Two years after the pandemic, inequities in immunization continues
On March 11, 2020, Tedros Adhanom Ghebreyesua, Director-General World Health Organization, announces to the world that we have entered into a pandemic of the novel coronavirus, COVID-19 and started a frenetic process to create a new vaccine to defeat this disease that until now it has taken more than 6 million lives.
After two years the vaccination has been too slow and inequality, despite being the global strategy to defeat the virus, in addition, there is large mass production of COVID-19 vaccines and produces others with compounds more effective, many of these are without distribution.
Many months later of reduced supply and even fighting for vaccines, now the production pace is well up, close to overproduction.
According to the International Federation of the Pharmaceutical Industry, IFPMA, more than 13 billion doses have been produced since the beginning of the pandemic, some 11 billion were administered, and approximately 60% of the world population would have at least a dose.
Airfinity, a scientific data analysis company, foresees that around will be produced 9 billion doses, including the pharmaceutical company Pfizer, which expects to manufacture 4 billion vaccines. The production of this vaccine will lead the world to excess doses and according to Airfinity, the G7 countries, and European Union (EU) already had 497 million doses surplus at the end of March. However, demand could fall to 6 billion doses this year, according to Thomas Cueni, Director General, IFPMA. India’s Serum Institute, which manufactured 2 billion doses in 2021, stopped making vaccines due to a lack of orders last December.
Despite large doses of production, immunization has been very unequal, it must be understood COVID-19 vaccines has a conservation shorts period.
Two examples could be examined, AstraZeneca and Novavax compounds last about six months, making it difficult to estimate how many vaccines are expired or expiring.
United Nations Development Program (UNDP) published last March the latest study indicating that only a tiny proportion of vaccines have been administered in developing countries, demonstrating the differences between rich and poor countries. Contextualizing inequalities regarding COVID-19 vaccination in September 2021, just over 3% of people in low-income countries had been vaccinated with at least one dose, in contrast to 60.18% in high-income countries.
At the same time, the lack of vaccination is compounded by those who do not wish to be vaccinated, which has facilitated, for example, the emergence of the Omicron variant, according to WHO Director-General Tedros Adhanom.
By July 2022, WHO has set the goal to have vaccinated 70% of each country’s population, however, inequalities in vaccines distribution seriously undermine this goal. Seven months after, we are nowhere near the target. The total number of vaccines administered has increased enormously, but the inequity in their distribution has also increased, with only 1% of the 11 billion doses delivered reaching low-income countries. This means that 2.8 billion people worldwide are still waiting to receive their first dose.
On average 42% of 92 inhabitants poorest countries of Vaccine Alliance, Gavi, received their primary dose COVID-19 vaccination, compared to 58% of the rest of the world. Also, the Covax mechanism is another attempt to achieve that 70%, a public-private partnership managed by WHO, which seeks to ensure equal access to vaccines. So far, it has already delivered 1.4 billion doses in 145 countries, well below the target of 2 billion doses by the end of 2021.
Some obstacles could not reach the goal despite having vaccines for 45% of inhabitants of 92 beneficiary countries, Covax said, including some 25 countries that do not have the infrastructure to run an effective campaign. In another case, many countries receive or received doses close to expiration.
A year after the first vaccine’s commercialization, the patent issue has not been resolved.
By the end of 2020, India and South Africa make requested to World Trade Organization (WTO) to suspend intellectual property rights for treatments and COVID-19 vaccines, a request supported by NGOs, political organizations, and States.
A first agreement was reached between four major players in the vaccine manufacturing market (EU, USA, India, South Africa), WTO make the announces in mid-March of this year, however, it remains to convince the remaining members of the body, including IFPMA and Switzerland, a country that hosts several pharmaceutical companies, due to the unanimity rule of the WTO.
It is necessary to understand that the proposed compromise would only apply to developing countries, as well as those accounting for less than 10% of annual world exports of COVID-19 vaccines, which de facto excludes China.
New vaccines and enhancements
Vaccines development as well improve the existing vaccines is a work being carried out by the manufacturers. It should be noted that current vaccines are based on the virus known at the beginning of the pandemic, which protects against severe disease and provides a partial safeguard against variants with COVID-19 mutations.
IFPMA indicated that they are developing new vaccines and adapting existing vaccines to protect against emerging variants, as well as working on the creation of universal or multivalent vaccines, which could offer protection for COVID-19 variants, including those that have not emerged.
Vaccination in Latin America and South Asia*
The Caribbean and Latin American countries that have the highest vaccination rates are: Chile, with just over 90% of people with their first vaccination, but are closely followed by Cuba, Argentina, and Uruguay with rates above 80%. Ecuador, Peru, Costa Rica, and Brazil have already reached 70% of the vaccinated population with their first dose.
With a 60% vaccination rate, we have Panama, Colombia, Nicaragua, and Mexico. The Dominican Republic and Venezuela are around 50% vaccinated for the first time. Bolivia, Honduras, and Paraguay are around 40% of the vaccinated population, and Guatemala closes with a very low 32.5% with one dose.
Meanwhile, in Southeast and part of Southwest Asia, vaccination rates are also high at levels similar to those in Latin America, with 78% having received at least one dose. Countries such as Brunei and Singapore are above 90%, while Cambodia, Malaysia, and Vietnam are at 80% of those vaccinated with at least one dose. Thailand, Laos, and Indonesia follow with around 70% of first-time vaccines. The Philippines is at 60% and further down we have Timor-Leste with just over 50% and Myanmar with 49% with the first dose.
Sri Lanka is above 60% and India would be well above 50% vaccinated with the first dose.
*This data was collected through various portals, including WHO, AS/COA, reporting ASEAN and OWD, between March 25 and April 10.