antigen which elicits a systemic immune response.[74] Authorized vaccines of this type are the Oxford–AstraZeneca COVID‑19 vaccine, Convidecia and the Janssen COVID‑19 vaccine are both one-shot vaccines which offer less complicated logistics and can be stored under ordinary refrigeration for several months.[82][83] Sputnik V uses Ad26 for its first dose, which is the same as Janssen's only dose, and Ad5 for the second dose, which is the same as Convidecia's only dose.[84] On 11 August 2021, the developers of Sputnik V proposed, in view of the Delta case surge, that Pfizer test the Ad26 component (termed its 'Light' version)[85] as a booster shot: Delta cases surge in US & Israel shows mRNA vaccines need a heterogeneous booster to strengthen & prolong immune response. #SputnikV pioneered mix&match approach, combo trials & showed 83.1% efficacy vs Delta. Today RDIF offers Pfizer to start trial with Sputnik Light as booster.[86] Inactivated vaccines consist of virus particles that are grown in culture and then killed using a method such as heat or formaldehyde to lose disease producing capacity, while still stimulating an immune response.[87] Authorized vaccines of this type are the Chinese CoronaVac[88][89][90] and the Sinopharm BIBP Subunit vaccines present one or more antigens without introducing whole pathogen particles. The antigens involved are often protein subunits, but can be any molecule that is a fragment of the pathogen.[97] The authorized vaccines of this type are the peptide vaccine EpiVacCorona, The V451 vaccine was previously in clinical trials, which were terminated because it was found that the vaccine may potentially cause incorrect results for subsequent HIV testing. Intranasal vaccines target mucosal immunity in the nasal mucosa which is a portal for viral entrance to the body.[105][106] These vaccines are designed to stimulate nasal immune factors, such as IgA.[105] In addition to inhibiting the virus, nasal vaccines provide ease of administration because no needles (and the accompanying needle phobia) are involved.[106][107] Nasal vaccines have been approved for other infections, such as influenza.[106][107] As of 2021, only one nasal vaccine, Flumist (USA); Fluenz Tetra (European Union), had been authorized in the United States and Europe for use as an influenza vaccine.[107][108] Additional types of vaccines that are in clinical trials include virus-like particle vaccines, multiple DNA plasmid vaccines,[109] Scientists investigated whether existing vaccines for unrelated conditions could prime the immune system and lessen the severity of COVID‑19 infection.[118] There is experimental evidence that the BCG vaccine for tuberculosis has non-specific effects on the immune system, but no evidence that this vaccine is effective against COVID‑19.[119] Since January 2020, vaccine development has been expedited via unprecedented collaboration in the multinational pharmaceutical industry and between governments.[28] Multiple steps along the entire development path are evaluated, including:[10][120] There have been several unique challenges with COVID‑19 vaccine development. The urgency to create a vaccine for COVID‑19 led to compressed schedules that shortened the standard vaccine development timeline, in some cases combining clinical trial steps over months, a process typically conducted sequentially over several years.[121] Public health programs have been described as in "[a] race to vaccinate individuals" with the early wave vaccines.[122] Timelines for conducting clinical research – normally a sequential process requiring years – are being compressed into safety, efficacy, and dosing trials running simultaneously over months, potentially compromising safety assurance.[121][123] As an example, Chinese vaccine developers and the government Chinese Center for Disease Control and Prevention began their efforts in January 2020,[124] and by March were pursuing numerous candidates on short timelines, with the goal to showcase Chinese technology strengths over those of the United States, and to reassure the Chinese people about the quality of vaccines produced in China.[121][125] The rapid development and urgency of producing a vaccine for the COVID‑19 pandemic was expected to increase the risks and failure rate of delivering a safe, effective vaccine.[58][59][126] Additionally, research at universities is obstructed by physical distancing and closing of laboratories.[127][128] Vaccines must progress through several phases of clinical trials to test for safety, immunogenicity, effectiveness, dose levels and adverse effects of the candidate vaccine.[129][130] Vaccine developers have to invest resources internationally to find enough participants for Phase II–III clinical trials when the virus has proved to be a "moving target" of changing transmission rates across and within countries, forcing companies to compete for trial participants.[131] Clinical trial organizers also may encounter people unwilling to be vaccinated due to vaccine hesitancy[132] or disbelief in the science of the vaccine technology and its ability to prevent infection.[133] As new vaccines are developed during the COVID‑19 pandemic, licensure of COVID‑19 vaccine candidates requires submission of a full dossier of information on development and manufacturing quality.[134][135][136] Internationally, the Access to COVID‑19 Tools Accelerator is a G20 and World Health Organization (WHO) initiative announced in April 2020.[137][138] It is a cross-discipline support structure to enable partners to share resources and knowledge. It comprises four pillars, each managed by two to three collaborating partners: Vaccines (also called "COVAX"), Diagnostics, Therapeutics, and Health Systems Connector.[139] The WHO's April 2020 "R&D Blueprint (for the) novel Coronavirus" documented a "large, international, multi-site, individually randomized controlled clinical trial" to allow "the concurrent evaluation of the benefits and risks of each promising candidate vaccine within 3–6 months of it being made available for the trial." The WHO vaccine coalition will prioritize which vaccines should go into Phase II and III clinical trials, and determine harmonized Phase III protocols for all vaccines achieving the pivotal trial stage.