As Omicron fades into the background, most of the world’s higher income countries are returning to “normal.” Nations like the UK, Switzerland, and Denmark are dropping mask mandates and lifting restrictions on events. There is also a body of evidence claiming that Omicron was never a big deal in Africa.
Overall, the world is starting to sense that with mass vaccination, as well as better treatments for severe cases, COVID-19 is shifting to become endemic. However, many scientists warn that any sigh of relief is premature, particularly because most developing countries are still under-vaccinated.
The vaccine equity gap is significant. Approximately the same number of people in the UK have had their third vaccine (just over 19 million) as the number in low income countries (LICs) who’ve been fully vaccinated (19.9 million). This, despite massive discrepancies in population size. In high income countries, 71% are fully vaccinated, compared with just 4.8% in LICs and 37% in lower middle income (LMIC) countries.
Plugging the vaccine gap could prove to be critical.
The risks of failure are high
As long as global vaccination levels lag, health authorities emphasize, the pandemic isn’t over. High infection rates anywhere in the world risk giving rise to another variant that’s more transmissible, more deadly, and/or more effective at escaping vaccines. The Delta variant, which began during the spike of April and May 2021, is a bitter case in point.
“As long as there are areas of the world where the virus could be evolving, and new mutants arriving, we all will be susceptible to these new variants,” says Glenda Gray, CEO of the South African Medical Research Council.
COVID vaccines are, unfortunately, prey to the law of diminishing returns. Health leaders point out that giving someone in Africa their first or second shot protects someone in America far more than giving the American yet another booster, so now is the time to close the vaccine equity gap.
Here are five steps we can — and must — take to get global vaccination done.
1. Increase vaccine supply
Although the supply of vaccine doses to LICs and LMICs increased drastically by the end of 2021, experts warn that it’s not enough. Most donated vaccines use an inactivated version of the virus that has proven to be less effective than Pfizer and Moderna’s mRNA vaccines.
To vaccinate the world with mRNA, we need another 15 billion doses over and above the 7 billion planned for 2022. People are calling for pharma companies to waive IP protection on their vaccines and share the technology, so that they can be produced in more parts of the world.
Currently, mRNA vaccines are only manufactured in Europe and North America. But Human Rights Watch made a list of 100+ companies in Africa, Asia, and Latin America that could make mRNA vaccines, if Pfizer and Moderna shared the technology and information. Ramping up mRNA vaccine production capability should be top of the to-do list.
2. Improve cold chain facilities
Ramping up vaccine supply is only the tip of the iceberg. As the non-profit organization COVID Global Accountability Platform points out, large-scale vaccination requires significant cold chain capabilities, distribution plans, a vaccinator workforce, data infrastructure, and public education and communication.
Cold chain facilities are especially important for many developing countries, which have large populations living in areas that are difficult to reach.
When vaccines are stored correctly, it prolongs their shelf life, and when health providers have insight into conditions, it reduces the risk that doses could be discarded before their actual expiration date.
Logistics data startup Logmore offers reliable conditions monitoring using QR codes, for example, which can be read through any smartphone. The system delivers real time data about vaccine temperature, location, shocks, and other conditions without requiring expensive equipment, ensuring full confidence in vaccine safety.
3. Upgrade public health data systems
Few LICs and LMICs have a robust digital health data system, which makes it difficult to schedule appointments and track how many people have been vaccinated. But countries are rapidly bridging the gap, either by developing their own open-source platforms, or turning to software companies for help.
India produced CoWIN, an open-source website that invites Indians to book an appointment and download their vaccination certificate, allows health providers to manage vaccine stocks and track workflows, and enables health authorities to track the vaccination drive.
Other countries are adopting vaccination management platforms by Google or Microsoft.
4. Ensure funding for vital supplies
Improving access to funding for these vital vaccine supplies is another leg in the global vaccine drive. LICs often lack funds for basic supplies to administer vaccines, like syringes, alcohol swabs, and vials.
It’s predicted that by the end of 2022, there’ll be a global shortfall of between one and two billion syringes. It’s vital to make sure that the developing world doesn’t suffer disproportionately from this lack.
Many healthcare systems don’t have enough healthcare workers to deliver COVID-19 vaccines, which are relatively complicated to administer and require specific training, so they also need funds to recruit, pay, and train more vaccinators.
As Dr. William Moss, executive director of the internal vaccine access center at Johns Hopkins Bloomberg school, observes, “It’s a lot harder to get funds donated to invest in the primary healthcare system, the vaccine delivery chain, or the transportation. All those are less appealing to outside donors and funders, but they’re critically important.”
5. Combat anti-vaccine disinformation
Finally, there’s an enormous need to overcome vaccine hesitancy and outright anti-vax propaganda.
Anti-vaxxers are plaguing every country in the world, but many developing countries have particularly low levels of trust in authorities, increasing the likelihood that people there will believe the vaccine disinformation that they access through their phones.
It’s vital to run effective public health campaigns to build trust in the vaccines. Health authorities can and should forge partnerships with local religious and community leaders, as well as with large local employers who can encourage employees and may have useful insights into the local consumer mindset.
Fast action today can prevent the Omicron of tomorrow
Omicron may be falling, but we don’t have to sit back and wait for the next variant to hit us in the face. If we take advantage of the post-Omicron drop to increase funding for vital vaccine supplies, improve cold chain facilities, health data systems, and vaccine supply, and move proactively to counter vaccine hesitancy, the next variant could be the last.
