Covid-19更新：焦点转向疫苗策略

1、COVID-19 UpdateRising tide turns focus to vaccine strategiesAsia Pacific Equity Research14 April 2021Infection data deteriorated, up 14%/50% w/w (global/Asia) following broader economic reopening. Even in the US, where first-dose vaccination rates have hit 36%, daily cases have risen to 70,000 cases

2、/day (or 10% w/w). Mortality rose 20%/25%/48% w/w in global/US/Asia following higher infections. Some relief may be that Asias average secondary infection rate (R0) has stayed around 0.9- 1.1, except in Thailand and India. We forecast 1.0-1.1 rates to persist as Asias weekly mobility level has decre

3、ased -12%p w/w to 76% of pre-COVID levels. We also note Indias daily vaccination speed is up to 3.7m doses/day (2.2m doses two weeks ago), catching up to Chinas 4.1m doses/day. We also cover three vaccine related topics Asia vaccination strategy under vaccine restraint, duration of antibody update (

4、Moderna), and Asias vaccination progress.Asia vaccination tracker. Asias vaccination rollout continued across the board last week. In particular, Indias vaccination speed was 3.7m/day last week (vs 2.2m two weeks ago). Compared to India, Mainland Chinas weekly vaccination speed has slowed to 4.1m do

5、ses/day (vs 4.8m doses/day two weeks ago totaling 163m vaccine doses registered. Singapore, Hong Kong, and Indonesia registered 19%/8%/6% (as of 6/12/10 Apr) of total population, based on first dose. Japan/Korea remain very slow with total doses administered at 1.3%/2.4% of the total population. (As

6、ia vaccine tracker: HYPERLINK l _bookmark0 Figure 1)Asias younger demographics might limit vaccine choice. The UK Medicines and Healthcare products Regulatory Agency (MHRA) said last week (link) that it is not recommending age restrictions in AstraZeneca vaccine use. That said, a separate press rele

7、ase slide (link), showed that the vaccine might have potential harm over potential benefit for low exposure group below age 30 (20-29 yr). Asia has a 10-20% higher proportion of population below the age of 30 ( HYPERLINK l _bookmark1 Table HYPERLINK l _bookmark1 3) compared to developed countries. K

8、orea and the Philippines have currently introduced age restrictions on the AstraZeneca Vaccine, whereas HK has suspended delivery of 7.5mn doses ( HYPERLINK l _bookmark2 Table 4). Considering restraint risk on the vaccine choice among younger generations, perhaps, some delay in Asian vaccination pro

9、gress may be a risk in 2Q21. AstraZenecas vaccine contributes 20-40% of total vaccine procurement among Asian countries. 93%/90% of Thailand/Indias existing vaccine order book is based on AstraZeneca vaccine.Moderna vaccine: Antibody lasts for six months post second jab. We think that regardless of

10、the vaccine type, vaccine efficacy has been largely proven at the point of vaccination. Korea CDCs press release on 11 Apr-21 showed Pfizer-BioNTech and AstraZeneca vaccines offering 100%/92% protection against COVID-19 infection for 14 days post first dose. Academic research (link) shows promising

11、large population data post Pfizer-BioNTech vaccination in Israel. Early time-series data suggests strong protection against all risks (new infection, symptomatic, hospitalization, mortality etc.) up to 42 days (or 7 days after second doses). That said, the period of antibody is still largely unknown

12、. Based on small group data (33 people), an academic posting last week (link) said that the Moderna vaccine shows a six-month duration of antibody post second jab.Insurance MW Kim AC (852) 2800-8517 HYPERLINK mailto:mw.kim mw.kimBloomberg JPMA MKIM J.P. Morgan Securities (Asia Pacific) Limited/J.P.

