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The problem with vaccine nationalism during a pandemic

For many people, the light at the end of the lockdown tunnel is a Covid vaccine. Multiple trials are underway with promising results and there have been suggestions that a vaccine could be rolled out as early as March next year. However, the problem is not just finding a vaccine which works but also distributing it in the fairest and most effective way.

Vaccine nationalism is a practice where countries act to protect their population often to the detriment of others. Wealthier countries will pay huge amounts of money to drug companies to ensure that when a vaccine is ready, they are the first to receive it.

The most recent time we have faced this issue was during the Swine Flu pandemic of 2009. Once a vaccine was found the USA, UK and Australia stockpiled it hoping to immunise their entire population, leaving low income countries struggling to access supplies. It took four months for other countries to receive the vaccine, and even then, it was because the richer countries had overestimated their need.

A new initiative set up by the World Health Organisation aims to fix this. Covid-19 Vaccines Global Access (COVAX), created with support from the Bill and Melinda Gates foundation, works to allow wealthier countries to support the global roll out of vaccines. They can either donate to COVAX or buy their vaccines directly thereby increasing its ability to support others.

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COVAX aims to supply two billion doses by the end of 2021, providing vaccinations to three per cent of each member country’s population in order to protect healthcare workers. After this it hopes to give a further 20 per cent to cover to the most vulnerable members, such as the elderly and immunocompromised. After this, COVAX will address the highest need, working to help halt outbreaks and aid countries who are at high risk or cannot afford the vaccines themselves.

COVAX also assists in the logistics of supplying vaccinations. Two of the leading vaccines, developed at Moderna and Pfizer, ship at -20°C and -70°C respectively. Getting these to remote areas lacking infrastructure will be a challenge. In addition, most current vaccine programs aim to vaccinate young children whereas the individuals most in need of the COVID vaccine will be elderly. Adapting these current programs will take time and a lot of money.

The UK has taken a stance somewhere in the middle between this collaborative approach and vaccine nationalism. Although they have contributed £500 million to COVAX they also have plans to stockpile 190 million doses of various vaccines in order to immunise most of the nation.

The problems with vaccine nationalism are both ethical and practical. Firstly, looking at the ethics of it, the idea that only the richest countries should have access is deeply disturbing. Many countries do not have the resources available to outbid the US or the UK for vaccines which they aren’t even sure they’ll be able to use.

In a more pragmatic view stockpiling vaccines makes little sense in a world as interconnected as our own. Governments are under immense pressure to provide a vaccine so their economies can restart but without the foreign markets many industries are still at risk. In addition, you can neither vaccinate your entire population nor can you completely stop the virus from re-entering your country.

Vaccines are based on a principle known as herd immunity. Once enough of a population are vaccinated then the pathogen is unable to spread. This means that even if the immunodeficient are unable to immediately receive the vaccine they are still protected. The process can take years, especially if more than one dose of the vaccine is required.

We are a global community and so trying to create herd immunity within just one country does not work. In South Korea, one woman who attended a church service whilst infected with COVID has been linked to over 5000 cases in the country. With social distancing and quarantines, this situation is far less likely, but still goes to show how quickly the actions of one individual can impact a country.

Initiatives such as COVAX are an exciting step forward but only time will tell if they are enough to ensure we end the pandemic globally as quickly as possible.

Image: Wikipedia Commons