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Restoring Trust: Polio Vaccines in Liberia

Polio Vaccines in Liberia
After enduring a surge in COVID-19 cases during the month of June 2021, Liberia may be experiencing some relief in its battle to beat the pandemic. According to Dr. Francis Karteh, a chief medical officer in Liberia, the country’s COVID-19 cases declined in the week leading up to July 12, 2021. However, Karteh also emphasized that the Liberian people must remain diligent in their COVID-19 prevention measures. The highly contagious Delta variant may regain strength if individuals become too relaxed. Nevertheless, this news offers hope for the country’s desire to move toward reopening businesses. But, even as COVID-19 infections decline in Liberia, vaccine hesitancy persists. This distrust of vaccines does not solely apply to the coronavirus vaccine though. UNICEF is currently undertaking efforts to reassure Liberians about the safety of polio vaccines in Liberia.

History and New Vaccine Hesitancy

In 2008, Liberia declared itself a polio-free country as a result of its mass vaccination success. However, Liberia recently discovered a circulating vaccine-derived poliovirus (VDPV) strain that stems from what was originally contained in the oral polio vaccine but has evolved to behave “more like the wild or naturally occurring virus.” Consequently, VDPV is more transmittable to the unvaccinated, especially in areas with inadequate sanitary conditions.

For this reason, the eradication of the poliovirus relies on the continued vaccination of children. Unfortunately, the COVID-19 pandemic forced Liberia to halt immunization programs, and as poliovirus infections increased, in February 2021, Liberia’s Ministry of Health announced the poliovirus outbreak as a “public health emergency” for the country.

On top of this, as Liberia begins to resume its polio vaccination operations, individuals are more hesitant about the polio vaccines. Following a year of COVID-19 vaccine misinformation circulating the globe, many Liberians wonder if one can trust any vaccine. Comfort Morphe, a midwife at Hydro MERCI Clinic, says she can “feel the weight [of the misinformation].”

Additionally, Mohamed Shariff, a teacher in the Liberian city of Monrovia, said that the campaign for polio vaccines in Liberia has had to evolve since there have been “so many refusals.” Many find the polio vaccine hesitancy peculiar since Liberia has “been using [the poliovirus vaccine] for years.” With vaccine uncertainty festering throughout the country, it is more challenging to quell the current rise in poliovirus infections.

UNICEF Partnership

Fortunately, in an effort to reduce vaccine hesitancy, UNICEF is partnering with Liberia’s Ministry of Health to communicate factual polio vaccine information through “radio talk shows, community engagement meetings, SMS” as well as posters and banners. The use of SMS notifications is especially beneficial since some communities in Liberia do not have stable internet access.

Volunteers also use the door-to-door approach to speak with parents on the importance of vaccinating children. Ummu Paasewe, for example, who works for Liberia’s Ministry of Health as a community mobilization officer, described how her team assures mothers that the vaccine is “the same kind of oral polio vaccine but more advanced” to combat this specific variation of the poliovirus. As a mother herself, Paasewe’s children are vaccinated and she contends that “immunization is a preventative method.”

Looking Forward

Other countries also see the benefits of supporting Liberia’s vaccination efforts. The Japanese government has supplied UNICEF with $2.7 million since 2020 to support women’s and children’s health in Liberia. Moreover, one of the Japanese government’s chief objectives is to get Liberians vaccinated against the poliovirus and COVID-19.

UNICEF representative to Liberia, Laila Omar Gad, stated that “just one child affected by polio is a risk to all children.” However, UNICEF volunteers remain optimistic and report that they have convinced many Liberian families about the polio vaccine’s safety and reliability. Through the dedication of Liberia’s Ministry of Health and support from UNICEF and Japan, vaccinating communities against the poliovirus looks to be an achievable goal.

– Madeline Murphy
Photo: Flickr

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Serbia’s Cash Incentives Encourage Vaccinations

Serbia’s cash incentivesIn May 2021, Serbian President Aleksandar Vučić announced a new incentive for Serbians to get their COVID-19 inoculations: cash payments. Each fully vaccinated person would receive 3,000 Serbian dinars, equivalent to about $30 in the United States. The policy, aimed at incentivizing Serbs to get vaccinated, may also play a major role in reducing poverty in Serbia. Serbia’s cash incentives to encourage vaccinations have inspired other countries to follow suit with similar strategies.

Poverty in Serbia

Serbia is one of Europe’s most impoverished countries. In 2017, the poverty rate stood at 19.30%. In 2020, the unemployment rate was around 9%, a drastic decline from its peak of 24% in 2012. Poverty rates are particularly high in the rural and southern regions of the country. In an environment of widespread poverty, $30 is a significant incentive that “equates to around 5% of the country’s average monthly salary.”