[140] National governments have also been involved in vaccine development. Canada announced funding of 96 projects for development and production of vaccines at Canadian companies and universities with plans to establish a "vaccine bank" that could be used if another coronavirus outbreak occurs,[141] and to support clinical trials and develop manufacturing and supply chains for vaccines.[142] China provided low-rate loans to one vaccine developer through its central bank, and "quickly made land available for the company" to build production plants.[123] Three Chinese vaccine companies and research institutes are supported by the government for financing research, conducting clinical trials, and manufacturing.[143] The United Kingdom government formed a COVID‑19 vaccine task force in April 2020 to stimulate local efforts for accelerated development of a vaccine through collaborations of industry, universities, and government agencies. The UK's Vaccine Taskforce contributed to every phase of development from research to manufacturing.[144] In the United States, the Biomedical Advanced Research and Development Authority (BARDA), a federal agency funding disease-fighting technology, announced investments to support American COVID‑19 vaccine development, and manufacture of the most promising candidates.[123][145] In May 2020, the government announced funding for a fast-track program called Operation Warp Speed.[146][147] By March 2021, BARDA had funded an estimated $19.3 billion in COVID‑19 vaccine development.[148] Large pharmaceutical companies with experience in making vaccines at scale, including Johnson & Johnson, AstraZeneca, and GlaxoSmithKline (GSK), formed alliances with biotechnology companies, governments, and universities to accelerate progression toward effective vaccines.[123][121] SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), the virus that causes COVID-19, was isolated in late 2019.[149] Its genetic sequence was published on 11 January 2020, triggering the urgent international response to prepare for an outbreak and hasten development of a preventive COVID-19 vaccine.[150][151][152] Since 2020, vaccine development has been expedited via unprecedented collaboration in the multinational pharmaceutical industry and between governments.[153] By June 2020, tens of billions of dollars were invested by corporations, governments, international health organizations, and university research groups to develop dozens of vaccine candidates and prepare for global vaccination programs to immunize against COVID‑19 infection.[151][154][155][156] According to the Coalition for Epidemic Preparedness Innovations (CEPI), the geographic distribution of COVID‑19 vaccine development shows North American entities to have about 40% of the activity, compared to 30% in Asia and Australia, 26% in Europe, and a few projects in South America and Africa.[150][153] In February 2020, the World Health Organization (WHO) said it did not expect a vaccine against SARS‑CoV‑2 to become available in less than 18 months.[157] Virologist Paul Offit commented that, in hindsight, the development of a safe and effective vaccine within 11 months was a remarkable feat.[158] The rapidly growing infection rate of COVID‑19 worldwide during 2020 stimulated international alliances and government efforts to urgently organize resources to make multiple vaccines on shortened timelines,[159] with four vaccine candidates entering human evaluation in March (see COVID-19 vaccine § Trial and authorization status).[150][160] On 24 June 2020, China approved the CanSino vaccine for limited use in the military, and two inactivated virus vaccines for emergency use in high-risk occupations.[161] On 11 August 2020, Russia announced the approval of its Sputnik V vaccine for emergency use, though one month later only small amounts of the vaccine had been distributed for use outside of the phase 3 trial.[162] The Pfizer–BioNTech partnership submitted an Emergency Use Authorization (EUA) request to the U.S. Food and Drug Administration (FDA) for the mRNA vaccine BNT162b2 (active ingredient tozinameran) on 20 November 2020.[163][164] On 2 December 2020, the United Kingdom's Medicines and Healthcare products Regulatory Agency (MHRA) gave temporary regulatory approval for the Pfizer–BioNTech vaccine,[165][166] becoming the first country to approve the vaccine and the first country in the Western world to approve the use of any COVID‑19 vaccine.[167][168][169] As of 21 December 2020, many countries and the European Union[170] had authorized or approved the Pfizer–BioNTech COVID‑19 vaccine. Bahrain and the United Arab Emirates granted emergency marketing authorization for the Sinopharm BIBP vaccine.[171][172] On 11 December 2020, the FDA granted an EUA for the Pfizer–BioNTech COVID‑19 vaccine.[173] A week later, they granted an EUA for mRNA-1273 (active ingredient elasomeran), the Moderna vaccine.[174][175][176][177] As of August 2021, studies reported that the COVID-19 vaccines available in the United States are "highly protective against severe illness, hospitalization, and death due to COVID-19".[180] In comparison with fully vaccinated people, the CDC reported that unvaccinated people were 5 times more likely to be infected, 10 times more likely to be hospitalized, and 11 times more likely to die.[181][182] Another study found that unvaccinated people were six times more likely to test positive, 37 times more likely to be hospitalized, and 67 times more likely to die, compared to those who had been vaccinated.[183] CDC reported that vaccine effectiveness fell from 91% against Alpha to 66% against Delta.[184] One expert stated that "those who are infected following vaccination are still not getting sick and not dying like was happening before vaccination."[185] By late August 2021 the Delta variant accounted for 99 percent of U.S. cases and was found to double the risk of severe illness and hospitalization for those not yet vaccinated.[186] On 10 December 2021, the UK Health Security Agency reported that early data indicated a 20- to 40-fold reduction in neutralizing activity for Omicron by sera from Pfizer 2-dose vaccinees relative to earlier strains. After a booster dose (usually with an mRNA vaccine),[187] vaccine effectiveness against symptomatic disease was at 70%–75%, and the effectiveness against severe disease was expected to be higher.