The case for a moratorium on booster shots

This week, the World Health Organization (WHO) called for wealthy nations to stop giving out booster shots in a push towards global vaccine equity. 

These nations should stall any booster shots until at least September, said WHO Director-General Tedros Adhanom Ghebreyesus at a press conference on Wednesday. Instead, excess vaccines should be donated to COVAX, the international vaccine distributor that aims to mitigate COVID-19 in low-income countries. When 10% of the population in every country has been vaccinated, then wealthy countries could resume administering boosters, Tedros said.

Here’s what he said at the conference (h/t Helen Branswell, STAT News):

I understand the concern of all governments to protect their people from the Delta variant. But we cannot and we should not accept countries that have already used most of the global supply of vaccine using even more of it while the world’s most vulnerable people remain unprotected.

It may seem counterintuitive for a country to not provide its citizens with extra protection when it has the means to do so. But the global numbers are staggering. About 50% of the U.S. population has now been fully vaccinated, and we have doses to spare (some of which are going to waste). Meanwhile, in most African countries, 1% or less of the population is vaccinated. This is even though vaccine demand is actually far higher in low-income nations than in the U.S.

Nature’s Amy Maxmen has a great piece unpacking this inequity. She cites a rather damning WHO analysis:

An internal analysis from the World Health Organization (WHO) estimates that if the 11 rich countries that are either rolling out boosters or considering it this year were to give the shots to everyone over 50 years old, they would use up roughly 440 million doses of the global supply. If all high-income and upper-middle-income nations were to do the same, the estimate doubles.

About 3.5 billion people in low- and lower-middle-income countries have yet to be vaccinated, Maxmen estimates. Give one dose to 10% of that number, and you use 350 million doses—less than the 440 million that rich nations would use up with boosters.

The longer that these low-income countries go without widespread vaccination, the more likely it is that new variants will emerge from their outbreaks. This is because, with every new COVID-19 case, the virus has a new opportunity to mutate. We’re already seeing Delta adapt to become even more transmissible and monitoring other potentially-concerning variants, like Lambda.

It’s unclear how much power the WHO has to enforce a booster shot moratorium, especially now that some countries (like Israel) have already gotten started on administering these extra shots. And it’s also worth noting that public health officials in the U.S. are shifting away from using “booster” to describe third shots for immunocompromised people or second shots who for those who received the one-and-done Johnson & Johnson vaccine; they say that these shots rather bring patients up to the same immunity levels as those who received two mRNA doses.

More vaccine reporting

  • We failed to vaccinate the world in 2021; will 2022 be more successful?
    In January, COVAX set a goal that many global health advocates considered modest: delivering 2.3 billion vaccine doses to low- and middle-income countries by the end of 2021. is saying it’ll deliver just 800 million vaccine doses by the end of 2021, according to the Washington Post, and only about 600 million had been delivered by early December.
  • One month into vaccinations for kids 5-11, uptake varies wildly by state
    It’s been about a month since the FDA and CDC authorized a version of Pfizer’s vaccine for children ages five to 11. Those kids whose parents immediately took them to get vaccinated are now eligible for their second doses, and will be considered fully vaccinated by Christmas. Despite widespread availability of the shots, vaccine uptake has varied wildly.
  • Omicron updates: More transmissible, immune evading, but still not cause for panic
    We continue to learn more about this new variant as it spreads rapidly across the world, though much of the data are still preliminary. Here are a few major updates, including how vaccines fare against Omicron, its rapid spread, and more.
  • Cash incentives for vaccination have little impact
    While politicians at all levels have praised cash incentives, research has shown that this strategy has little impact on actually convincing Americans to get vaccinated. A recent investigation I worked on (at the Documenting COVID-19 project and the Missouri Independent) provides new evidence for this trend: the state of Missouri allocated $11 million for gift cards that residents could get upon receiving their first or second vaccine dose, but the vast majority of local health departments opted not to participate in the program—and a very small number of gift cards have been distributed thus far.
  • Vaccines aren’t enough: What Biden can do about Omicron
    This past Monday, President Biden said in a speech, “We’re throwing everything we can at this virus, tracking it from every angle.” Which I, personally, found laughable. The U.S.’s anti-COVID strategy basically revolves around vaccines, and it’s not sufficient for stopping new surges.

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