Vaccine Rollout Priorities: An Imperative and Lifesaving Shift
A nurse prepares a vaccine to be administered in Accra, Ghana, in March 2021. Photo by Nana Kofi Acquah.
COVID-19 vaccines are now widely available in the United States. State, local, and federal governments have promoted media campaigns to dissolve anti-vaccination propaganda and provide factual information regarding the effects and importance of the vaccine. These campaigns have become increasingly necessary in encouraging hesitant Americans to get vaccinated.
However, many countries face a dire lack of vaccines, despite citizens stating they would like to be vaccinated and are frustrated with the inequity of vaccine rollout. African countries, particularly Chad, Burkina Faso, Burundi, Eritrea and Tanzania, are at the bottom of the vaccine rollout list, and the entirety of the African continent currently accounts for a mere 1% of vaccines administered globally. Even countries, such as Malawi, that are receiving vaccines often receive doses with short shelf lives that they cannot properly preserve, which creates challenges for arranging vaccine campaigns. Equity among COVID-19 vaccine distribution is critical to ending the pandemic. Health experts have identified slow global vaccine rollout and disparities as a driving force for the emergence of new variants, such as the highly contagious Omicron. Countries with high vaccine availability, such as the United States, must step up to actively support vaccine production and distribution in countries without ample supply. Taking accountability and acknowledging the role wealthier nations can play in providing vaccines and protecting populations from COVID-19 can expedite vaccine rollout and the end of the pandemic.
Many healthcare professionals in countries without access to vaccines have not been informed by their governments as to why their country cannot adequately provide vaccines. For example, Haiti has only vaccinated around 1% of its population of 11 million people as of January 1, 2022 according to Reuters Estimates. Approximately 756,000 doses of the AstraZeneca vaccine were supposed to be provided through COVAX, a project developed by the World Health Organization designed to ensure equitable access to vaccines worldwide, in January of 2021. However, Haitian government officials claim they lack the infrastructure and resources required to preserve the vaccines.
Haiti, and other low-income nations, have not become a global priority for vaccine distribution in part because its citizens are on average relatively young, the average being only 24. COVID-19 tends to manifest less severely in younger individuals and thus many Haitian citizens who contracted COVID-19 had very mild cases and survived, therefore reducing global concern over case numbers. It is also possible that since Haiti has only had 738 reported COVID-19 deaths, many Haitians suspect that it has not been a priority amongst global leaders to vaccinate members of their nation. Life has primarily returned to normal in Haiti, with mask mandates in place but not widely followed and people continuing to work and attend school, as they have throughout the pandemic because of severe poverty. Because Haiti’s infection rates are so low, many government officials and citizens within the nation do not view vaccination rollout as a priority. This view is exacerbated by a desire to focus on other major issues faced by the country, such as homelessness, kidnapping, and poverty. However, inequality in regards to vaccine access is directly related to global wealth and health inequalities which is critical to address for the wellbeing of all global citizens.
On September 22nd, President Biden announced that the United States will step up to provide lower income nations with COVID-19 vaccines, by doubling its purchase of Pfizer vaccines to supply 1 billion doses to nations that lack access to vaccines such as Mexico, Indonesia, and Colombia. He has set a goal of vaccinating 70 percent of the global population within the upcoming year. During the recent COVID-19 summit in September 2021, United Nations Secretary General António Guterres stated that “global health security has now failed, to the tune of 4.5 million lives, and counting” in reference to COVID-19’s global death toll. The summit’s resounding message to global leaders was that effective vaccines against COVID-19 exist, and if properly administered to all nations—not just wealthy ones—can end the COVID-19 pandemic. Low and middle-income nations are still drastically impacted by the COVID-19 pandemic and will continue to experience case surges and new variants. Providing more efficient global vaccine rollout can reduce infection rates and the risk of new variants emerging across the world.
Despite the U.S.’s current donation of 160 million COVID-19 vaccinations to approximately 93 countries, this comprises only a fraction of the necessary amount of vaccines required to meet its goal of vaccinating 70 percent of the global population by the time the UN reconvenes in September 2022. Furthermore, current research suggests that the poorest nations cannot expect to be fully vaccinated until 2023. While vaccine producers initially aimed to make enough doses to vaccinate the majority of the global population by the end of 2021, their production estimates do not account for politically-rooted delays affecting distribution, such as the imposition of controls on exports, or that the majority of vaccine doses are still being purchased and used by wealthier countries.
As of September 2021, only about 64% of the U.S. population was fully vaccinated against COVID-19, with 42.9% of those individuals having also received a booster. Globally, close to nine billion doses have been administered worldwide, as of December 2021.
60% of the global population has received at least one dose of the COVID-19 vaccine. However, about 72% of the shots that have been administered were given to citizens of high or middle-income nations, while only 0.9% of vaccines were administered in lower-income nations. Pledges made by leaders of wealthy nations, like the one President Biden made, are unlikely to drastically expedite the process of vaccine distribution in poorer countries. This is in part due to severe global restrictions on exports, considering both the EU and the United States prohibit the export of certain vaccines and vaccine ingredients despite them being permitted in vaccines provided in other countries. With such constraints on exports, lower-income nations are experiencing slow rollout because they are often dependent on receiving vaccines from wealthier nations with such exportation restrictions.
Higher vaccination rates are even more imperative with the emergence of the Omicron variant of COVID-19. Public health officials and scientists have quickly identified the variant as concerning, particularly because it may not be as effectively prevented by vaccines, unlike previous variants such as Beta and Delta. The emergence of Omicron demonstrates the utter importance of global vaccine rollout in order to prevent more variants from arising. South Africa has been receiving criticism from wealthier nations for its emergence of a new COVID-19 variant. However, in a statement made on November 27, an official from the African Union, consisting of 55 member states that make up the African continents, claimed that developed countries are truly to blame for the Omicron variant. Wealthier nations refusing to prioritize equitable, urgent vaccine distribution while still permitting citizens to travel overseas despite many people remaining unvaccinated inevitably leads to new variants emerging in countries with lower vaccination rates. If the United States and other developed nations refuse to step up and actively prioritize vaccine distribution in poorer continents and countries, COVID-19 will continue to mutate and infect more people. The Omicron variant is highly contagious, which can lead to higher infection and death rates, hospitalizations, and place a strain on healthcare resources.
Inequitable vaccine distribution has become the primary global threat to end the spread of COVID-19, particularly volatile variants like Omicron. Nations with low levels of vaccinations are at an incredibly high risk of experiencing substantial increases in COVID-19 cases due to developing variants. It is critical that world leaders make a commitment to vaccinating the global population as a whole. Actively supplying vaccines and supporting the COVAX initiative can drastically increase vaccination rates, but wealthy nations must begin to shift their priorities to vaccine donation and participation in programs such as COVAX. Countries such as the United States have a responsibility to make the process of global vaccine distribution efficient and widespread. Wealthier nations donating supplies and dosages, as well as ensuring infrastructure to safely administer and preserve dosages, is critical to achieving stability and normalcy.
Lauren Winkleblack is a junior at Barnard College studying human rights and literature.