The world’s vaccination campaign against Covid is running out of steam

In the middle of last year, the World Health Organization began promoting an ambitious goal, which it said was essential to ending the pandemic: to fully vaccinate 70% of the population of each country against COVID. -19 by June 2022.

Now, it’s clear that the world will fall far short of that goal by the deadline. And there is a growing sense of resignation among public health experts that high COVID vaccine coverage may never be achieved in most low-income countries because the funding that states United’s dire need is drying up and governments and donors are turning to other priorities.

“The reality is there is a loss of momentum,” said Dr Isaac Adewole, a former minister of health in Nigeria who is now a consultant for the Africa Centers for Disease Control and Prevention.

Only a few of the world’s 82 poorest countries – including Bangladesh, Bhutan, Cambodia and Nepal – have reached the 70% vaccination threshold. Many are below 20%, according to data compiled from government sources by the University of Oxford’s Our World in Data project.

By comparison, about two-thirds of the world’s wealthiest countries have reached 70%. (The United States is at 66%.)

The consequences of failing to achieve high vaccination coverage worldwide could be serious. Public health experts say abandoning the global effort could lead to the emergence of dangerous new variants that would threaten the world’s precarious efforts to live with the virus.

“This pandemic is not over yet – far from it – and it is imperative that countries use the doses they have to protect their people as much as possible,” said Dr Seth Berkeley, CEO of Gavi, the organization non-profit that manages the global network. COVAX Vaccine Clearinghouse.

Countries in different parts of the world, including some in Eastern Europe and the Middle East, have seen their vaccination rates stagnate in recent months at a third or less of their populations. But the vaccination rate in Africa remains the most dismal.

Less than 17% of Africans have received primary vaccination against COVID. Nearly half of the vaccine doses delivered to the continent so far have not been used. Last month, the number of doses injected on the mainland fell by 35% compared to February. WHO officials attributed the decline to the replacement of mass vaccination campaigns with smaller-scale campaigns in several countries.

Some public health experts point to reasons for optimism that the global vaccination campaign still has steam. Despite the decline from the peak in February, the number of COVID vaccinations administered each day in Africa is still close to a pandemic peak. And Gavi earlier this month attracted a major new round of funding pledges, securing $4.8 billion in commitments, although it fell short of its $5.2 billion target.

There is also hope that a global COVID summit the White House plans to co-host next month could be an opportunity to generate momentum and funding.

But declining public demand has led some health officials and experts to question quietly, and in some cases outright, whether the 70% vaccination target is achievable or even reasonable.

Reported deaths from COVID-19 remain relatively low in sub-Saharan Africa, although there is debate about the extent to which this reflects poor data tracking. The perception, however, in many countries in the region, is that the disease does not pose a serious threat, certainly not as much as other pervasive health problems that demand attention with limited health care resources.

Many low-income governments are focusing on their savings and other health issues like HIV, said Fifa Rahman, a civil society representative with a group launched by the WHO to coordinate the global response to COVID. . “There are a lot of competing priorities, but that’s a symptom of losing momentum. Because when the momentum was there, everyone said, ‘Where are our vaccines?’ »

After the WHO began promoting the 70% immunization goal, many low-income governments adopted the goal for their own populations. The Biden administration also approved it in September, setting a September 2022 deadline.

At the time, two doses of the vaccines from Pfizer and Moderna were supposed to offer very strong protection against even mild illnesses, and there was still hope that reaching high levels of vaccination coverage would tame the virus. But the emergence of new variants and the spread of the virus in Africa has changed the calculus.

The vaccine regimens that had been planned for the developing world offered little protection against infection with the omicron variant. And as countries in sub-Saharan Africa were shut out of vaccine distribution for much of last year, more Africans gained protection from the virus against natural infection, which, according to studies, works together with two doses of mRNA to prevent infection. New WHO data shows that at least two-thirds of Africans had been infected with the virus before the omicron wave.

Given these factors, some public health experts in Africa argue that the general target of 70% no longer makes sense. “There is very little value. In fact, we will gain a lot more by reaching over 90% of people over 50,” said Shabir Madhi, professor of vaccinology and dean of the faculty of health sciences at the University of the Witwatersrand in Johannesburg. About two-thirds of South Africans over the age of 50 are currently fully immunized.

Madhi said South Africa could close mass vaccination sites and increase efforts to search for the most vulnerable at church services and in government offices that pay monthly pension benefits.

Katherine O’Brien, who leads the WHO’s work on vaccines and immunizations, said the agency encourages countries to focus on its most vulnerable citizens rather than vaccinating “a random set of 70%” of their populations. The aspiration, she said, has always been “100% health workers, 100% older people, 100% pregnant women, 100% people in those high-risk groups. »

Countries can of course make decisions about which health goal they want to prioritize, O’Brien said, but limited resources shouldn’t be the barrier to vaccinating against the coronavirus. “The world has enough resources to do this, if countries want to do it,” she said. “And that really should be the North Star.”

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