After a difficult start in spring 2021, high-income countries are seeing their citizens vaccinated against the deadly COVID-19 virus in huge numbers. Canada, for example, has fully-vaccinated some 55 percent of the country, leading the world in vaccine coverage, while in the U.S., a total of 56 percent are fully or partially vaccinated. Comparing that to the global population, 87 percent are not yet fully vaccinated, and a mere 1.1% of people in low-income countries have received at least one dose.
A group of expert panelists from around the globe laid out this global vaccine inequality in a virtual gathering July 21 entitled, “The Road to Equitable Vaccinations for COVID-19 in Global Settings.” On the agenda: discussing the current pandemic outlook and giving recommendations on how leaders can make the biggest impact towards halting the pandemic. BC Children’s Hospital’s Centre for International Child Health and Healthy Starts team at the hospital’s Research Institute hosted the online panel and discussion session.
While Canada leads worldwide in its population largely vaccinated against COVID-19, most countries' citizens around the globe remain un-vaccinated (pictured: Dr. Catherine Hankins) (photo: Tamara Dudley)
Ethical considerations in immunizing children in high-resourced settings kicked off the program, along with the “how” of enabling vaccine access for large unvaccinated populations in low- and middle-income countries. The panelists expressed anger and frustration at the lack of progress in most nations. Dr. Catherine Hankins, co-chair of the Canada COVID-19 Immunity Task Force and McGill University professor of Public and Population Health, said the pandemic represents the “biggest failure in global solidarity we’ve seen yet.” Only one-eighth of healthcare workers around the world are fully vaccinated, she noted.
“Our successes are almost directly because the rest of the world is yet to get adequate vaccination coverage,” said Dr. Srinivas Murthy, clinical associate professor in the Department of Pediatrics at the University of British Columbia and critical care specialist and investigator at the BC Children’s Hospital. Dr. Murthy is a pandemic preparedness research chair, specializing in pandemic clinical research infrastructure. “Our 80 percent is only possible because only one percent of the world in low-income countries can get vaccines.”
Said Safura Abdool Karim, senior researcher at the University of Witwatersrand, South Africa, and a member of the African Vaccine Delivery Alliance: “Less than 1.1 percent of all people living in low-income countries have been vaccinated. That is something to pause and reflect on when we see coverage rates in excess of 70 percent in wealthier countries." She further addressed the sparse coverage of vaccine coverage in the African region, noting, “That is not an accident; that is global health inequities made manifest.”
“Many of the region’s countries that have achieved higher vaccination rates have done so without vaccines such as Pfizer or Johnson & Johnson, but with vaccines that are not as effective,” Karim said, referring to a roughly 9 percent vaccination rate in South Africa. “That is what was offered and available to be sold to us. We’ve seen a lot of high breakthrough rates, and the vaccines have not been effective against newer variants.”
Dr. Manish Sadarangani, associate professor in UBC's Department of Pediatrics, director of the Vaccine Evaluation Center and investigator at BC Children’s Hospital Research Institute, moderated the event. Some 70 participants tuned in to listen and debate with panelists Karim; McGill's Dr. Hankins; Dr. Murthy of BC Children’s Hospital; and Public Health Agency of Canada Public Health Ethics Consultative Group Member Dr. Maxwell Smith, also assistant professor at Western University’s Faculty of Health Sciences and co-director of the Health Ethics, Law and Policy Lab.
The panel reflected on calls to action for global leaders, with top recommendations including:
- Global solidarity and investment in pandemic measures
>Dr. Hankins shared a report from the International Monetary Fund predicting a requisite $50 billion investment globally in pandemic measures estimated to have a $9 trillion return by 2025.
- Strengthening healthcare systems in low- and middle-income countries, including manufacturing capabilities for vaccines and Personal Protective Equipment, to reduce the need of relying on high-income countries
>“Global inequity to access around medicine and biotechnology is not a new problem," Karim said. "This pandemic has exposed a systemic problem and if we don’t address it, it will continue being the problem moving forward.”
- Strategic slowing of vaccinations in certain populations in high-income countries to share with low- and middle-income countries
>“What sacrifices are we willing to make in order to address these inequities?" asked Dr. Smith. "One might be slowing vaccinations in certain populations in our own countries to share with other countries… We need a very clear strategy about how we will vaccinate the rest of our population while sharing our vaccines with rest of world.”
- Honouring COVAX contracts before bilateral deals
>“Canada needs to pressure manufacturers to honor COVAX contracts before ours as vaccines become available," said Dr. Hankins. "Donate all possible doses now, before September, in a race against Delta [COVID-19 variant]. We need to make this investment now. It is absolutely critical.”
Canadians can #GiveAVax by donating to UNICEF Canada’s fundraising campaign. The Government of Canada will match donations made by September 6, 2021 by up to $10 million.
Concepts from "The Road to Equitable Vaccinations for COVID-19 in Global Settings" panel discussion (infographic: Shazmeen Omar)
Read more on BC Children’s Hospital global health.
Watch video clips from the panel.
Top to bottom, left to right: Dr. Srinivas Murthy, Dr. Catherine Hankins, Dr. Manish Sadarangani; Dr. Maxwell Smith, Safura Abdool Karim (photo: Tamara Dudley)