The Greatest Risk Lies Within the Unvaccinated

As the Food and Drug Administration (FDA) prepares two upcoming meetings on October 14 and 15 to discuss the safety and nature of boosters shot doses from the Moderna and Johnson and Johnson vaccine, the World Health Organization (WHO) has firmly reasserted its stance that there is little data to support the need for a third or fourth shot.

While recent WHO guidelines warn against booster shots, the organization has continued to push the necessity of accelerating current efforts to vaccinate unvaccinated individuals. “Vaccinating many more people who were unvaccinated will save lives so it’s a fairly straightforward proposition,” said Bruce Aylward, a senior advisor and director general to the WHO, in a press conference on August 18. There is currently little being done by high- and middle-income countries to increase the quantitative amount of vaccinated individuals, which is predicted to yield a much greater protection from future mutations.

Indeed, the WHO has maintained that global inoculation is a necessity, not a luxury. “The virus is evolving and it’s not in the best interests of leaders just to focus on narrow nationalistic goals when we live in an interconnected world and the virus is mutating quickly,” warned Tedros Adhonam Ghebreyesus on August 18. Clinical evidence sets a clear precedent: the necessity for booster shots is tenuous. “We don’t know if booster doses are going to make a big difference in terms of severe disease and death in the near term. You’ve just heard the scientists speak to the evidence in that regard.” Larger and developed countries should not feel a sense of immunity once local populations have been vaccinated and provided with the booster shot. The absence of an international effort to provide and distribute vaccines will continue to exacerbate the risk of future mutations and outbreaks.

Even so, the discourse between domestic and international health organizations outlines a larger problem that currently hampers chances to inoculate populations globally. “The divide between the haves and have-nots will only grow larger if manufacturers and leaders prioritise booster shots over supply to low and middle-income countries,” said Ghebreyesus. “At present, just ten countries have administered 75 [percent] of all vaccine supplies, and low-income countries have vaccinated barely [two percent] of their people.” There should be a critical urgency for countries who have vaccinated most of their domestic populations to convert efforts in a globally centered vaccination plan.

COVAX, an initiative to “accelerate the development, production, and equitable access” of COVID-19 vaccines, is currently led by the WHO and UNICEF. Founded in 2020 when COVID-19 began spreading uncontrollably at an international scale, COVAX aims to provide a support system for low and middle-income countries struggling to acquire and distribute vaccinations. While the aim of distributing two billion vaccines by the first quarter of 2021 presented an optimistic look on vaccine distribution, the projection proved little more than just that. As of September 9, the COVAX initiative has distributed just 240 million doses in 139 countries and has “largely [placed] the blame on the shoulders of the world’s richest countries, some of which have purchased more than enough vaccines for their populations.” However, COVAX itself is at fault for the middling progress towards its goals, owing to mismanagement and excessive prudence. The COVAX agreement forbade any country or group from making vaccine purchases that numbered more than 20 percent of its population size, a preventative measure to reduce hoarding and stockpiling reserves. However, such nominally-prudent measures have proven ineffectual as larger nations such as the U.S. continue to stockpile as underdeveloped countries struggle to purchase any vaccines at all. A December 2020 BBC report revealed that the top 14 percent of countries in the world have secured over 50 percent of the world’s safest and effective vaccines. International aid efforts have only redirected vaccines back into the richest parts of the world, with the European Union exporting 34 million doses towards “Singapore, Saudi Arabia and Hong Kong — countries that have no problem sourcing and paying for vaccines.”

In the first quarter of 2022, the vaccination gap between low earning and developed countries will continue to widen, with high-earning countries projected to vaccinate over 90 percent of their populations compared to the two percent of low-income countries. The lack of infrastructural and financial support that low-middle and low-income countries can fall back on during a crisis has stagnated any effort to get their communities the necessary doses without third-party support. 

While developed countries continue to discuss the possibility to expand booster shot programs, countries with access to the necessary resources for supporting their lower income counterparts should shift their focus to international aid. COVAX and initiatives like it are a good start but they are blatantly insufficient in acquiring and distributing to the necessary scale that is needed to prevent outbreaks in the future.

By: Andrew Chinn