13、Morgan Broking (Hong Kong) LimitedLing Wang AC(852) 2800 8599 HYPERLINK mailto:ling.wang ling.wangBloomberg JPMA LWANG J.P. Morgan Securities (Asia Pacific) Limited/J.P. Morgan Broking (Hong Kong) LimitedAditi Joshi(91-22) 6157-3366 HYPERLINK mailto:aditi.joshi aditi.joshiJ.P. Morgan Securities (Asi

14、a Pacific) Limited/J.P. Morgan India Private LimitedAlex Tso, CFA(852) 2800-0496 HYPERLINK mailto:alex.tso ale HYPERLINK mailto:x.tso x.tsoJ.P. Morgan Securities (Asia Pacific) Limited/J.P. Morgan Broking (Hong Kong) LimitedSee page 22 for analyst certification and important disclosures, including n

15、on-US analyst disclosures.J.P. Morgan does and seeks to do business with companies covered in its research reports. As a result, investors should be aware that the firm may have a conflict of interest that could affect the objectivity of this report. Investors should consider this report as only a s

16、ingle factor in making their investment decision. HYPERLINK / Key research notesCOVID-19 Update: EM-DM diverge again, but vaccine progress spurs optimism 07 Apr 21COVID-19 Update: Cases trend up, but vaccination momentum is building 31 Mar 21COVID-19 Update: Vaccination benefits becoming evident at

17、a 15-20% vaccination rate 25 Mar 21COVID-19 Update: Beyond the Ides of March, Stay Optimistic on Outlook Mar 18, 2021COVID-19 Update:Out with the old, in with the “modified”? Mar 10, 2021COVID-19 Update: What if 10-15% of the population is vaccinated first in Asia? 02 Mar 21COVID-19 Update: A milder

18、 spring in Asia? Feb 25, 2021COVID-19 Update: Year of the Ox: Promising early signs Feb 17, 2021COVID-19 Update: Vaccine vs. Mutation Feb 9, 2021COVID-19 Update: Will 2021 see a baby drought?Feb 2, 2021COVID-19 Update: Better curve control, but whats next? Jan 27, 2021COVID-19 Update: Three challeng

19、es in curve control/ vaccination this January Jan 20, 2021COVID-19 Update: Will China achieve community immunity in 1Q21? Jan 13, 2021COVID-19 Update: From Here to Immunity: Tracking Vaccine Roll Out Jan 6, 2021COVID-19 EM Asia Year Ahead 2021: Applying Covid-19 data to inform portfolio choices; Rei

20、terate OW on Indonesia, Thailand Dec 10, 2020COVID-19 Update: Declining mortality rate argues for soft-handed policy Dec 2, 2020Rising curve pressure in EM countriesGlobal/Asia cases of infections have been worsening at 14%/50% w/w following increasing human activities in March and holidays in early

21、 April. Whilst we are observing greater infection curve pressure in EM countries such as India (average daily cases: 125K, 70% w/w) and Brazil (71K, 10% w/w), we also note that, even in the US (vaccination: 36%, based on first dose), daily cases have started to rise at 10% w/w (or 70,000 cases/ day)

22、. Compared to last week, average daily mortality cases have risen across the globe at 20%/25%/7%/48% w/w in global/US/EU/Asia. Current mortality rate (=direct death/ reported cases) is 2.2% (=2.9m/136.1m vs model forecast: 2.0%).Asias average secondary infection rate (R0) has risen to 1.21(+0.08) la

23、st week largely due to Thailands larger infection reporting (500 cases per day vs 60 cases per day two weeks ago). Excluding Thailand, the force of transmission rate has lowered staying around 0.93-1.11. As Asias weekly mobility level has lowered to 76% level (-12%p w/w) compared to pre-COVID level

24、during last week, we forecast R0 would stay around 1.0-1.1 in the next two weeks. We believe rising daily cases in several spots could be offset by immediately stricter social distancing rules in Asia.Moving into April, we observe larger daily cases of infections even among countries with strong ear

25、ly progress on vaccination such as Chile, UAE, Bahrain and Hungary. This, in our view, remains the risk of variants. The next focus would be on whether Israel and the UK would continue to show positive datapoints beyond this summer season. If so, the speed of vaccination could be regarded as an impo

