Vaccine Equity
Vaccine equity is important when it comes to distributing COVID-19 vaccines within different parts of the world. Some global initiatives plan on reaching out to many communities by spreading the importance of getting a COVID-19 vaccine. Additionally, other factors exist that one should consider when it comes to the importance of promoting vaccine equity.

COVAX Initiative

The purpose of the COVID-19 Vaccines Global Access Facility, also known as COVAX, is to promote vaccine equity by increasing the availability of vaccines globally. COVAX’s main focus is on providing vaccines to citizens of many countries between now and the rest of 2021. This includes prioritizing countries that would benefit from receiving free vaccines. While working with organizations such as the World Health Organization (WHO) and UNICEF, COVAX will receive enough support to ensure that more people will contribute to improving vaccine access.

Voices for Vaccines

The goal of one global challenge is to expand information regarding COVID-19 vaccines around the world. In collaboration with the Nursing Now Challenge Global Solutions Initiative, the Voices for Vaccines challenge encourages healthcare workers to spread awareness about COVID-19 vaccines and help improve vaccine equity. Anyone who applies will be able to share experiences they have had with other patients, along with sharing their personal knowledge. This challenge will also give workers the opportunity to have open discussions about the importance of promoting equal access to vaccines.

Intrepid Travel’s Vaccine Equity Campaign

One company recently came up with a plan to promote vaccine equity in different parts of the world. One of the things Intrepid Travel’s campaign focuses on is increasing the availability of COVID-19 vaccines. This will occur by informing people about COVID-19 vaccines and expanding access to improve access to vaccines. A donation from the Intrepid Foundation will also go towards supporting the cause. Some places such as Peru and Sri Lanka have provided transportation and hosted informational sessions to help increase people’s access to vaccines.

Other Ways to Increase Vaccine Equity

 One fact that one should consider when it comes to increasing vaccine equity is the creation process of COVID-19 vaccines. The process of tech transfer makes it more difficult for manufacturers to prepare vaccines due to supply, leading countries that need more vaccines to lose access to them. Some forms of technology can help increase the availability of needles and other important items. Companies choosing to work together will be helpful in promoting vaccine equity and saving lives.

The COVAX initiative plans to prioritize expanding access to COVID-19 vaccines and help improve access to vaccines. The Voices for Vaccines challenge is a way to encourage health care workers to emphasize the importance of receiving vaccinations. Intrepid Travel’s vaccine campaign focuses on eliminating barriers to vaccine access. Focusing on where vaccines go after manufacturers create them can have a positive impact on vaccine equity.

– Chloe Moody
Photo: Wikipedia Commons

Vaccination Campaign in Kenya
Due to COVID-19, routine vaccination campaigns came to a halt in several developing countries. As a result, there were several outbreaks of other diseases, including rubella and measles. Measles is a highly contagious virus, and while it is preventable with a vaccine, it can lead to severe complications, and even death, if an individual goes unvaccinated. The pandemic offset vaccination campaigns in more than 40 countries in both 2020 and 2021, which “increases the risk of bigger outbreaks around the world.” One of the countries impacted by delayed immunizations is Kenya. However, the new measles and rubella vaccination campaign in Kenya that started in June 2021 may save the lives of millions of infants and young children.

Vaccination Campaign in Kenya

The measles and rubella vaccination campaign in Kenya, also known as the MR campaign, began on June 26, 2021, and ended on July 5, 2021. Several organizations, including the World Health Organization and UNICEF, worked with the government of Kenya to deliver the vaccines. The initiative occurred in 22 Kenyan counties. Additionally, the organizations prioritized the counties with especially high numbers of measles cases and high counts of unvaccinated children. The campaign targeted children from 9 months old all the way up to children 5 years of age. Overall, the campaign targeted around four million children in Kenya.

The operation incorporated collaborative measures to allow the campaigns to run smoothly and quickly throughout the counties. This included hiring a high number of healthcare workers and setting up more than 5,000 vaccination sites. More than 16,000 healthcare workers participated in administering the vaccines. Along with the cost-free vaccines administered at health clinics and facilities, the operation included vaccination spots at “preschools, marketplaces, churches and other designated places on specific days” with the aim of vaccinating as many children as possible. Additionally, in order to raise awareness, a telecommunications company sent out mass text messages about the campaign.