[188] Fully vaccinated individuals with breakthrough infections have peak viral load similar to unvaccinated cases and can efficiently transmit infection in household settings.[190] However, the magnitude of transmission by individuals with Delta breakthrough infections appears to be 50% increased in unvaccinated individuals vs that in vaccinated individuals.[190] Serious adverse events associated with receipt of new vaccines targeting COVID‑19 are of high interest to the public.[191] All vaccines that are administered via intramuscular injection, including COVID‑19 vaccines, have side effects related to the mild trauma associated with the procedure and introduction of a foreign substance into the body.[192] These include soreness, redness, rash, and inflammation at the injection site. Other common side effects include fatigue, headache, myalgia (muscle pain), and arthralgia (joint pain) which generally resolve within a few days.[193][194] One less-frequent side effect (that generally occurs in less than 1 in 1,000 people) is hypersensitivity (allergy) to one or more of the vaccine's ingredients, which in some rare cases may cause anaphylaxis.[195][196][197][198] Anaphylaxis has occurred in approximately 2 to 5 people per million vaccinated in the United States.[199] An increased risk of rare and potentially fatal thrombosis events have been associated following the administration of the Janssen (Johnson and Johnson)[200][201] and Oxford-AstraZeneca COVID‑19 vaccines,[201][202][203][204] with the highest reported rate among females in their 30s and 40s. The rate of thrombosis events following vaccination with the Johnson and Johnson and AstraZeneca vaccines has been estimated at 1 case per 100,000 vaccinations compared to between 0.22 and 1.57 cases per 100,000 per year in the general population.[201] There is no increased risk for thrombotic events after vaccination with mRNA COVID‑19 vaccines like Pfizer and Moderna.[199] According to studies, the combination of two different COVID-19 vaccines, also called cross vaccination or mix-and-match method, provides protection equivalent to that of mRNA vaccines – including protection against the Delta variant. Individuals who receive the combination of two different vaccines produce strong immune responses, with side effects no worse than those caused by standard regimens.[205] Available data show that fully vaccinated individuals and those previously infected with SARS-CoV-2 have a low risk of subsequent infection for at least 6 months.[206][207][208] Data are currently insufficient to determine an antibody titer threshold that indicates when an individual is protected from infection. Multiple studies show that antibody titers are associated with protection at the population level, but individual protection titers remain unknown. For some populations, such as the elderly and the immunocompromised, protection levels may be reduced after both vaccination and infection. Finally, current data suggest that the level of protection may not be the same for all variants of the virus.[206] As new data continue to emerge,[209] recommendations will need to be updated periodically. It is important to note that at this time, there is no authorized or approved test that providers or the public can use to reliably determine if a person is protected from infection.[206] Note about table to the right: Number and percentage of people who have received at least one dose of a COVID‑19 vaccine (unless noted otherwise). May include vaccination of non-citizens, which can push totals beyond 100% of the local population. Table is updated daily by a bot.[note 2] As of 21 February 2022, 10.57 billion COVID-19 vaccine doses have been administered worldwide, with 62.3 percent of the global population having received at least one dose. While 31.82 million vaccines were then being administered daily, only 11.4 percent of people in low-income countries had received at least a first vaccine by February 2022, according to official reports from national health agencies, which are collated by Our World in Data.[211] During a pandemic on the rapid timeline and scale of COVID-19 cases in 2020, international organizations like the World Health Organization (WHO) and Coalition for Epidemic Preparedness Innovations (CEPI), vaccine developers, governments, and industry evaluated the distribution of the eventual vaccine(s).[212] Individual countries producing a vaccine may be persuaded to favor the highest bidder for manufacturing or provide first-service to their own country.[213][214][215][216] Experts emphasize that licensed vaccines should be available and affordable for people at the frontline of healthcare and having the greatest need.[213][214][216] In April 2020, it was reported that the UK agreed to work with 20 other countries and global organizations including France, Germany and Italy to find a vaccine and to share the results, and that UK citizens would not get preferential access to any new COVID‑19 vaccines developed by taxpayer-funded UK universities.[217] Several companies planned to initially manufacture a vaccine at artificially low pricing, then increase prices for profitability later if annual vaccinations are needed and as countries build stock for future needs.[216] An April 2020 CEPI report stated: "Strong international coordination and cooperation between vaccine developers, regulators, policymakers, funders, public health bodies, and governments will be needed to ensure that promising late-stage vaccine candidates can be manufactured in sufficient quantities and equitably supplied to all affected areas, particularly low-resource regions."[218] The WHO and CEPI are developing financial resources and guidelines for global deployment of several safe, effective COVID‑19 vaccines, recognizing the need is different across countries and population segments.[212][219][220][221] For example, successful COVID‑19 vaccines would be allocated early to healthcare personnel and populations at greatest risk of severe illness and death from COVID‑19 infection, such as the elderly or densely-populated impoverished people.[222][223] Share of people who have received at least one dose of a COVID-19 vaccine relative to a country's total population. Date is on the map. Commons source. COVID-19 vaccine doses administered per 100 people by country. Date is on the map. Commons source. Countries have extremely unequal access to the COVID-19 vaccine. Vaccine equity has not been achieved, or even approximated. The inequity has harmed both countries with poor access and countries with good access.