26、rtant factor in community immunity and also the next step towards economic reopening regardless of the vaccine type.Table 1: COVID-19: New daily cases of infection/ Death (weekly average) (5 to 11 Apr-21)Persons, %New daily cases of infectionsGlobalUSEUAsiaBrazilIndiaMarch-2025,3246,06815,4039881844

27、5March-21Week 1 (1-7 of Mar-21)400,25759,596161,05732,78566,86916,295Week 2 (8-14 of Mar-21)420,20451,820179,50139,39966,28921,178Week 3 (15-21 of Mar-21)473,14154,360198,64957,76473,55234,297Week 4 (22-28 of Mar-21)565,27763,370246,70682,28476,63653,213Week 5 (29 of Mar to 4 of Apr-21)585,13363,428

28、243,041109,39564,32473,412April-21Compared to last weekCompared to 4 weeks ago Compared to Mar-2014%59%2530%10%35%1054%-6%27%1378%50%317%16506%10%7%38418%70%489%277336%New daily direct deathGlobalUSEUAsiaBrazilIndiaWeek 1 (5-11 of Apr-21)666,13170,000227,678164,09871,010124,757March-201,3321731,0013

29、46 1March-21Week 1 (1-7 of Mar-21)8,9491,7063,3184671,496115Week 2 (8-14 of Mar-21)8,6111,4073,1154481,831108Week 3 (15-21 of Mar-21)8,7941,0683,1494722,259164Week 4 (22-28 of Mar-21)9,7819973,7205732,595257Week 5 (29 of Mar to 4 of Apr-21)9,8508093,6098502,747439April-21Week 1 (5-11 of Apr-21)11,85

30、61,0093,8541,2593,101665Compared to last week20%25%7%48%13%51%Compared to 4 weeks ago38%-28%24%181%69%517%Compared to Mar-20790%483%285%3604%47720%58762%Source: Johns Hopkins. J.P. MorganFigure 1: COVID-19: Asia secondary infection rate (R0) trend and forecastxSource: J.P. Morgan estimates, Johns Ho

31、pkins. Note: we estimate the secondary infection rate as ratio of current new cases and the average of new cases in the preceding 5-day period.Figure 2: COVID-19: EM vs DM daily new infection per 1M population45040035030025020015010050-New infections per 1M populationDMEMGlobalSource: Johns Hopkins.

32、Asias younger demographics might limit vaccine choiceIn contrast to developed countries, broadly speaking, Asia countries vaccine order book has largely concentrated on two types of vaccines SinoVac and AstraZeneca. Thus, under the current structure, if one of two vaccines uncertainty is to grow fur

33、ther, several Asia countries would likely review their vaccination schedule.Especially in case of the AstraZeneca vaccine, the vaccine accounts of 90%+ of the total vaccine order book for India and Thailand to build community immunity. Also, other countries such as Japan, Korea, the Philippines and

34、Indonesia have 39%, 25%, 25% and 23% of their total order book as AstraZenecas vaccine orders. Thus, potential revisions in this vaccination schedule/further diversification of vaccine procurement, in our view, would be a potential risk on the planned community immunity targets.Figure 3: Asia: Astra

35、Zenecas vaccine as % of total vaccine order book%93%90%39%25%25%23%19%0%ThailandIndiaJapanKoreaPhilippinesIndonesiaMalaysiaHK SARSource: Local news, J.P. Morgan.According to the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK last week (link), the MHRA is not recommending age re

36、strictions in regards to AstraZeneca vaccine use. This is due to the MHRA concluding that a possible link between AstraZeneca vaccine and blood clots is extremely rare and unlikely to incur potential risk. In the UK, 20.2 million doses of the AstraZeneca vaccine had been given by 31 Mar-21 and the o

37、verall risk of the blood clots is approximately four people in a million who receive the vaccine.That said, in a separate press release slide (link), it was shown that the vaccine might have potential harm over potential benefit for the low exposure risk group below the age of 30 (20-29 yr).Table 2:

38、 Astra Zeneca COVID 19 vaccine: the potential benefits and harmsFor 100,000 people withLow exposure risk*Medium exposure riskHigh exposure riskAgegroupPotentialbenefits*Potentialharms*Potentialbenefits*Potentialharms*Potentialbenefits*Potentialharms*20-29yr30-39yr2.70.880.824.90.84