How Cash Incentives Can Reduce Poverty

Serbia’s cash incentives could be an effective way of reducing poverty. A 2019 study in Kenya showed that cash transfers to impoverished families had a significant impact not only on the recipients but on the entire local community. The study found that each dollar of aid increased economic activity in the region by $2.60. President Aleksandar Vučić’s cash incentives might provide a similar economic boost in Serbia’s cash-poor economy.

Cash Payments Boost Vaccination Rates

The advantages of Serbia’s cash incentives are far-reaching. By providing a strong monetary incentive, the Serbian government increased the number of people who chose to get vaccinated. The public health benefits of a vaccinated country are obvious, but a vaccinated county will also boost Serbia’s economy. Economists universally agree that vaccination programs will add billions of dollars to the global economy within the next few years.

The World Economic Forum states that by ending the pandemic, “10 major economies could be $466 billion better off by 2025.” With vaccinations, workers will be able to resume their everyday jobs, businesses can reopen and the economy can flourish. Greater wages will mean greater prosperity for everyone. Due to these economic benefits, Serbia’s vaccination program will likely pay for itself many times over.

Cash Payment Successes

Serbia’s cash incentive strategy may already be paying off. As of August 4, 2021, almost 40% of Serbia’s population is fully vaccinated, significantly more than the majority of Serbia’s Balkan neighbors. Neighboring Bosnia and Herzegovina has only a 7% vaccination rate, and Bulgaria, only 15%. Perhaps these countries, both of which have their own poverty problems, would benefit from Serbia’s vaccination strategy.

Serbia is not the only country to offer rewards for COVID-19 inoculations. In neighboring Romania, Bran Castle offered visitors free admission if they came to receive their shots. Additionally, the U.S. state of West Virginia offered $100 awards to anyone getting a vaccine. Vaccination will allow an individual entry into lotteries where participants will have the chance to win cars, scholarships and even a million-dollar grand prize.

Serbia’s program, however, is one of the first and most ambitious programs to encourage COVID-19 vaccinations. With a cash incentive strategy, Serbia demonstrates how a single action can provide several benefits, reducing poverty at the same time.

– Thomas Brodey
Photo: Flickr

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The Bosnia and Herzegovina Vaccine Rollout

Bosnia and Herzegovina Vaccine Rollout
The impact of COVID-19 on poverty in Bosnia and Herzegovina has been quite profound. The country has been experiencing a severe recession, the worst in 25 years. Due to government borrowing in an effort to ease the strains stemming from the crisis, the national debt has soared. As a result, the Bosnia and Herzegovina vaccine rollout has been slow because its government has been unable to afford vaccines.

However, due to Russia, China and Europe providing donations, the country has received a large number of vaccines. On top of this, overseas organizations such as the United Nations High Commissioner for Refugees (UNHCR) have been continuing to advocate for Bosnia and Herzegovina’s most vulnerable citizens.

The Lack of Purchase

In stark contrast to neighboring Serbia’s successful vaccine rollout, Bosnia and Herzegovina has not bought a single vaccine. Due to a disorganized government and the impact of a steep recession, the country has been relying on donations. The impact of COVID-19 on poverty in Bosnia and Herzegovina has prevented the nation from organizing a rollout of its own, thus endangering its citizens.

Pilgrimage to Serbia

Because of the slow vaccine rollout in Bosnia and Herzegovina, many Bosnians have migrated to neighboring Serbia, which has had an exponentially more successful vaccine rollout, to receive their vaccine. This is particularly striking because of the tensions between the two countries. The Serbian President Aleksandar Vučić is well-known for downplaying the Srebrenica genocide, which took place in 1995. This was during the Yugoslavian wars of independence and took the lives of many Bosnian Muslims.

Donations are Keeping the Country Afloat

Because of the impact of COVID-19 on poverty in Bosnia-Herzegovina, the country has been relying on large donations from countries that are further into their vaccine rollout than Bosnia and Herzegovina. After initial donations from Russia and China, the E.U. provided vaccines to Bosnia and Herzegovina. This also included Albania, North Macedonia, Kosovo, Montenegro and Serbia, with 651,000 doses of BioNTech-Pfizer vaccine in April 2021. In June 2021, Austria committed to donating 1 million doses of mainly AstraZeneca vaccine to the Western Bulkan bloc.

The UNHCR Advocate for the Vaccination of Asylum Seekers

While the Bosnian government is reluctant to vaccinate its population of refugees and asylum seekers, the United Nations High Commissioner for Refugees (UNHCR) continues to advocate for the vaccination of those within the country without international protection. Previous successes have been seen in Serbia where the UNHCR has managed to vaccinate a large number of refugees, with 53 having their vaccine on the first day of operations.

