| The Covid vaccine market didn't exist a year ago. Now it's one of the world's top products, with 2021 sales estimated as high as $190 billion if shotmakers hit their production targets, and two Chinese companies accounting for at least a quarter of the revenue. The estimate from Airfinity Ltd. sheds new light on how nine companies — including U.S.-based Pfizer Inc. and Moderna Inc. along with China's Sinovac Biotech Ltd. and Sinopharm Group Co. — stand to benefit from sales of Covid inoculations. Production constraints and shortfalls will likely bring the final 2021 sales numbers closer to a range that tops out at $115 billion, the research firm said. Developed in record time and often supported by government funds, Covid vaccines are helping countries save lives and avert trillions of dollars in costs. Access to the doses for many lower-income countries, however, remains hampered, in part because of costs and wealthier countries cornering shots. "These are very significant numbers, and it's also why not all countries have been able to secure the necessary supplies,'' says Rasmus Bech Hansen, Airfinity's chief executive officer, "because it does require quite a sizable investment to vaccinate your whole population."  People wait in line to receive a vaccine dose in Rio de Janeiro, Brazil. Photographer: Andre Coelho/Bloomberg China is playing an influential role in immunizing the world, shipping more doses overseas than all other nations combined as India grapples with a devastating outbreak that has shut down exports of shots. Sinovac could reel in as much as $25 billion and Sinopharm as much as $23 billion, with each attracting at least $16 billion, Airfinity's data show. "We've seen Chinese exports interpreted as a policy tool, but the actual revenue has been overlooked," Bech Hansen said. Pfizer and Moderna could account for as much as $44 billion and $32 billion, respectively, though the figures are likely to be lower, according to Airfinity. A lack of detail on the contracts makes it difficult to predict sales, with drugmakers often using tiered pricing models that charge countries based on their income levels. Uneven vaccine distribution has increased pressure on wealthy countries to share excess shots and step up financial contributions to try to close the access gap. Group of 20 leaders including China and the U.S. have called for greater global cooperation to defeat the virus, and drugmakers including Pfizer last week pledged to get more vaccines to poorer countries over the next 18 months. "The profits we're seeing are magnitudes larger than what it would cost to fully vaccinate the poorest countries in the world," said Anna Bezruki, a Global Health Centre researcher at the Graduate Institute of International and Development Studies in Geneva. "It's not that these profits are necessarily bad or prices are completely unreasonable. It's more a question of who is getting access."—James Paton | 
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