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Health workers first, along with residents and nursing home staff. Those people should get the COVID-19 vaccine before anyone else, the U.S. Centers for Disease Control and Prevention said Tuesday.
This recommendation applies to the United States. But what about health workers from other countries? Or the elderly with health problems? Should a nurse in Peru, at high risk of contracting the virus, be immunized before a low-risk person in the United States receives the vaccine?
Niko Lusiani, senior advisor to the global humanitarian organization Oxfam, believes the strategy makes sense both scientifically and morally.
“I work in front of a computer right now in the safety of my home,” he says. “I would be happy not to get a vaccine so that a grandmother with a medical condition in Kuala Lumpur or Lima, Peru can have access to the vaccine. I think a lot of people will feel that way.”
But, he says, the opposite will likely happen right now: low-risk people in the United States will likely be immunized earlier than many high-risk people in poor countries.
“Part of the reason is that rich countries are stockpiling the supply of vaccines,” Lusiani says. “It is understandable, to some extent, that you want to protect your own people. That said, leave many people out.”
When the pandemic started, rich countries started shopping. Some have even called it “panic buying”. These countries began making deals with drug companies to purchase experimental COVID-19 vaccines, even before clinical trials were over. The details of many of these deals are not public, NPR reported.
At the time, no one knew which experimental vaccine would work. So the rich countries were hedging their bets. But now it appears that many of the vaccines will be effective.
Pfizer and Moderna’s vaccines appear to be over 90% effective. Both companies have already asked the U.S. Food and Drug Administration to authorize emergency use of their COVID-19 vaccines. And AstraZeneca is probably not far behind. Last week, the company said its vaccine was likely to be around 70 percent effective.
When these doses become available over the next year, some affluent counties are likely to end up with more vaccines than necessary, says Andrea Taylor, who helps direct the Duke Global Health Innovation Center. The United States will likely have enough doses to vaccinate its population twice. And Canada will have enough for its population five times over.
“Our data shows that nearly 10 billion doses have been reserved,” says Taylor. “And most of those doses were bought from high-income countries.”
For example, almost all of Pfizer’s doses will go to rich countries. And the initial doses of Moderna will go to the United States, Taylor says, leaving little vaccine for people in poor countries this year and possibly even 2022. Some people likely won’t be immunized until 2023, Taylor and his colleagues estimate.
“There are very significant inequalities,” he says. “We haven’t really seen these inequalities close in the past two months.”
That said, there is good news, says Kalipso Chalkidou, who heads global health policy at the Center for Global Development. Half of the vaccine doses from AstraZeneca and its partner Oxford University go to low- and middle-income countries. At least 500 million doses will go to India and 300 million doses will go to COVAX, a World Health Organization initiative that helps poorer countries acquire doses.
For several reasons, the AstraZeneca vaccine will be key in bridging the accessibility gap around the world, says Chalkidou. First, this vaccine is also easier to transport and store because it only requires refrigeration. Moderna’s vaccine must be stored in a freezer, and Pfizer’s vaccine requires a special type of freezer that many clinics and hospitals do not have.
AstraZeneca is also rapidly ramping up production by sharing its technology with other vaccine manufacturers. The company has already entered into an agreement with the Serum Institute of India, the largest vaccine manufacturer in the world, to produce hundreds of millions of doses next year.
Finally, the AstraZeneca vaccine will be much cheaper than other vaccines. You’ll like it costing less than a fifth of the Moderna and Pfizer vaccines.
“AstraZeneca has signaled that they want to make this available to people in poorer countries at the lowest possible price, effectively at a cost. This is quite important,” says Chalkidou.
Because if the world wants to end this pandemic, he says, it needs to produce billions of doses of not just a vaccine, but also an affordable one. [Copyright 2020 NPR]
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