Prioritizing Prevention

Since 2016, immunizations have been declining in Kenya, causing the number of outbreaks to rise, even though “the MR vaccine has been offered as part of the routine childhood immunization program” within the country.  The pandemic worsened those conditions, with 16.6 million African children missing “supplemental vaccination against measles between January 2020 and April 2021.” Moreover, measles surveillance declined in 2020.

In order for communities to avoid measles outbreaks, full vaccination rates need to be at least 95% for children. However, just 50% of children in Kenya received the full vaccine in 2020. Thankfully, with support from the Kenyan government and organizations such as UNICEF, health officials were able to provide MR vaccines to children across the country. This helped to manage measles outbreaks and safeguard the lives of many children this year. To continue more health initiatives after the MR vaccination campaign, Kenya is rolling out even more vaccination campaigns. This also includes a “multi-antigen catch-up campaign” to reduce the chances of further outbreaks and decrease the number of preventable deaths in Kenya.

– Karuna Lakhiani
Photo: Flickr

Vaccine Scarcity in Africa
The COVID-19 pandemic has put the world in a vulnerable position for the past 18 months. Though vaccines from Pfizer, Moderna and Johnson & Johnson have saved lives in the U.S., almost half of the United States still has not received vaccinations despite widespread access. As a result, cases continue to rise. Africa has seen more than 6 million COVID-19 cases and around 170,000 COVID-19 deaths, according to the World Health Organization (WHO) Regional Office of Africa. Unlike the U.S., which struggles with COVID-19 vaccine hesitancy, vaccine scarcity in Africa is prevalent.

Vaccine Distribution in Africa

Vaccine scarcity in Africa continues to hamper African countries’ ability to vaccinate their populations. About four in five of the 38 million doses that African nations received as of June 2021 have gone to Morocco, Nigeria, Ethiopia, Egypt, Kenya, Ghana, Zimbabwe, Angola, Tunisia and Senegal. As of June 2021, less than 1% of the continent’s population of 1.2 billion had been fully vaccinated.

“Africa is already playing COVID-19 vaccination catch-up, and the gap is widening,” said WHO Regional Director for Africa Dr. Matshidiso Moeti in an April press briefing. “Although progress has been made, many African countries have barely moved beyond the starting line.”

AIDS as a Comorbidity

A historical parallel to Africa’s slow COVID-19 vaccine rate is the disproportionate prevalence of AIDS across the continent. The two diseases interact, with AIDS increasing the risk of serious infection or death from COVID-19.

About two in three people living with HIV come from sub-Saharan Africa, according to UNAIDS. Studies that occurred in England and South Africa show that HIV doubles the chance of dying from COVID-19.

Precautions to prevent COVID-19’s spread in Africa, such as lockdowns, also delayed HIV testing and treatment. Data from African and Asian nations showed a nearly 40% dip in testing and treatment during initial 2020 lockdowns compared to the same period in 2019.

Upcoming Donations from the US

As the U.S. reaches the 50% mark for domestic vaccination, it is beginning to donate more vaccines to other countries and help combat vaccine scarcity in Africa. For example, it is in the process of sending 25 million vaccine doses to Africa, according to State Department Coordinator for Global COVID-19 Response and Health Security Gayle Smith’s statement at a digital press conference on July 21. The U.S. will donate an additional 500 million Pfizer doses, with many going to Africa. The Pfizer dose donations will occur through COVAX, an organization that allocates vaccines to participating countries monthly. COVAX will distribute the first batch of doses, totaling 60 million, in August 2021.

The U.S. State Department wants Africa to be able to produce its own vaccinations in the future. “We’re investing through our Development Finance Corporation right now in South Africa and Senegal in increased vaccine production and will be making other investments,” said Smith. “We believe that, for now and for the future, it’s important that Africa produce vaccines for its own consumptions rather than being dependent on having to import those in the majority of its medical requirements.”

Jessica Umbro
Photo: Flickr

Vaccinating Rural Communities
There are logistical differences between distributing vaccines to heavily populated urban centers and poorer outlying areas. These differences require attention to ensure equitable distribution of the COVID-19 vaccine. Vaccinating rural communities, which are the most vulnerable to COVID-19, requires special attention. 

The Geographic Information System (GIS) is a tool for vaccinating rural communities to ensure equitable distribution. This system of maps allows civic authorities to access a comprehensive source of data and translate it into actionable information on the optimal places for setting up relief operations of any kind.

Information on socioeconomic conditions combined with an overlay of physical terrain provides the tools for determining who is most in need of immunization. This ensures that vaccine site planners make the most of a decentralized distribution plan when deciding how to provide for rural areas efficiently.

What Is It?