The Future

Despite the crushing impact that the recession has had on the vaccine rollout, with international collaboration the future is looking brighter for the population of Bosnia and Herzegovina. With organizations such as UNHCR advocating for the nation’s most vulnerable, few will slip through the cracks in the vaccine initiative.

– Augustus Bambridge-Sutton
Photo: Flickr

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AstraZeneca’s Role in the Global Vaccination Effort

AstraZeneca's Role in the Global Vaccination EffortThe Oxford/AstraZeneca vaccine made many controversial headlines in mid-March 2021 because of a suspected link between it and a rare and sometimes fatal blood clot that forms in the brain. However, the AstraZeneca vaccine will be a crucial part of the global vaccine rollout effort. Not only is it a safe and effective vaccine approved by the World Health Organization (WHO), but it may also be the best candidate to vaccinate the world’s most vulnerable populations in developing countries. AstraZeneca’s role in the global vaccination effort is key in ensuring the global eradication of COVID-19.

The Science Behind the AstraZeneca Vaccine

The AstraZeneca vaccine is around 70% effective against COVID-19 with some studies suggesting it can be up to 90% effective. Although it is less effective than the Pfizer and Moderna vaccines, it is still more effective than what many experts anticipated any vaccine would be.

In mid-March, some European countries paused the AstraZeneca vaccine rollout based on claims that it caused a rare blood clot. A lack of evidence led every country to resume production and use of the vaccine. Out of 11 million people who received the AstraZeneca vaccine in the U.K., five people reported developing this blood clot. Though there has been no sufficient data to suggest any correlation, British officials and the European Medicines Agency (EMA) will continue to monitor the vaccine in case of other side effects.

Because of its effectiveness against COVID-19, the AstraZeneca vaccine has joined the ranks of other WHO-approved vaccines, like Pfizer and Moderna. Here are some reasons why AstraZeneca is better than other vaccines in leading global vaccination efforts.

Benefits of AstraZeneca

  • Cost: The AstraZeneca vaccine will not be marked up. This means it will cost less than $5 per dose. By contrast, the Pfizer vaccine is $20 per dose, and the Moderna vaccine is around $35. This makes the Oxford/AstraZeneca vaccine a more feasible option for developing countries with limited funds.
  • Temperature: The AstraZeneca vaccine does not need to remain at the astronomically low temperatures the Moderna and Pfizer vaccines require. Instead, it can stay at standard refrigeration levels for months. Thus, for developing countries, which often lack the distribution infrastructure and/or are very hot, the AstraZeneca vaccine is the ideal option.
  • Commitments: Oxford/AstraZeneca has already promised it will provide the developing world with more than a billion doses of the vaccine. Of that, 300 million vaccines will come through the WHO’s COVAX initiative. While Moderna has recently joined the COVAX initiative, the bulk of its agreement of 500 million doses will not be distributed until 2022. Pfizer has joined Oxford/AstraZeneca in the COVAX initiative.
  • Production: A major barrier to widespread vaccine rollout is that countries and companies often lack the infrastructure or ability to produce the vaccines fast enough. The solution would be for vaccine companies to relinquish intellectual property (like patents) to let others produce generic versions. Unlike other WHO-approved vaccines, AstraZeneca has shared its patent information with manufacturers in some low-income/developing counties that need the vaccine desperately, like India and Brazil.
  • Current events: In mid-February, COVAX supplied 600,000 AstraZeneca vaccines to Ghana. As of the beginning of March, Cote d’Ivoire also received and began rolling out approximately 500,000 vaccines from COVAX. The initiative is using AstraZeneca because it can be kept at a temperature that makes it a simpler vaccine to distribute. The AstraZeneca vaccines given to these two countries came from a factory in India.

Why is it Important to Vaccinate the World?

Developed countries cannot focus only on their own vaccination efforts and neglect the needs of low-to-middle-income countries. If vaccines do not reach developing countries effectively and quickly, these countries will face even more severe economic distress. This will worsen inequality between wealthy and impoverished nations. Until developing countries have significant access to vaccines, the global economy will lose around $150 billion in output every year. AstraZeneca’s role in the global vaccination effort is essential in ensuring this does not happen.

Additionally, many epidemiologists argue that developing countries must receive substantial amounts of the vaccine at the same time as wealthier countries for the global rollout to be the most successful. Otherwise, the virus will continue to spread and mutate, leaving the vaccine efforts in developing countries to be less effective.

President Biden recognizes that the U.S. population will not be safe from the pandemic if people in developing countries are not protected. Following this, Biden has promised that any surplus vaccine doses will go to developing counties. AstraZeneca’s role in the global vaccination effort is essential in ending the global pandemic and ensuring safety for all nations.

– Elyssa Nielsen
Photo: Flickr