39、0-49yr5.70.516.70.551.50.550-59yr10.50.4310.495.60.460-69yr0.2127.70.2Source: UK Government (.uk/government/uploads/system/uploads/attachment_data/file/976877/CovidStats_07-04-21- final.pdf) and J.P. Morgan.Note: * Potential Benefit: ICU admissions due to COVID-19 prevented, * Potential h

40、arms: Serious harms due to the vaccine, * exposure risk definition:Low: Based on COVID-19 incidence of 2 per 10,000: roughly UK in MarchMedium: Based on COVID-19 incidence of 6 per 10,000: roughly UK in FebruaryHigh: Based on COVID incidence of 20 per 10,000: roughly UK at peak of second waveAsia: S

41、maller infection risk & Younger demographicsExcept India, broadly speaking, Asia has managed its COVID-19 infection risk pretty well in line with lower exposure risk scenarios since the pandemic outbreak last year. More importantly, Asia countries have 10-20% higher proportion of the population belo

42、w the age of 30 compared to developed countries ( HYPERLINK l _bookmark1 Table 3). The Philippines, India, Indonesia and Malaysia are Asia countries where the population mix below the age of 30 is above half of the total population. We note that, currently, Korea and the Philippines have introduced

43、the age restrictions for the AstraZeneca vaccine, whereas HK has suspended delivery of 7.5mn doses ( HYPERLINK l _bookmark2 Table 4).Picturing the 2Q21 vaccination schedule in Asia, perhaps, the vaccine take-up rate might be slowed considering restraint risk on the vaccine choice among younger gener

44、ations. That said, for countries currently still under high/ medium exposure risk scenario, we believe, as the potential benefits could be greater than over potential harm in all age groups, overall vaccination should continue regardless of the vaccine type.We will update Asias estimated revised com

45、munity immunity time next week post each governments revised vaccination schedule/target announcements.Table 3: Asia: Population with age below 30 yearsPersons in million, %Population withToage below 30y (mn)tal population (mn)% of populationbelow 30yKorea 15.951.331.0%India 738.31,381.653.4%Japan 3

46、3.8126.426.7%Indonesia 139.7273.951.0%Thailand 25.969.837.1%Malaysia 16.332.450.2%Philippines 64.0109.858.3%Singapore 1.85.931.5%HK 2.07.527.1%Source: World Bank, J.P. Morgan.Table 4: Asia: Vaccination policy revision related to AstraZenecaDoses in million, %Total vaccineTotal dosesDosesprocurement

47、so far (mn)% of AstraZeneca order bookViews on AstraZenecaAlternate vaccine planResumed AstraZeneca jab for people agedadministered (mn)administered as % of populationKorea2.125%30-60 years after temporarily suspending use for those 60 years old or younger- People aged 30 or younger are excludedUse

48、of J&Js Janssen approvedPfizer-BioNTech1.22.4%India31.090%- Continuing use of AstraZeneca doses- Bharat Biotech104.57.6%Japan3.039%- Use of AstraZeneca doses not started yet- Pfizer-BioNTech- Moderna (under review)1.61.3%Indonesia39.023%- Continuing use of AstraZeneca doses- Sinovac15.15.5%- Continu

49、ing use of AstraZeneca asThailand2.193%Principal shot- Sinovac0.60.8%Malaysia3.719%Philippines5.625%Reviewing use of AstraZenecaTemporarily suspended use for people below 60y of agePfizer-BioNTechSinovac0.92.9%1.11.0%1.728.5%Sputnik VCanSinoBioSinovacPfizer BioNTechPfizer-BioNTechSingaporeN/AN/A- In

50、 talks to secure AstraZeneca dosesSinovacModernaHK2.60%- The govt wont take delivery of the vaccinesupply theyve ordered (7.5m)Source: Local news, Our World in data, World Bank, J.P. Morgan.SinovacPfizer-BioNTechUse of J&Js Janssen under review0.811.1%Figure 4: COVID 19: Forecast on vaccination as a

