WHO Calls For Moratorium On Covid-19 Booster Shots To Address Global Vaccine Inequality

On Wednesday, August 4th, World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus called on the world’s wealthy nations to delay administering booster shots of COVID-19 vaccines to their populations until vaccination rates increase in vulnerable low and middle-income countries. The more deadly, more infectious Delta variant has driven a surge in cases in many countries around the world, including so-called breakthrough infections in people who have been fully vaccinated.

In response, some wealthy countries are planning or have already begun administering third doses to certain segments of their populations, despite the lack of consensus among scientists on the effectiveness of third shots in boosting immunity. But it is in low and middle-income countries, where hundreds of millions of people are still waiting to receive their first shot, that the Delta variant poses the greatest threat. The moratorium on booster shots would last at least until September, to enable every country to vaccinate at least 10 percent of their population by that time.

“I understand the concern of all governments to protect their people from the Delta variant,” said Mr. Ghebreyesus. “But we cannot accept countries that have already used most of the global supply of vaccines using even more of it, while the world’s most vulnerable people remain unprotected.” Mr. Ghebreyesus emphasized that at this point in the pandemic, more than 80% of the 4 billion doses administered worldwide have gone to high and upper-middle-income countries.

Meanwhile, vaccine rollouts in less wealthy nations have remained painfully slow. In Africa, only about 1.5 percent of the continent’s population is fully vaccinated. In some cases, even healthcare workers and the elderly have not yet received their first dose. This has left the region particularly vulnerable to the Delta variant. On August 2nd, the WHO said that Africa had seen an 80 percent rise in deaths from COVID-19 in a single month, driven largely by the spread of the Delta variant.

Many low and middle-income countries are relying primarily on donated vaccines to immunize their populations. But the United Nations-backed COVAX program, which was created to prevent the sort of drastic vaccine inequality that is evident in the world today, is failing to distribute shots quickly enough in vulnerable countries.

So far, the program has delivered 163 million doses, mostly to low-income nations — far short of the 640 million-dose mark that the program aimed to reach by this point. While many wealthier countries have donated millions of shots to these countries (including the United States donating over 110 million doses), there is still a staggering gap in the scale of vaccine rollouts. According to the WHO, where high-income countries are now giving out vaccines within their borders at a rate of about 100 doses per 100 people, low-income countries have administered only around 1.5 doses per 100 people.

Among the countries that are already giving out booster shots or are planning to do so are Israel, Germany, France, Hungary, and Russia. The booster shots are intended to supplement immunity in the groups most at risk of serious illness and death from COVID-19. Israel is offering third doses to anyone over the age of 60. The WHO has emphasized that the moratorium on booster shots that it is urging wealthy countries to observe does not extend to immunocompromised people, who may require an additional dose to build up the same level of immunity that most people acquire from two doses.

Scientists are not yet in agreement on whether or not third doses are necessary for boosting immunity. Some data from Israel supports Pfizer-BioNTech’s claim that the protection granted by the two-dose Pfizer-BioNTech vaccine decreases slightly over time. However, the current evidence suggests that all of the vaccines are highly effective in preventing serious illness and death from COVID-19, including from the Delta variant. The unvaccinated remain by far the most vulnerable.

“We need an urgent reversal, from the majority of vaccines going to high-income countries, to the majority going to low-income countries,” said Mr. Ghebreyesus on Wednesday. The Director-General called on wealthy nations to redirect vaccines towards the most vulnerable countries, emphasizing the need for leadership from the G20, whose member nations “are the biggest producers, the biggest consumers and the biggest donors of COVID-19 vaccines.” Mr. Ghebreyesus also called on the pharmaceutical companies producing the vaccines to “prioritize COVAX.”

Unfortunately, there is little incentive for these companies to do so. It is far more profitable for vaccine producers to sell doses to wealthier countries because low-income countries pay less per dose. For this reason, Pfizer-BioNTech and Moderna have been quick to promote the purchase of doses for booster shots by wealthy governments, despite the lack of conclusive scientific evidence. Medecins Sans Frontieres has called the move “sheer profiteering on the part of pharmaceutical companies.”

As the Delta variant rages, it is the unvaccinated people of the poorest nations who are most at risk, and it is to these nations that the vaccine doses currently being secured mostly by a handful of wealthy countries must be diverted.

Present levels of vaccine inequality are not only unconscionable but also threaten to prolong the pandemic for everyone, putting the entire world at risk if new variants continue to emerge and spread. The few countries and pharmaceutical companies that control most of the global vaccine supply must be held accountable for more than just their own populations and shareholders and must step up their efforts to make vaccines available to the world’s most vulnerable people.