Ireland should postpone boosters until poorer countries have caught up

There is a moral and scientific imperative that we correct the inequity between high- and low-income countries in accessing vaccines

A Kenyan woman getting  a Covid-19 vaccine at the Kenyatta National Hospital in Nairobi. Photograph: Simon Maina/AFP via Getty Images

A Kenyan woman getting a Covid-19 vaccine at the Kenyatta National Hospital in Nairobi. Photograph: Simon Maina/AFP via Getty Images

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While Ireland and other high-income countries are already considering administering Covid-19 booster shots to protect their vulnerable populations, the concerning reality is that vaccines remain out of reach for poor communities across the globe.

Europe has administered 88 doses of vaccine per 100 people, North America 85. However, the African continent has vaccinated only 2 per cent of its population. There are countries such as Burundi and Eritrea that have not even started vaccinating. Yet the number of Covid-19 cases in many African countries are at their highest level, with death rates higher than the global average.

Because of the Delta variant, Ireland and other high-income countries are experiencing an increase of Covid-19 infections and are understandably considering booster Covid-19 vaccine shots. However, the countries with high vaccination rates are already protected against severe Covid-19 diseases and death, a benefit the poorer countries with very low vaccination rates do not have.

Scientific evidence points towards the fact that high transmission rates favour the emergence of new variants of Covid-19 virus, so reducing transmission across the world through vaccination is one way to protect us all from Covid-19 variants of concern.

The inequality in access to Covid-19 vaccines resulted in the head of World Health Organisation (WHO), Dr Tedros Adahom, calling for a moratorium on booster Covid-19 shots in high-income countries until the end of September to allow for at least 10 per cent of low-income countries populations to be vaccinated. But even 10 per cent coverage will not protect the low-income countries from Covid-19.

Total doses distributed to Ireland Total doses administered in Ireland
8,557,330 7,297,243

Unprotected

In Dr Adahom’s words “we cannot, and we should not, accept countries that have already used most of the global supply of vaccines using even more of it, while the world’s most vulnerable people remain unprotected”.

The White House press secretary said the WHO call “is a false choice, we believe we can do both”. While in theory this is true, the reality is very different.

The scientific journal Nature estimates that if the 11 rich countries rolling out or considering boosters this year were to give shots to everyone over 50 years old they would use up roughly 440 million doses of the global supply. If all high- and upper middle-income countries were to do it, the estimate doubles.

The global supply of Covid-19 vaccines is limited, partly because the knowledge to make the vaccines has not been shared. A request by low- and middle-income countries to the World Trade Organisation (WTO) for a waiver of intellectual properties of Covid-19 vaccines and treatments (perfectly legitimate under WTO’s rules), has been blocked by the EU and the UK. Unprecedently, for a US administration President Joe Biden has supported it. Such a move would ramp up vaccine production in low- and middle-income countries.

Nature has also reported that almost all the mRNA vaccine doses expected this year from Pfizer-BioNTech and Moderna have been purchased by the US and Europe, leaving low- and middle-income countries depending on donations from high-income countries and WHO-led vaccine initiatives such as COVAX. COVAX, however, does not have the resources; neither has it set a target to vaccinate all the countries that participate in it (which are mostly of low- and middle-income).

Commitment

The USA has donated 110 million Covid-19 vaccine doses to low-income countries so far, part of a half a billion doses commitment made by President Biden. The UK is also planning to donate millions of Covid-19 vaccines doses to low-income countries, and Chinese and Russian vaccines have also made it to several low-income countries. This is very welcome.

But there is a moral and scientific imperative that we correct the stark inequity that exists between high- and low-income countries in access to Covid-19 vaccines as soon as possible. All our lives depend on it. As Irish-born Dr. Mike Ryan of the WHO has put it “no one is safe until all of us is safe”.

Dr Enida Friel is head of monitoring, evaluation and learning with GOAL

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