We have too many vaccines. The dilemma of recalls and the doses lacking in poor countries

We have too many vaccines. The dilemma of recalls and the doses lacking in poor countries
We have too many vaccines. The dilemma of recalls and the doses lacking in poor countries

While the third dose is being discussed in the West, the world’s poor are left with blunt weapons in the face of the virus. According to ‘Our World in data’, a scientific publication site of the University of Oxford, 5.82 million doses have been administered globally, but the crumbs arrive in developing countries: only 1.9% of people living in low-income countries have received at least one dose, and in Africa fewer than 4 in 100 people have had two.

And to think that today there are vaccines and in the near future there will be more and more: according to a recent report by Airfinity, a research agency that deals with data analysis, currently about 1.5 billion doses are produced per month which will reach 2 before the end of the year. By that date there should be enough vaccines (more than 12 billion doses) for the entire world population over the age of 12.

Vaccines advancing to rich countries

The point will be how to distribute them. Rasmus Bech Hansen, co-founder and CEO of Airfinity, explained that vaccine production has now reached a “turning point” and today the challenge for Western countries “is no longer supply, but demand”. However, the destination of the excess doses will be a direct consequence of the “political decisions” taken by the individual states.

According to the report, at the end of the year the United States, the European Union, Canada and the United Kingdom will have a surplus of 1.2 billion doses (of which 500 million already in September), an estimate that also takes into account the vaccines needed to administer the third dose. to 80% of the population over 12. The G7 states and the EU have promised to allocate over 1 billion doses to poor countries, delivering less than 15% to date. The reason is obvious. After last spring’s supply problems, Western governments prefer to be cautious and stockpile in warehouses to ensure recalls. Even at the expense of those countries that do not yet have access to vaccines.

China has done better than the West, which has already supplied 770 million doses to emerging or developing countries and has pledged to reach two billion during the year. For 2021, Beijing is expected to produce 5.7 billion doses, out of a total of 12.2 billion produced globally. Chinese President Xi Jinping called vaccines a public good and recently announced a new $ 100 million commitment to the World Health Organization’s (WHO) Covax vaccine distribution program.

WHO and the moratorium on booster doses

The question therefore is whether the richer countries, the West in the lead, are doing enough to help emerging ones emerge from the pandemic. The answer is: probably not. In this context we must place the tough position of the WHO which a month ago had asked for “a global moratorium” on booster doses.

“The third dose – the director general Tedros Adhanom Ghebreyesus recently reiterated – could be necessary for the populations most at risk, where there is evidence of a reduction in immunity against the possibility of developing severe Covid and death”. For example, for “immunocompromised people who have not responded sufficiently to the initial” vaccine “doses or who no longer produce antibodies. But for now – he warned – we do not want to see widespread use of ‘boosters’ for healthy people who are fully vaccinated. “. According to the World Health Organization, the moratorium should be extended “at least at the end of 2021, to allow each country to vaccinate at least 40% of its population”.

The third dose dilemma. The scientific community is divided

But is the third dose really necessary? Israel was the first country to start with boosters based on data showing, after about six months, a decreased effectiveness of the vaccine in preventing infection and mild or moderate disease, although the same decline was not observed against severe forms of Covid.

There is no uniformity of views in the scientific community on this point. According to a review conducted by an international group of scientists, including experts from the World Health Organization WHO and the American Medicines Agency Fda, “the studies currently available do not provide credible evidence of a substantial decline in protection against serious disease. , which is the primary goal of vaccination “.

The FDA itself in the past few hours has pointed out that vaccines already provide sufficient protection without the need for additional doses, complicating the decisions of the administration of the US president, Joe Biden, on the need for the recall. Pfizer’s briefing report stating that the booster is needed is different because of data from Israel and other sources indicating that the vaccine’s effectiveness is decreasing.

And so on the third dose each country goes on its own: if Israel has given the green light from 12 years upwards, in Italy, France and Germany the recall will be guaranteed for now only to people at risk, while in the United Kingdom to all over 50. If in doubt, however, even the unused doses remain in stock.

A serious mistake according to Ana-Maria Henao-Restrepo of WHO, lead author of the review cited above, who was clear on this point. “While administering a ‘booster’ may ultimately produce some benefit,” this “will not outweigh the benefits of providing initial protection to the unvaccinated,” warns the expert. “If vaccines are now distributed where they are needed most, they could accelerate the end of the pandemic, inhibiting the further evolution of the variants.”

When will there be vaccines for everyone?

Scholars now agree that Sars-Cov-2 will remain an endemic virus, but there is no doubt that vaccinating a large part of the world population would represent a decisive turning point, new variants permitting. When will the goal be achieved? It is difficult to make predictions in the face of choices that are indeed political but obviously also depend on the evolution of the pandemic and on numerous other variables such as the duration of immunity induced by vaccines (including boosters).

Today, however, we know that the problem of the shortage of doses will not remain so for very long: according to Airfinity’s forecasts, production should reach 22 billion in May 2022, enough to guarantee three doses to the entire world population.

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