of the covid‑19 pandemic in 2020, the who issued a guideline as an emergency use listing of new vaccines, a process derived from the 2013–16 ebola epidemic. it required that a vaccine candidate developed for a life-threatening emergency be manufactured using gmp and that it complete development according to who prequalification procedures. even 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. in the uk and the eu, companies may use a "rolling review process", supplying data as they become available during phase iii trials, rather than developing the full documentation over months or years at the end of clinical research, as is typical. this rolling process allows the uk's regulator (mhra) and the european committee for medicinal products for human use to evaluate clinical data in real time, enabling a promising vaccine candidate to be approved on a rapid timeline by both the uk's mhra and the european medicines agency (ema). a rolling review process for the moderna vaccine candidate was initiated in october by health canada and the ema, and in november in canada for the pfizer-biontech candidate. early authorizations in china and russia 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. 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. in september, the united arab emirates approved emergency use of the sinopharm bibp vaccine for healthcare workers, followed by similar emergency use approval from bahrain in november. first authorizations of rna vaccines in the united states, an emergency use authorization (eua) is "a mechanism to facilitate the availability and use of medical countermeasures, including vaccines, during public health emergencies, such as the current covid‑19 pandemic." once an eua is issued by the fda, the vaccine developer is expected to continue the phase iii clinical trial to finalize safety and efficacy data, leading to application for licensure (approval) in the united states. in mid-2020, concerns that the fda might grant a vaccine eua before full evidence from a phase iii clinical trial was available raised broad concerns about the potential for lowered standards in the face of political pressure. on 8 september 2020, nine leading pharmaceutical companies involved in covid‑19 vaccine research signed a letter, pledging that they would submit their vaccines for emergency use authorization only after phase iii trials had demonstrated safety and efficacy. pfizer-biontech covid-19 vaccine. the pfizer-biontech partnership submitted an eua request to the fda for the mrna vaccine bnt162b2 (active ingredient tozinameran) on 20 november 2020. on 2 december 2020, the united kingdom's medicines and healthcare products regulatory agency (mhra) gave temporary regulatory approval for the pfizer–biontech vaccine, becoming the first country to approve this vaccine and the first country in the western world to approve the use of any covid‑19 vaccine. on 8 december 2020, 90-year-old margaret keenan received the vaccine at university hospital coventry, becoming the first person known to be vaccinated outside of a trial, as the uk's vaccination programme began. however, other vaccines had been given earlier in russia. on 11 december 2020, the us food and drug administration (fda) granted an emergency use authorization (eua) for the pfizer-biontech vaccine. on 19 december 2020, the swiss agency for therapeutic products (swissmedic) approved the pfizer-biontech vaccine for regular use, two months after receiving the application. this was the first authorization by a stringent regulatory authority under a standard procedure for any covid‑19 vaccine. on 23 december, a 90-year-old lucerne resident became the first person to receive the vaccine in continental europe. as of december 2020, many countries and the european union have authorized or approved the pfizer-biontech covid‑19 vaccine. bahrain and the united arab emirates granted emergency marketing authorization for the sinopharm bibp vaccine. in the united kingdom, 138,000 people had received the pfizer-biontech covid‑19 vaccine comirnaty by 16 december, during the first week of the uk vaccination programme. on 18 december 2020, the us fda granted an eua for mrna-1273, the moderna vaccine. vaccine manufacturers are awaiting full approvals to name their vaccines. moderna submitted a request for an eua for mrna-1273 to the fda on 30 november 2020. on 18 december 2020, the fda granted an eua for the moderna vaccine. united kingdom the uk medicines and healthcare products regulatory agency (mhra) gave the first approval to the oxford/astrazeneca vaccine on 30 december 2020, as its second vaccine to enter the national rollout under a conditional and temporary authorization to supply. australia in october 2020, the australian therapeutic goods administration (tga) granted provisional determinations to astrazeneca pty ltd in relation to its covid‑19 vaccine, chadox1-s and to pfizer australia pty ltd in relation to its covid‑19 vaccine, bnt162b2 . janssen cilag pty ltd was granted a provisional determination in relation to its covid‑19 vaccine, ad26.cov2.s, in november 2020. on 24 january 2021, the tga granted provisional approval to pfizer australia pty ltd for comirnaty. on 24 june 2021, the tga granted provisional determination to moderna australia pty ltd for elasomeran. european union in october 2020, the committee for medicinal products for human use (chmp) of the european medicines agency (ema) started 'rolling reviews' of the vaccines known as covid‑19 vaccine astrazeneca (chadox1-sars-cov-2) and pfizer-biontech covid‑19 vaccine (bnt162b2). the ema released an update on the status of its rolling review of the covid‑19 vaccine astrazeneca in december 2020, after the uk granted a temporary authorization of supply for the vaccine. in november 2020, the ema published a safety monitoring plan and guidance on risk management planning (rmp) for covid‑19 vaccines. the plan outlines how relevant new information emerging after the authorization and uptake of covid‑19 vaccines in the pandemic situation will be collected and promptly reviewed. all rmps for covid‑19 vaccines will be published on the ema's website. the ema published guidance for developers of potential covid‑19 vaccines on the clinical evidence to include in marketing authorization applications. in november 2020, the chmp started a rolling review of the moderna vaccine for covid‑19 known as mrna-1273. in december 2020, the ema received application for conditional marketing authorizations (cma) for the mrna vaccines bnt162b2 and mrna1273 (moderna covid‑19 vaccine). the assessments of the vaccines are scheduled to proceed under accelerated timelines with the possibility of opinions issued within weeks. in december 2020, the chmp started a rolling review of the ad26.cov2.s covid‑19 vaccine from janssen-cilag international n.v. on 21 december 2020, the chmp recommended granting a conditional marketing authorization for the pfizer-biontech covid‑19 vaccine, comirnaty (active ingredient tozinameran), developed by biontech and pfizer. the recommendation was accepted by the european commission the same day. on 6 january 2021, the chmp recommended granting a conditional marketing authorization for covid-19 vaccine moderna and the recommendation was accepted by the european commission the same day. in january 2021, the ema received an application for conditional marketing authorization (cma) for the covid‑19 vaccine known as covid‑19 vaccine astrazeneca, developed by astrazeneca and oxford university. on 29 january 2021, the chmp recommended granting the conditional marketing authorization and the recommendation was accepted by the european commission the same day. in february 2021, the chmp started a rolling review of nvx-cov2373, a covid‑19 vaccine being developed by novavax cz as (a subsidiary of novavax, inc.) and a rolling review of cvncov, a covid‑19 vaccine being developed by curevac ag. in february 2021, the ema announced that they are developing vaccine guidance to address the virus variants. in february 2021, the ema received an application for conditional marketing authorization (cma) for the covid-19 vaccine janssen developed by janssen-cilag international n.v. the ema recommended a conditional marketing authorization of the covid-19 vaccine janssen on 11 march 2021, and it was accepted by the european commission the same day. in march 2021, the chmp started a rolling review of sputnik v (gam-covid-vac). the eu applicant is r-pharm germany gmbh. in may 2021, the cmmp started evaluating the use of comirnaty to include young people aged 12 to 15, and it started a rolling review of sinovac covid-19 vaccine. the eu applicant for sinovac is life'on s.r.l.