[227] Nations pledged to buy doses of the COVID‑19 vaccine before the doses were available. Though high-income nations represent only 14% of the global population, as of 15 November 2020, they had contracted to buy 51% of all pre-sold doses. Some high-income nations bought more doses than would be necessary to vaccinate their entire populations.[9] On 18 January 2021, WHO Director-General Tedros Adhanom Ghebreyesus warned of problems with equitable distribution: "More than 39 million doses of vaccine have now been administered in at least 49 higher-income countries. Just 25 doses have been given in one lowest-income country. Not 25 million; not 25 thousand; just 25."[228] In March, it was revealed the US attempted to convince Brazil not to purchase the Sputnik V COVID‑19 vaccine, fearing "Russian influence" in Latin America.[229] Some nations involved in long-standing territorial disputes have reportedly had their access to vaccines blocked by competing nations; Palestine has accused Israel of blocking vaccine delivery to Gaza, while Taiwan has suggested that China has hampered its efforts to procure vaccine doses.[230][231][232] A single dose of the COVID‑19 vaccine by AstraZeneca would cost 47 Egyptian pounds (EGP), and the authorities are selling it between 100 and 200 EGP. A report by Carnegie Endowment for International Peace cited the poverty rate in Egypt as around 29.7 percent, which constitutes approximately 30.5 million people, and claimed that about 15 million of the Egyptians would be unable to gain access to the luxury of vaccination. A human rights lawyer, Khaled Ali, launched a lawsuit against the government, forcing them to provide vaccination free of cost to all members of the public.[233] According to immunologist Dr. Anthony Fauci, mutant strains of the virus and limited vaccine distribution pose continuing risks and he said: "we have to get the entire world vaccinated, not just our own country."[234] Edward Bergmark and Arick Wierson are calling for a global vaccination effort and wrote that the wealthier nations' "me-first" mentality could ultimately backfire because the spread of the virus in poorer countries would lead to more variants, against which the vaccines could be less effective.[235] On 10 March 2021, the United States, Britain, European Union member states and some other members of the World Trade Organization (WTO) blocked a push by more than eighty developing countries to waive COVID‑19 vaccine patent rights in an effort to boost production of vaccines for poor nations.[236] On 5 May 2021, the US government under President Joe Biden announced that it supports waiving intellectual property protections for COVID‑19 vaccines.[237] The Members of the European Parliament have backed a motion demanding the temporary lifting of intellectual properties rights for COVID‑19 vaccines.[238] In a meeting in April 2021, the World Health Organization's emergency committee addressed concerns of persistent inequity in the global vaccine distribution.[239] Although 9 percent of the world's population lives in the 29 poorest countries, these countries had received only 0.3% of all vaccines administered as of May 2021.[240] On 15 March, Brazilian journalism agency Agência Pública reported that the country vaccinated about twice as many people who declare themselves white than black and noted that mortality from COVID‑19 is higher in the black population.[241] In May 2021, UNICEF made an urgent appeal to industrialised nations to pool their excess COVID‑19 vaccine capacity to make up for a 125-million-dose gap in the COVAX program. The program mostly relied on the Oxford–AstraZeneca COVID‑19 vaccine produced by Serum Institute of India, which faced serious supply problems due to increased domestic vaccine needs in India from March to June 2021. Only a limited amount of vaccines can be distributed efficiently, and the shortfall of vaccines in South America and parts of Asia are due to a lack of expedient donations by richer nations. International aid organisations have pointed at Nepal, Sri Lanka, and Maldives as well as Argentina and Brazil, and some parts of the Caribbean as problem areas, where vaccines are in short supply. In mid-May 2021, UNICEF was also critical of the fact that most proposed donations of Moderna and Pfizer vaccines were not slated for delivery until the second half of 2021, or early in 2022.[242] On 1 July 2021, the heads of the World Bank Group, the International Monetary Fund, the World Health Organization, and the World Trade Organization said in a joint statement: "As many countries are struggling with new variants and a third wave of COVID‑19 infections, accelerating access to vaccines becomes even more critical to ending the pandemic everywhere and achieving broad-based growth. We are deeply concerned about the limited vaccines, therapeutics, diagnostics, and support for deliveries available to developing countries."[243][244] In July 2021, The BMJ reported that countries have thrown out over 250,000 vaccine doses as supply exceeded demand and strict laws prevented the sharing of vaccines.[245] A survey by The New York Times found that over a million doses of vaccine had been thrown away in ten U.S. states because federal regulations prohibit recalling them, preventing their redistribution abroad.[246] Furthermore, doses donated close to expiration often cannot be administered quickly enough by recipient countries and end up having to be discarded.[247] Amnesty International and Oxfam International have criticized the support of vaccine monopolies by the governments of producing countries, noting that this is dramatically increasing the dose price by five times and often much more, creating an economic barrier to access for poor countries.[248][249] Médecins Sans Frontières (Doctors without Borders) has also criticized vaccine monopolies and repeatedly called from their suspension, supporting the TRIPS Waiver. The waiver was first proposed in October 2020, and has support from most countries, but delayed by opposition from EU (especially Germany - major EU countries such as France, Italy and Spain support the exemption),[250] UK, Norway, and Switzerland, among others. MSF called for a Day of Action in September 2021 to put pressure on the WTO Minister's meeting in November, which was expected to discuss the TRIPS IP waiver.