As we approach the one-year anniversary of the first lockdown, vaccines are now rolling out to end the COVID-19 pandemic. This virus has taken millions of lives and destabilized economies around the world. But as we begin to see the light at the end of the tunnel, it is becoming increasingly clear that for now, only the richest countries will have wide access to the lifesaving vaccines which can bring this pandemic to an end.
Late last fall, Pfizer-BioNTech and Moderna, two large international pharmaceutical firms, officially concluded early clinical studies for their own COVID-19 vaccines. Both utilized experimental mRNA technology which relays instructions for our cells to produce a harmless “spike protein,” also found on the surface of the coronavirus. Our immune systems are then triggered to produce antibodies to fight coronavirus as soon as it is detected in the body. This is a different approach from how traditional vaccines (i.e., for rabies and the flu shot) known as inactivated vaccines perform. The traditional method introduces killed viral particles to the body’s immune system so it can produce antibodies without having to deal with the full severity of the virus. Comparatively, inactivated vaccines pose a greater risk than mRNA vaccines which do not expose the body to the actual virus at all, even if it is a weaker version.
Once clinical trial data demonstrated that the Pfizer and Moderna vaccines had high efficacy rates, both were swiftly approved by several nations for administration. However, by that point, countries like the U.S., Canada, and Bahrain had already pre-ordered hundreds of millions of doses. These countries ordered enough doses to vaccinate their population several times over, with the UK ordering 367 million doses--more than 5 times its population. These countries pre-ordered not just the Pfizier and Moderna vaccines, but also others close to concluding clinical trials in case any one of them do not deliver---a luxury smaller countries simply cannot afford.
As a result, poorer countries, with weak healthcare infrastructures, have been placed in a difficult position. The hoarding of vaccines has driven up prices, and these countries have been forced to settle for less reliable non-Western vaccines from producers not utilizing mRNA technology. The Chinese pharmaceutical company Sinovac’s inactivated vaccine CoronaVac, for example, which at time of publication has not been approved by the WHO, claimed to have a 78% efficacy rate. But in early January of 2021, Brazilian scientists at the Butantan Institute released trial data showing that number to be a little over 50% and is a little unsettling to Brazilian civilians, as the country already has 10 million doses of CoronaVac on hand. Another point of concern is that Chinese health officials never published full clinical trial data on CoronaVac as even at home, hundreds of thousands of Chinese citizens were vaccinated before it was proven safe in clinical trials.
Despite these concerns, CoronaVac will still be widely used in developing countries, like Brazil, which are struggling to curb the average tens of thousands of infections per day. This vaccine offers more logistical advantages, as Sinovac claims their vaccine can be stored in a standard refrigerator unlike the Pfizer vaccine, and promises to provide 300 million doses in a year. This makes CoronaVac more accessible to developing countries and for those who can’t afford it, China is sending them vaccine aid. Last month, 13 developing countries including Nepal, Myanmar, and the Philippines received vaccines and China promises to aid 38 more developing countries.
China has also sent its first batch of vaccines to Pakistan, symbolic of their long and strong friendship, and provided one million doses to Serbia after the “price was drastically lowered” for President Aleksandar Vucic. Through vaccine diplomacy, at arguably the most critical time of the pandemic, China is cementing its global influence whereas leaders of the Western world are hoarding vaccines.
Over the course of the next few months, the most important organization will be COVAX, an initiative co-led by the WHO which pledges to fairly distribute 2 billion doses by the end of 2021. This is a massive undertaking that requires ample funding from members and global cooperation that will most likely arrive only after the majority of developed countries in COVAX are already vaccinated. That was the case when the WHO re-launched their smallpox eradication campaign in 1967, even though it was already eliminated in North America and Europe a decade earlier. At that time, countries in South America, Asia, and Africa suffered regular smallpox outbreaks (there is still no proven treatment for smallpox) yet had little access to the vaccine until there was a strong global effort and funding to pursue investigations where cases still loomed. But unlike smallpox, the novel coronavirus is rapidly mutating with variants found all over the world that are threatening the efficacy of these vaccines.
Thus, let this be a lesson for how Western leaders should approach the next phase of the pandemic. It was widely expected that rich countries would take advantage of their financial resources to prioritize their populations. But public health measures must take into account the global nature of the crisis. If domestic efforts are not reproduced internationally, the global pandemic will not end. China realizes this and is taking advantage of the leadership vacuum left unoccupied by Western countries. Though China’s motivations may be cynical, it is clearly setting an example of how to both address the local spread of the coronavirus, and also protect its global neighbors. If wealthier countries do not adopt an international strategy to the pandemic, like China’s, we may find ourselves caught in a vicious viral cycle, in which new variant production outpaces vaccine distribution. The West needs to accept that vaccine nationalism does not equate to being safe, in fact, it places all of us in even greater danger. The time to act is now.