Vaccine equity

Vials of coronavirus vaccine are seen on a counter. (Photo: Unsplash/Brano/iStock via Getty Images)

'Appalled' by Vaccine Booster Plans, WHO Chief Rebukes Big Pharma, Rich Nations

"I will not stay silent when the companies and countries that control the global supply of vaccines think the world's poor should be satisfied with leftovers," said Dr. Tedros Adhanom Ghebreyesus.

With the Biden administration expected to begin offering third doses of Pfizer's coronavirus vaccine to the U.S. public in less than two weeks despite vocal pushback from many experts, the head of the World Health Organization on Wednesday demanded a moratorium on booster shots until at least the end of the year in order to free up supply for low-income nations.

"Low- and lower-middle income countries are not the second or third priority."
--Dr. Tedros Adhanom Ghebreyesus

During his weekly press briefing, WHO Director-General Dr. Tedros Adhanom Ghebreyesus said he is "appalled" that rich nations are moving ahead with booster campaigns as billions of people across the globe lack access to a single dose. Less than 2% of people in low-income countries have been fully vaccinated against Covid-19, according to Our World in Data.

The pharmaceutical companies and wealthy countries that largely control global vaccine production "have long had the capacity to not only vaccinate their own priority groups, but to simultaneously support the vaccination of those same groups in all countries," noted Tedros, who last month called for a moratorium on boosters until the end of September.

But because "there has been little change in the global situation" since the initial moratorium recommendation, Tedros on Wednesday urged an "extension of the moratorium until at least the end of the year, to enable every country to vaccinate at least 40% of its population."

"Low- and lower-middle income countries are not the second or third priority," he continued. "Their health workers, older people, and other at-risk groups have the same right to be protected. I will not stay silent when the companies and countries that control the global supply of vaccines think the world's poor should be satisfied with leftovers."

The Biden White House and the leadership of other rich countries have thus far dismissed the WHO's call for a booster moratorium, pointing to their pledges to collectively donate more than a billion vaccine doses to poor nations that are struggling to combat the highly infectious Delta variant.

"But less than 15% of those doses have materialized," Tedros said Wednesday. "We don't want any more promises. We just want the vaccines."

Tedros' remarks came as the Biden administration faced criticism from both federal health officials and outside experts over its plan to make booster shots available in the U.S. by September 20. In a joint statement last month, administration officials recommended that people get booster shots starting eight months after their second vaccine dose. The United Kingdom, Germany, France, and Israel have also begun providing booster shots to their populations.

"It is unconscionable for the outcomes of Covid-19 to be determined simply by the country one resides in."
--Zain Chagla and Madhukar Pai

While the Biden administration originally intended to offer boosters to Pfizer and Moderna vaccine recipients in the U.S. by late September, White House chief medical adviser Dr. Anthony Fauci said over the weekend that the Moderna rollout could be delayed "as the company waits for regulators to sign off on a third dose."

"The bottom line is, very likely, at least part of the plan will be implemented, but ultimately the entire plan will be," said Fauci.

But public health experts have questioned whether there's sufficient data to justify boosters for fully vaccinated people who are not immunocompromised. Scientists have also argued that it's immoral for rich countries to widely administer third doses as so much of the world remains unprotected from Covid-19, inequity that heightens the risk of dangerous new variants emerging and spreading across the globe.

Tulio de Oliveira, a computational biologist at the University of KwaZulu-Natal in Durban, South Africa, told Science magazine last month that booster rollouts in wealthy nations are "unfair to say the least, potentially... even criminal."

In a letter to the journal Nature Medicine last week, Zain Chagla of McMaster University in Ontario and Madhukar Pai of McGill University in Montreal wrote that "since rich nations have procured a giant share of current and future doses, booster vaccination programs will mean that low-income countries will have to wait longer to get their orders fulfilled."

One recent analysis projected that the world's richest countries will have 1.2 billion extra coronavirus vaccine doses by the end of the year. Meanwhile, the WHO's Africa director warned Thursday that the continent is set to receive "25% less doses" by the end of 2021 than previously anticipated--in part due to booster campaigns in rich countries.

Chagla and Pai argued in their letter that "it is unconscionable for the outcomes of Covid-19 to be determined simply by the country one resides in."

"As more rich nations consider boosters, their local public-health communities need to wake up to the widening chasm of vaccine inequity and its devastating consequences, especially with the Delta variant ripping through populations," the pair wrote. "All of us need to look within and ask hard questions. Are we as a species willing to protect all humankind, or do we mostly care about optimizing protection for people in wealthy nations?"

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