[251][252][253] On 4 August 2021, to reduce unequal distribution between rich and poor countries, the WHO called for a moratorium on a booster dose at least until the end of September. However, on 18 August, the United States government announced plans to offer booster doses 8 months after the initial course to the general population, starting with priority groups. Before the announcement, the WHO harshly criticized this type of decision, citing the lack of evidence for the need for boosters, except for patients with specific conditions. At this time, vaccine coverage of at least one dose was 58% in high-income countries and only 1.3% in low-income countries, and 1.14 million Americans already received an unauthorized booster dose. US officials argued that waning efficacy against mild and moderate disease might indicate reduced protection against severe disease in the coming months. Israel, France, Germany, and the United Kingdom have also started planning boosters for specific groups.[254][255][256] On 14 September 2021, more than 140 former world leaders, and Nobel laureates, including former President of France François Hollande, former Prime Minister of the United Kingdom Gordon Brown, former Prime Minister of New Zealand Helen Clark, and Professor Joseph Stiglitz, called on the candidates to be the next German chancellor to declare themselves in favour of waiving intellectual property rules for COVID‑19 vaccines and transferring vaccine technologies.[257] In November 2021, nursing unions in 28 countries have filed a formal appeal with the United Nations over the refusal of the UK, EU, Norway, Switzerland, and Singapore to temporarily waive patents for Covid vaccines.[258] During his first international trip, President of Peru Pedro Castillo spoke at the seventy-sixth session of the United Nations General Assembly on 21 September 2021, proposing the creation of an international treaty signed by world leaders and pharmaceutical companies to guarantee universal vaccine access, arguing "The battle against the pandemic has shown us the failure of the international community to cooperate under the principle of solidarity".[259][260] Optimizing the societal benefit of vaccination may benefit from a strategy that is tailored to the state of the pandemic, the demographics of a country, the age of the recipients, the availability of vaccines, and the individual risk for severe disease: In the UK, the interval between prime and boost dose was extended to vaccinate as many persons as early as possible,[261] many countries are starting to give an additional booster shot to the immunosuppressed[262][263] and the elderly,[264] and research predicts an additional benefit of personalizing vaccine dose in the setting of limited vaccine availability when a wave of virus Variants of Concern hits a country.[265] While vaccines substantially reduce the probability of infection, it is still possible for fully vaccinated people to contract and spread COVID‑19.[266] Public health agencies have recommended that vaccinated people continue using preventive measures (wear face masks, social distance, wash hands) to avoid infecting others, especially vulnerable people, particularly in areas with high community spread. Governments have indicated that such recommendations will be reduced as vaccination rates increase and community spread declines.[267] Vaccine inequity damages the global economy, disrupting the global supply chain.[227] Most vaccines were being reserved for wealthy countries, as of September 2021,[268] some of which have more vaccine than is needed to fully vaccinate their populations.[9] When people, undervaccinated, needlessly die, suffer disability, and live under lockdown restrictions, they cannot supply the same goods and services. This harms the economies of undervaccinated and overvaccinated countries alike. Since rich countries have larger economies, rich countries may lose more money to vaccine inequity than poor ones,[227] though the poor ones will lose a higher percentage of GDP and suffer longer-term effects.[269] High-income countries would profit an estimated US$4.80 for every $1 spent on giving vaccines to lower-income countries.[227] The International Monetary Fund sees the vaccine divide between rich and poor nations as a serious obstacle to a global economic recovery.[270] Vaccine inequity disproportionately affects refuge-providing states, as they tend to be poorer, and refugees and displaced people are economically more vulnerable even within those low-income states, so they have suffered more economically from vaccine inequity.[271] Several governments agreed to shield pharmaceutical companies like Pfizer and Moderna from negligence claims related to COVID‑19 vaccines (and treatments), as in previous pandemics, when governments also took on liability for such claims. In the US, these liability shields took effect on 4 February 2020, when the US Secretary of Health and Human Services Alex Azar published a notice of declaration under the Public Readiness and Emergency Preparedness Act (PREP Act) for medical countermeasures against COVID‑19, covering "any vaccine, used to treat, diagnose, cure, prevent, or mitigate COVID‑19, or the transmission of SARS-CoV-2 or a virus mutating therefrom". The declaration precludes "liability claims alleging negligence by a manufacturer in creating a vaccine, or negligence by a health care provider in prescribing the wrong dose, absent willful misconduct." In other words, absent "willful misconduct", these companies can not be sued for money damages for any injuries that occur between 2020 and 2024 from the administration of vaccines and treatments related to COVID‑19.[272] The declaration is effective in the United States through 1 October 2024.[272] In December 2020, the UK government granted Pfizer legal indemnity for its COVID‑19 vaccine.[273] In the European Union, the COVID‑19 vaccines are licensed under a Conditional Marketing Authorisation which does not exempt manufacturers from civil and administrative liability claims.[274] While the purchasing contracts with vaccine manufacturers remain secret, they do not contain liability exemptions even for side-effects not known at the time of licensure.