51、 % of total population among Asia countriesSource: J.P. Morgan estimates, local news. Please note solid lines take into account the public disclosure on vaccine distribution timing announced by the country. Dashed lines are based on J.P. Morgan estimates. * It is deemed to arrive the community immun

52、ity once over 60% of total population is vaccinated. Considering the vaccine efficacy and other factors not considered at the initial stage of vaccination, we put an 80% as the point to reach the community immunity.Table 5: Asia: Vaccine order book vs vaccine procured (breakdown by manufacturer)Dose

53、s in millionKoreaIndiaJapanIndonesiaThailandMalaysiaPhilippinesSingaporeHKTotal vaccine doses ordered158mn (for 79mn3303103202866.7(mn)people)20mn (Dec- 20)26mnAstraZeneca- Rolled out200mn120mn20mn- reserved12.8mnfrom 26th Feb 202135mn- 20mn (Dec-Pfizer-BioNTech20)6mn (in Feb-21)Rolled out144mn50mn3

54、2mnfrom 27th Feb 2021Secured enough doses148- 2.6mn-30mnfrom PfizerBioNTech, Moderna, and Sinovac147.5mnModerna40mn (Dec- 20)Approval for Moderna under review13mn2mnSinovac125.5mnSinopharm15mn- in talks to buy 5mn more12mn- 25mn7.5mnNovavax40mn (in Feb-21)50mn30mnCovax (WHOs project)20mn- 97mn of As

55、traZeneca54mn of AstraZeneca30mn (4.58 mn of AstraZeneca)Bharat Biotech- 10mn-20mnSputnik V6.4mnCanSino Bio3.5mnTotal vaccinedoses procured (mn)2.1N/A3.039.0N/A2.6 mn- 117,300arrived in FebAstraZenecaPfizer-BioNTechModerna- 1.5mn arrived in Feb-217mn in 2Q21- 117,000 (in Feb-21)-500,000arri

56、ved in Mar-216mn in 2Q21Delivery will begin in May- 2111mn in Jan-2110mn in 2Q21Mostly to be produced locally-Mostly to be produced locally- 386,000 (Feb-21)-452,790 (Feb-21)- 654,615 (Mar-21)- 990,000 (Mar-21)- 526,500 (Mar-21)will receive 40mn doses in Jun-21 if approved& 10mn in Sep-21, if approv

57、edby 3Q21-21- 150,000 inMay-21- Mostly to be produced locally from Jun-21600,000 doses - Deliveryto arrive in Jun- expected in 2Q21211mn arrived in March- 312,390 InFeb-21- 83,070 on15th Mar-21- 124,020On Mar 22,- 125,190on 26th March- 21- Delivery to begin in mid-2021- 585,000arrived in Feb-21- 1.2

58、mn (Dec-20) - 200,000- 1.8mn (Dec-20) arrived- 200,000 doses - 600,000 arrivedSinovac- 15mn (Jan-21)- 800,000arrived in Mar- 10mn (Feb-21) arrived in Mar- 21in Feb-21- 10mn scheduled 21- 1.4mn in Mar-21- 1mn in April- in Apr-21 21- 2.5mn to arrive - 2mn in Jun-211mn arrived in Feb-211mn arrived in M

59、ar-21Sinopharmin Apr-21 by 2Q21Novavax- to be rolled out from 2Q21- 20mn doses by 3Q21- 35-40% of the-432k todoses would be Covax (WHOsarrive in April- available in Q1project)21- 60-65 % would- 729k inbe available in2Q21the second quarterReceived 1.1mn of AstraZeneca in Mar-21Delivery of total 11mn

60、to be completed by May-21- 525,600 doses of AstraZeneca arrived in Mar-21- 117,000 doses of Pfizer in April- 21- 979,200 mndoses of AstraZeneca in Apr-21- 5.5mn suppliedBharat Biotech-4.5mn to be supplied in 2Q21Source: Local news, J.P. Morgan.How long would antibodies last post the jab?We think tha