A pandemic Within a pandemic: Vaccines, access and resources

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Low-and middle-income countries are looking for vaccination options for their people but resources are scarce and many societies do not have the structures in place to use many of the vaccine candidates such as Pfizer and Moderna. Photo by RF._.studio from Pexels.

For many, the time they have eagerly anticipated for months has finally arrived: Our family and friends are receiving the COVID-19 vaccine, replacing fear with hope and allowing people to slowly ease into small social gatherings that have been taboo for a whole year. Governor Lamont has moved up the schedule for vaccination in Connecticut, allowing teenagers, who are generally at lower risk of severe illness, to register for inoculation as soon as early April. Even with these trends, citizens in Connecticut, the United States, and those in more affluent countries are becoming impatient as they wait for their turn. While it is hard to view this position as one of privilege, there are 130 countries that, according to UNICEF, have “yet to administer a single dose”.  

There are 2.5 billion people behind that statistic.  

Low-and middle-income countries are looking for vaccination options for their people. However, resources are scarce and many societies do not have the structures in place to use many of the vaccine candidates. For example, some low-income countries do not have the resources to refrigerate vaccines at the low temperatures some, such as the Pfizer and Moderna vaccines, require. 

In addition, some of the vaccines these countries have ordered may not be as effective against the newer variants of COVID-19. South Africa has recently announced that it will be delaying the start of its vaccination programs due to a small study that showed that the AstraZeneca vaccine has not prevented mild and moderate infections. Around 90% of the COVID-19 cases in South Africa are caused by the novel B.1.351 mutant. This variant has also been found (in much lower levels) across the globe. 

The AstraZeneca vaccine had appeared to be a desirable option for low-income countries: It is relatively cheap, does not need to be kept at low temperatures and is produced all over the world. South Africa plans to replace AstraZeneca vaccines with Johnson & Johnson. Some countries, such as Bangladesh and El Salvador, have only secured contracts with AstraZeneca and do not have any access to alternatives outside the doses they hope to receive from the COVAX program, which is acquiring vaccines to distribute across 190 different economies.  

Latin American countries are resorting to Sinovac, a vaccine with only 50% efficacy. Sergio Litewka, a professor of surgery and ethics at the University of Miami, claims that the countries “say, well, at least 50% is better than nothing”

Other countries have resorted to solutions with cryptic scientific backing. For example, Argentina has been distributing the Sputnik V vaccine from Russia without even seeing data to back up claims of safety or efficacy. Indeed, it was “given the green light … before any significant data about Phase 3 clinical trials for the inoculation had been made public”

Desperation can be an empowering force. However, if there is a risk associated with cheaper vaccine candidates there could be drastic, almost immediate negative consequences that would disproportionally impact less affluent countries. Preventing this is not only the responsibility of government officials in these countries, but also officials from around the world. Clear humanitarian reasons aside, we are in this pandemic together. If one area of the world is struggling to manage the virus, it will have more chances to mutate and there will be a greater chance of developing a new variant that is resistant to vaccines, more transmissible and/or more lethal. Class disparities are no longer an issue of ethics alone; we can simply not afford them if we are to return to a world that is not dominated by COVID-19. 

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