[275] The Bureau of Investigative Journalism, a nonprofit news organization, reported in an investigation that unnamed officials in some countries, such as Argentina and Brazil, said that Pfizer demanded guarantees against costs of legal cases due to adverse effects in the form of liability waivers and sovereign assets such as federal bank reserves, embassy buildings or military bases, going beyond the expected from other countries such as the US.[276] During the pandemic parliamentary inquiry in Brazil, Pfizer's representative said that its terms for Brazil are the same as for all other countries with which it has signed deals.[277] In June 2021, a report revealed that the UB-612 vaccine, developed by the US-based COVAXX, was a venture initiated for profits by the Blackwater founder Erik Prince. In a series of text messages to Paul Behrends, the close associate recruited for the COVAXX project, Prince described the profit-making possibilities in selling the COVID‑19 vaccines. COVAXX provided no data from the clinical trials on safety or efficacy. The responsibility of creating distribution networks was assigned to an Abu Dhabi-based entity, which was mentioned as "Windward Capital" on the COVAXX letterhead but was actually Windward Holdings. The firm's sole shareholder, which handled "professional, scientific and technical activities", was Erik Prince. In March 2021, COVAXX raised $1.35 billion in a private placement.[278]Adenovirus vector vaccines
Inactivated virus vaccines
Subunit vaccines
Intranasal
Other types
Planning and development
Challenges
Organizations
History
Effectiveness
Effectiveness against transmission
Adverse events
![[icon]](http://upload.wikimedia.org/wikipedia/commons/thumb/1/1c/Wiki_letter_w_cropped.svg/20px-Wiki_letter_w_cropped.svg.png){kind=small}
Mix and match
Duration of immunity
Society and culture
Distribution
Location Vaccinated[b] Percent[c] 
World[d] 4,898,997,900 62.2% 
China 1,266,426,000 87.7% 
India 962,283,459 69.1% 
European Union 334,961,077 74.9% 
United States[e] 252,791,817 76.1% 
Indonesia 189,533,698 68.6% 
Brazil 176,141,497 82.3% 
Pakistan 122,046,024 54.2% 
Bangladesh 102,503,628 61.6% 
Japan 101,571,281 80.6% 
Mexico 84,958,858 65.2% 
Vietnam 79,216,176 80.7% 
Russia 78,284,278 53.6% 
Philippines 68,231,892 62.0% 
Germany 63,366,170 75.5% 
Iran 62,037,154 73.0% 
Turkey 57,619,810 67.8% 
France 53,919,703 80.0% 
Thailand 53,110,518 75.9% 
United Kingdom 52,556,789 77.0% 
Italy[f] 50,578,527 83.8% 
South Korea 44,799,651 87.3% 
Colombia 41,079,423 80.1% 
Spain 41,030,936 87.8% 
Argentina 40,197,226 88.1% 
Egypt 39,317,370 37.7% 
Canada 32,516,701 85.4% 
Malaysia 26,558,395 81.0% 
Saudi Arabia 25,792,668 73.0% 
Peru 25,214,266 75.6% 
Morocco 24,800,057 66.4% 
Myanmar 22,810,233 41.6% 
Poland 22,488,032 59.5% 
Venezuela 22,157,232 77.2% 
Australia 21,976,357 85.2% 
South Africa 20,564,143 34.2% 
Taiwan 19,280,344 80.8% 
Nepal 18,261,165 61.5% 
Uzbekistan 18,221,843 53.7% 
Chile 17,716,805 92.2% 
Sri Lanka 16,836,546 78.3% 
Ukraine 15,675,592 36.1% 
Nigeria 14,834,559 7.0% 
Ecuador 14,729,705 82.3% 
Cambodia 14,388,242 84.9% 
Netherlands 13,444,988 78.3% 
Uganda 12,742,231 27.0% 
Mozambique 10,759,191 33.5% 
Cuba 10,597,367 93.6% 
Angola 10,241,793 30.2% 
Ethiopia 10,122,093 8.6% 
United Arab Emirates 9,890,206 99.0% 
Portugal 9,641,304 94.8% 
Iraq 9,589,248 23.3% 
Kazakhstan 9,338,220 49.2% 
Belgium 9,198,967 79.1% 
Rwanda 8,507,727 64.1% 
Kenya 8,506,810 15.5% 
Romania 8,127,352 42.5% 
Greece 7,840,499 75.6% 
Sweden 7,798,800 76.8% 
Ghana 7,473,144 23.6% 
Algeria 7,403,900 16.6% 
Tunisia 7,123,498 59.7% 
Guatemala 7,096,019 38.9% 
Dominican Republic 7,076,169 64.6% 
Czech Republic 6,937,592 64.7% 
Bolivia 6,872,780 58.1% 
Austria 6,781,590 75.0% 
Israel 6,697,554 72.1% 
Hungary 6,386,416 66.3% 
Switzerland 6,075,055 69.7% 
Hong Kong 5,618,244 74.4% 
Ivory Coast 5,546,012 20.5% 
Belarus 5,387,508 57.0% 
Nicaragua 5,371,365 80.1% 
Honduras 5,299,044 52.7% 
Azerbaijan 5,280,393 51.6% 
Singapore 4,948,618 90.7% 
Denmark 4,845,268 83.3% 
Laos 4,827,386 65.4% 
Afghanistan 4,723,416 11.9% 
Tajikistan 4,659,726 47.8% 
Jordan 4,630,227 45.1% 
El Salvador 4,554,203 69.9% 
Finland 4,467,815 80.5% 
Sudan 4,408,196 9.8% 
Zimbabwe 4,338,919 28.8% 
Norway 4,326,880 79.2% 
New Zealand 4,243,621 82.8% 
Costa Rica 4,119,679 80.2% 
Republic of Ireland 4,042,164 81.1% 
Paraguay 3,761,096 52.1% 
Guinea 3,531,742 26.2% 
Kuwait 3,376,127 78.0% 
Serbia 3,340,847 48.6% 
Oman 3,194,312 61.1% 
Panama 3,190,056 72.8% 
Uruguay 2,957,466 84.9% 
Slovakia 2,816,198 51.7% 
Tanzania 2,545,391 4.1% 
Lebanon 2,477,451 36.6% 
Qatar 2,360,308 80.5% 
Croatia 2,304,151 56.5% 
Mongolia 2,270,828 68.2% 
Benin 2,269,942 18.2% 
Syria 2,125,205 11.6% 
Libya 2,101,417 30.2% 
Palestine 2,079,315 39.8% 
Lithuania 1,945,495 72.3% 
Bulgaria 1,904,143 27.6% 
Georgia 1,556,385 39.1% 
Malawi 1,511,574 7.7% 
Mauritania 1,505,964 31.5% 
Niger 1,442,884 5.7% 
Senegal 1,421,720 8.3% 
Togo 1,415,448 16.7% 
Kyrgyzstan 1,412,915 21.3% 
Botswana 1,376,754 57.4% 
Somalia 1,354,850 8.3% 
Latvia 1,341,433 71.8% 
Albania 1,263,745 44.0% 
Slovenia 1,263,529 60.8% 
Bahrain 1,227,305 70.2% 
Sierra Leone 1,208,855 14.8% 
Burkina Faso 1,169,097 5.4% 
Liberia 1,116,709 21.6% 
Mali 1,077,715 5.2% 
Armenia 1,067,296 36.0% 
Moldova 989,897 24.6% 
Madagascar 978,718 3.4% 
Mauritius 954,272 74.9% 
Bosnia and Herzegovina 943,394 28.9% 
Kosovo 897,602 50.4% 
Estonia 856,701 64.7% 
North Macedonia 850,807 40.9% 
Cameroon 837,860 3.1% 
Zambia 806,611 4.3% 
Jamaica 760,643 25.6% 
Trinidad and Tobago 739,605 52.7% 
Republic of the Congo 734,721 13.0% 
Cyprus 686,819 76.7% 
Timor-Leste 674,828 50.2% 
Fiji 666,202 73.8% 
Lesotho 648,817 30.1% 
Central African Republic 619,646 12.6% 
Yemen 610,183 2.0% 
Bhutan 594,872 76.3% 
Macau 516,877 78.5% 
Guinea-Bissau 506,823 25.1% 
Luxembourg 477,852 75.3% 
Malta 468,633 90.8% 
Democratic Republic of the Congo 440,134 0.5% 
Namibia 429,742 16.6% 
Guyana 428,991 54.3% 
Brunei 407,042 92.2% 
Maldives 398,010 73.2% 
Eswatini 378,854 32.3% 
Cabo Verde 346,572 61.7% 
Comoros 341,102 38.4% 
South Sudan 325,688 2.9% 
Gambia 317,855 12.8% 
Iceland 309,168 83.8% 
Papua New Guinea 297,688 3.3% 
Montenegro 288,242 45.9% 
Gabon 284,889 12.5% 
Northern Cyprus 284,357 74.4% 
Chad 267,953 1.6% 
