LOS ANGELES - As many as 60 countries, including some of the world’s poorest, might be stalled at the first shots of their coronavirus vaccinations because nearly all deliveries through the global program intended to help them are blocked until as late as June. That’s a problem that could threaten the progress made in developed countries that have vaccinated larger portions of their populations — including the United States, experts say.
On April 9, the head of the World Health Organization slammed the "shocking imbalance" in global COVID-19 vaccination. WHO Director General Tedros Adhanom Ghebreysus said that while one in four people in rich countries had received a vaccine, only one in 500 people in poorer countries had gotten a dose.
In an April 6 interview with FOX TV Stations, Dr. Anthony Fauci, the nation’s top infectious disease expert, pushed the importance of getting as many people in vaccinated as possible — not just in the U.S., but around the world.
COVID-19 variants place everyone at risk, even if the developed world is vaccinated
Fauci explained that while vaccinating the majority of the U.S. is an important goal, the longer the novel coronavirus is allowed to spread and replicate, the greater the chances more transmissible and more deadly variants could emerge.
The possible emergence of coronavirus variants capable of evading immunity imparted by COVID-19 vaccines would put the chances of herd immunity at risk and prolong a devastating ongoing pandemic.
"If we suppress it in the United States or in the developed world, that’s going to be great," Fauci said. "Now, this brings up an important question: As long as you have virus replicating anywhere in the world, the chances of developing variants are considerable, which will ultimately come back and could perhaps negatively impact our own response. That’s one of the real prevailing arguments for why we need to make sure the whole world gets vaccinated – not just the people in the developed world."
According to the International Rescue Committee, COVID-19 cases and deaths last month surged in numerous crisis-hit countries: by 322% in Kenya, 379% in Yemen and 529% in northeast Syria.
COVAX, the global initiative to provide vaccines to countries lacking the clout to negotiate for scarce supplies on their own, has in the past week shipped more than 25,000 doses to low-income countries only twice on any given day. Deliveries have all but halted since April 5, the Associated Press reported.
During the past two weeks, according to data compiled daily by UNICEF, fewer than 2 million COVAX doses in total were cleared for shipment to 92 countries in the developing world — the same amount injected in Britain alone.
Earlier this month, the WHO appealed to rich countries to urgently share 10 million doses to meet the U.N. target of starting COVID-19 vaccinations in every country within the first 100 days of the year. So far, countries have pledged hundreds of millions of dollars to COVAX. But there are simply no doses to buy, and no country has agreed to immediately share what it has.
Bilateral donations of doses tend to go along political lines, rather than to countries with the most infections, and they aren’t nearly enough to compensate for the goals that COVAX has set out. Think Global Health, a data site managed by the Council on Foreign Relations, identified 19 countries that have donated a total of 27.5 million doses to 102 nations as April 8.
Variants vs. vaccines
But even though Fauci believes the U.S. hasn’t lost the race to vaccinate its own population, he is still concerned about mutated strains of the coronavirus circulating around the world.
Two new studies on the B.1.1.7 coronavirus variant that first emerged out of the U.K. and is now the dominant strain circulating throughout the U.S. found an increased viral load within the variant, suggesting that it is much more transmissible than the original strain of the novel coronavirus that first caused the worldwide pandemic.
So far, there has been no evidence to suggest that the current COVID-19 vaccines won’t work against the B.1.1.7 variant.
Still, more deadly mutations of the novel coronavirus like the variant that emerged out of South Africa and one out of Brazil are keeping medical experts on their toes.
A laboratory study from Pfizer Inc-BioNTech published in February suggested that the company’s current COVID-19 vaccine may generate a significantly less robust antibody response against the South Africa variant of the coronavirus.
According to the in-vitro study published in the New England Journal of Medicine (NEJM), lab results "indicated a reduction in neutralization," of the virus.
Researchers analyzed blood from people who had taken the Pfizer coronavirus vaccine and identified a two-thirds reduction in the level of neutralizing COVID-19 antibodies to the South Africa variant. This was compared with the most common variant of the virus prevalent in the U.S.
"It is unclear what effect a reduction in neutralization by approximately two-thirds would have on BNT162b2-elicited protection from Covid-19 caused by the B.1.351 lineage of SARS-CoV-2," researchers wrote.
Despite the results of the in vitro lab test, the company said that there is still no clinical evidence from human trials that the South African mutation reduces the overall protection of the vaccine.
Research published in March on the worrisome COVID-19 mutation that exploded in Brazil seems to suggest what scientists have feared: The variant, known as P.1, appears to spread more easily and appears more capable of reinfecting those who have already recovered from previous bouts of COVID-19.
The findings showed that the P.1 variant drove the second wave of COVID-19 infections in Manaus, Brazil — the same Amazon region already devastated by a first wave in the spring of 2020.
The researchers estimated that P.1 is somewhere between 1.4 and 2.2 times more transmissible than other lineages of the novel coronavirus.
An added complication in the effort to vaccinate much of the population to put an end to the health crisis is the emergence of COVID-19 mutations and how they play a role in whether or not booster shots for coronavirus vaccines will be necessary.
Both Moderna and Pfizer have published research saying their two-dose vaccines protect people up to six months after getting their second shot.
But the effectiveness of existing vaccines against emerging variants is not guaranteed.
The CEO of Pfizer said during a televised interview Thursday that people will "likely" need a third dose of the COVID-19 vaccine. Albert Bourla told CNBC that the booster shot would likely need to be administered within 12 months of getting fully vaccinated and that, possibly, every year.
Moderna’s Chief Medical Officer Tal Zaks also said the company should be able to provide booster shots for protection against COVID-19 variants and mutations by the end of this year, Reuters reported last week.
Speaking during a program for the Economic Club of New York, Zaks said the booster shots Moderna is testing show a confident level of protection against coronavirus variants, according to Reuters.
Unequal access to effective vaccines could prolong the pandemic for ‘several more years’
Poorer countries don’t have equal access to Pfizer and Moderna’s vaccines, which are currently the most effective against COVID-19.
Internal WHO documents obtained by the AP show the uncertainty about deliveries "is causing some countries to lose faith in the COVAX (effort)." That is prompting WHO to consider speeding up its endorsement of vaccines from China and Russia, which have not been authorized by any regulators in Europe or North America.
The WHO documents show the U.N. agency is facing questions from COVAX participants about allotments in addition to "uncertainty about whether all those who were vaccinated in round 1 are guaranteed a second dose."
WHO declined to respond specifically to the issues raised in the internal materials but has previously said countries are "very keen" to get vaccines as soon as possible and insisted it hasn’t heard any complaints about the process.
Concern over the link between the AstraZeneca shot and rare blood clots has also "created nervousness both around its safety and efficacy," WHO noted. Among its proposed solutions is a decision to "expedite review of additional products" from China and Russia.
WHO said last month it might be possible to greenlight the Chinese vaccines by the end of April.
Some experts have noted that Sinopharm and Sinovac, two Chinese-made vaccines, lack published data, and there are reports of people needing a third dose to be protected.
"If there is something that we miss from not having thoroughly evaluated the risks of serious adverse events from these vaccines, that would undermine the confidence in all the good products that we’re using that we know are safe," said Dora Curry, director of health equity and rights at CARE International.
Other experts worried that delays could erode faith in governments that were particularly efficient in their vaccination programs and were counting on second doses soon.
"In the absence of high vaccination coverage globally, we risk dragging out the pandemic for several more years," said Lavanya Vasudevan, an assistant professor at Duke University’s Global Health Institute. "Every day that the virus is in circulation is an opportunity for it to mutate into a more deadly variant."
The Associated Press contributed to this story.