Suriname 265,523 44.9% 
Equatorial Guinea 251,474 17.3% 
Belize 233,957 57.8% 
Solomon Islands 197,796 28.1% 
New Caledonia 186,918 64.8% 
French Polynesia 182,726 64.7% 
Bahamas 162,601 41.0% 
Barbados 159,619 55.5% 
Haiti 150,155 1.3% 
Samoa 145,589 72.7% 
Djibouti 131,370 13.1% 
Vanuatu 110,235 35.0% 
Curaçao 106,623 64.7% 
Sao Tome and Principe 88,983 39.8% 
Aruba 87,259 81.4% 
Seychelles 83,419 84.3% 
Jersey 82,474 81.6% 
Kiribati 74,579 61.4% 
Tonga 74,004 69.3% 
Isle of Man 69,336 81.2% 
Antigua and Barbuda 63,244 64.1% 
Cayman Islands 59,441 89.4% 
Andorra 57,709 74.6% 
Saint Lucia 57,543 31.2% 
Guernsey 54,146 85.4% 
Bermuda 46,961 75.6% 
Grenada 42,855 37.9% 
Faroe Islands 41,715 85.0% 
Gibraltar 41,691 123.8% 
Greenland 41,229 72.5% 
Saint Vincent and the Grenadines 34,930 31.4% 
Turkmenistan 32,240 0.5% 
Dominica 32,027 44.4% 
Saint Kitts and Nevis 31,100 58.1% 
Turks and Caicos Islands 30,801 78.5% 
Sint Maarten 27,743 63.9% 
Liechtenstein 26,701 69.8% 
Monaco 26,672 67.5% 
San Marino 24,570 72.2% Caribbean Netherlands 19,109 72.3% 
British Virgin Islands 18,786 61.8% 
Cook Islands 13,062 74.3% 
Anguilla 10,230 67.6% 
Burundi 8,452 0.1% 
Nauru 7,764 71.4% 
Tuvalu 6,230 52.2% Wallis and Futuna 6,151 55.4% Saint Helena, Ascension and Tristan da Cunha 4,361 71.8% 
Falkland Islands 2,632 75.6% 
Montserrat 1,842 37.0% 
Niue 1,184 73.2% 
Tokelau 968 70.8% 
Pitcairn Islands 47 100.0% 
North Korea 0 0.0% 
Access
.jpg)
Economics
— United Nations, COVID vaccines: Widening inequality and millions vulnerable[268]Liability
Controversy
Misinformation and hesitancy
See also
Notes
References
Although initially several terms were used to describe the syndrome … the term that has gained widespread use is vaccine-induced immune thrombotic thrombocytopenia (VITT). Thrombosis with thrombocytopenia syndrome has also been used, but it is a more general term that can be caused by other conditions
We believe the name "VITT" works well … the term clearly denotes the key features of the disorder … provides a useful mnemonic for disease recognition in the usual sequence of events … need not mandate that thrombosis be present … "TTS" … has limited clinical utility, since many conditions … present with the duad of thrombosis and thrombocytopenia
The name of the vaccine was changed to Vaxzevria on 25 March 2021.
Vaxzevria (COVID‑19 Vaccine (ChAdOx1-S recombinant) EMA/182334/2021 Text was copied from this source which is © European Medicines Agency. Reproduction is authorized provided the source is acknowledged.It is vital that we evaluate as many vaccines as possible as we cannot predict how many will turn out to be viable. To increase the chances of success (given the high level of attrition during vaccine development), we must test all candidate vaccines until they fail. [The] WHO is working to ensure that all of them have the chance of being tested at the initial stage of development. The results for the efficacy of each vaccine are expected within three to six months, and this evidence, combined with data on safety, will inform decisions about whether it can be used on a wider scale.
It is vital that we evaluate as many vaccines as possible as we cannot predict how many will turn out to be viable. To increase the chances of success (given the high level of attrition during vaccine development), we must test all candidate vaccines until they fail. [The] WHO is working to ensure that all of them have the chance of being tested at the initial stage of development. The results for the efficacy of each vaccine are expected within three to six months and this evidence, combined with data on safety, will inform decisions about whether it can be used on a wider scale.
CEPI estimates that developing up to three vaccines in the next 12–18 months will require an investment of at least US$2 billion. This estimate includes Phase 1 clinical trials of eight vaccine candidates, progression of up to six candidates through Phase 2 and 3 trials, completion of regulatory and quality requirements for at least three vaccines, and enhancing global manufacturing capacity for three vaccines.
{{cite journal}}: Cite journal requires |journal= (help)
This article incorporates text from this source, which is in the public domain. This article incorporates text from this source, which is in the public domain.{{cite journal}}: CS1 maint: uses authors parameter (link)It is vital that we evaluate as many vaccines as possible as we cannot predict how many will turn out to be viable. To increase the chances of success (given the high level of attrition during vaccine development), we must test all candidate vaccines until they fail. [The] WHO is working to ensure that all of them have the chance of being tested at the initial stage of development. The results for the efficacy of each vaccine are expected within three to six months and this evidence, combined with data on safety, will inform decisions about whether it can be used on a wider scale.
CEPI estimates that developing up to three vaccines in the next 12–18 months will require an investment of at least US$2 billion. This estimate includes Phase 1 clinical trials of eight vaccine candidates, progression of up to six candidates through Phase 2 and 3 trials, completion of regulatory and quality requirements for at least three vaccines, and enhancing global manufacturing capacity for three vaccines.
Further reading
Vaccine protocols
External links
Wikiquote has quotations related to: COVID-19 vaccine
Media files used on this page
Author/Creator: Alexey Solodovnikov (Idea, Producer, CG, Editor), Valeria Arkhipova (Scientific Сonsultant), Licence: CC BY-SA 4.0
Scientifically accurate atomic model of the external structure of the Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2), a strain (genetic variant) of the coronavirus that caused Coronavirus disease (COVID-19), first identified in Wuhan, China, during December 2019
Each separate locus (amorphous blob) is an atom of:
.svg)
Author/Creator: Geraki, Licence: CC BY-SA 4.0
SARS-CoV-2 logo in Wikimedia colors
Author/Creator: unknown, Licence:
The Flag of Europe is the flag and emblem of the European Union (EU) and Council of Europe (CoE). It consists of a circle of 12 golden (yellow) stars on a blue background. It was created in 1955 by the CoE and adopted by the EU, then the European Communities, in the 1980s.
The CoE and EU are distinct in membership and nature. The CoE is a 47-member international organisation dealing with human rights and rule of law, while the EU is a quasi-federal union of 27 states focused on economic integration and political cooperation. Today, the flag is mostly associated with the latter.
It was the intention of the CoE that the flag should come to represent Europe as a whole, and since its adoption the membership of the CoE covers nearly the entire continent. This is why the EU adopted the same flag. The flag has been used to represent Europe in sporting events and as a pro-democracy banner outside the Union.
Author/Creator: unknown, Licence: PD
Author/Creator: unknown, Licence: PD
Author/Creator: unknown, Licence: PD
Flag of Mexico Official version of the Flag of the United Mexican States or Mexico, adopted September 16th 1968 by Decree (Published August 17th 1968), Ratio 4:7. The previous version of the flag displayed a slightly different Coat of Arms. It was redesigned to be even more resplendent due to the upcoming Mexico City 1968 Olympic Games; According to Flag of Mexico, the colors are Green Pantone 3425 C and Red Pantone 186 C. According to [1] or [2], that translates to RGB 206, 17, 38 for the red, and RGB 0, 104, 71 for the green.
Flag of Iran. The tricolor flag was introduced in 1906, but after the Islamic Revolution of 1979 the Arabic words 'Allahu akbar' ('God is great'), written in the Kufic script of the Qur'an and repeated 22 times, were added to the red and green strips where they border the white central strip and in the middle is the emblem of Iran (which is a stylized Persian alphabet of the Arabic word Allah ("God")).
The official ISIRI standard (translation at FotW) gives two slightly different methods of construction for the flag: a compass-and-straightedge construction used for File:Flag of Iran (official).svg, and a "simplified" construction sheet with rational numbers used for this file.
The national flag of Kingdom of Thailand since September 2017; there are total of 3 colours:
- Red represents the blood spilt to protect Thailand’s independence and often more simply described as representing the nation.
- White represents the religion of Buddhism, the predominant religion of the nation
- Blue represents the monarchy of the nation, which is recognised as the centre of Thai hearts.
Flag of the United Kingdom, Union Jack or Union Flag in a 1:2 ratio (typical on British warships and also the rank flag of an admiral of the fleet).
Author/Creator: unknown, Licence: PD
Author/Creator: unknown, Licence: PD
.svg)
Flag of Canada introduced in 1965, using Pantone colors. This design replaced the Canadian Red Ensign design.
.svg)
Flag of Australia, when congruence with this colour chart is required (i.e. when a "less bright" version is needed).
See Flag of Australia.svg for main file information.
It is easy to put a border around this flag image
Made by author of Xramp, first uploaded by Denelson83 as Flag of Ecuador.svg, modifications by Husunqu.
Flag of Ethiopia
Flag of Portugal, created by Columbano Bordalo Pinheiro (1857-1929), officially adopted by Portuguese government in June 30th 1911 (in use since about November 1910). Color shades matching the RGB values officially reccomended here. (PMS values should be used for direct ink or textile; CMYK for 4-color offset printing on paper; this is an image for screen display, RGB should be used.)
.svg)
The civil ensign and flag of Belgium. It is identical to Image:Flag of Belgium.svg except that it has a 2:3 ratio, instead of 13:15.
Flag of Rwanda. The flag ratio is 2:3 with the stripes being 2:1:1. Colors are the following officially: Pantone 299 C 2X (blue), RAL 6029 (green), RAL 1023 (yellow) and RAL 1003 (golden yellow). (As of 03/08/2010, the only color used is the Pantone 299 C, which is from here. The rest of the colors are RAL shades from here.)
Author/Creator: unknown, Licence: PD
The flag of the Dominican Republic has a centered white cross that extends to the edges. This emblem is similar to the flag design and shows a bible, a cross of gold and 6 Dominican flags. There are branches of olive and palm around the shield and above on the ribbon is the motto "Dios,Patria!, Libertad" ("God, Country, Freedom") and to amiable freedom. The blue is said to stand for liberty, red for the fire and blood of the independence struggle and the white cross symbolized that God has not forgotten his people. "Republica Dominicana". The Dominican flag was designed by Juan Pablo Duarte, father of the national Independence of Dominican Republic. The first dominican flag was sewn by a young lady named Concepción Bona, who lived across the street of El Baluarte, monument where the patriots gathered to fight for the independence, the night of February 27th, 1844. Concepción Bona was helped by her first cousin María de Jesús Pina.
.svg)
Flag of Austria with the red in the Austrian national colours which was official ordered within the Austrian Armed Forces (Bundesheer) in the characteristic “Pantone 032 C” (since May 2018 the Red is ordered in the characteristic “Pantone 186 C”.)
Flag of Israel. Shows a Magen David (“Shield of David”) between two stripes. The Shield of David is a traditional Jewish symbol. The stripes symbolize a Jewish prayer shawl (tallit).
Flag of Switzerland. To view Commons page of Switzerland → Confoederatio Helvetica.
Flag of the Ivory Coast, written by Jon Harald Søby, modified by Zscout370. The colors match to what is reported at http://fotw.vexillum.com/flags/ci.html.
Flag of Laos
Flag of Norway. The colors approximately correspond to Pantone 200 C (deep red) and 281 C (dark blue).
Flag of New Zealand. Specification: http://www.mch.govt.nz/nzflag/description.html , quoting New Zealand Gazette, 27 June 1902.
Note that the green portion of the flag was designed to represent the majority Catholic residents of the island, the orange side the minority Protestant and the white middle part peace and harmony between them.
It is easy to put a border around this flag image
It is easy to put a border around this flag image
Flag of Mauritania, adopted in 2017. The National Assembly added red stripes to the top and bottom edges to represent “the blood shed by the martyrs of independence”.
Flag of Senegal
Flag of Albania
The flag of Slovenia.
- "The construction sheet for the coat of arms and flag of the Republic of Slovenia
- is issued in the Official Gazette Uradni list Republike Slovenije #67, 27 October 1994
- as the addendum to the Law on the coat of arms and flag."
.svg){kind=link}