It is best to view GIS as a method of overlapping different types of data on a given location so that an interested party can view it in light of whatever context they might need. GIS users can filter out whatever data they do not find relevant to their task.

National Geographic adds that the system operates through entering relevant information such as topography and housing distribution in a process called “data capture.” This stores information in snapshots that can inform viewers of how recent their data is and illustrate changes through certain date ranges.

These data stem from multiple sources, involving images from an aerial scan and/or records of human activity. So, the value of GIS in vaccinating rural communities stems from the clear picture it offers distributors on where they can have the most impact. Pandemic frontline workers can make informed decisions wherever they are by pulling up relevant data from their maps on areas of interest.

Who Does It Help?

GIS, with its ability to keep people up-to-date on the condition of areas in need, provides the means to supplement efforts with additional pre-planning. Aside from working around the capacity of available healthcare centers by choosing areas with sufficient personnel and space for vaccinating rural communities, there are more benefits of GIS. These include:

  1. Once GIS creates fairness in planning for nationwide immunity, its information on demographics helps at managing vaccine distribution by relative need based on their vulnerability to COVID-19. On a broad scale, this can mean selecting a cluster of people based on relatively low access to healthcare or a high concentration of infirmities. On a smaller scale, this might involve isolating demographic groups such as the homeless or discriminated minorities.
  2. Keeping track of vaccine stockpiles becomes more important when a larger distribution range requires storing vaccines closer to rural areas. In cases where a country is using vaccines that require two doses, timely delivery is crucial. By storing vaccines in the countryside, distributors find a median between shortening the logistical tail and allowing for the distance necessary for reaching impoverished areas without such hospitals.

Who Is Using GIS?

South Africa quickly adopted GIS as a means of vaccinating rural communities in situations where income gaps between different municipalities impacted travel times to the nearest hospital.

“Reaching South Africans in remote places has begun using mobile teams and mobile pharmacies to ensure that the vaccination program covers ‘the last mile,’” writes Luis Monzon on work the South African government did with volunteers from health NGO Right to Care. Right To Care’s mobile pharmacies regularly use their access to digital maps for tasks as routine as locating the optimal route to their destinations.

An earlier success story is that of Nigeria’s experience using GIS in its efforts to eradicate polio when it was discovered that hand-drawn maps did not accurately reflect resources on the ground. This realization and the use of geospatial data served as the basis for fine-tuning the Nigerian government’s strategy. In having the foundation for a distribution strategy before receiving 16 million doses of Oxford-AstraZeneca’s vaccine, government projections indicate a 40% immunization rate by the end of 2021.

Equal Opportunity Efficiency

Widespread adoption of GIS ensures that a country’s disaster response strategy can protect even the most remote areas from the destabilizing influence of a national crisis. Future applications of this technology likewise stand to benefit as its pool of experienced users broadens.

Whether the responsibility of vaccinating rural communities is in response to a national health crisis or other disruption to normalcy, GIS ensures the fastest possible response in mitigating the impact of a disaster. Expanding access to such comprehensive data serves as a further step in building a self-sufficient network for disaster-preparedness beyond the scope of a pandemic.

– Samuel Katz
Photo: Flickr

COVID-19 Vaccination in UruguayAt the start of the COVID-19 pandemic, Uruguay had some of the lowest infection rates in Latin America. On June 30, 2020, Bloomberg reported that while its bordering country Brazil had 1.34 million total cases, Uruguay had only 932 cases. Now, about a year later, COVID-19 vaccination rates in Uruguay are among the highest in Latin America, with more than four million doses received by citizens.

Impacts of COVID-19 in Uruguay

As a result of the COVID-19 pandemic, Uruguay’s unemployment rates have increased dramatically. In March 2020, more than 86,000 citizens applied for unemployment insurance. Before the pandemic, applications averaged 11,000 per month. A complete vaccination rollout is critical for Uruguay’s citizens to return to work.

Uruguay has already started to reopen businesses, but since only about half of the country has been vaccinated, infections are increasing. In order to avoid another shutdown of the country and another fall in employment, efforts for COVID-19 vaccination in Uruguay need to receive continued support and funding.

Vaccine Success

On June 8, 2021, Uruguay released reports about the success of the Sinovac Biotech vaccine along with more information about the Pfizer vaccine. According to Reuters, Sinovac’s COVID-19 vaccine was more than 90% successful in preventing intensive hospitalization and death. Further, the vaccine reduced COVID-19 infections by 61%. The Pfizer vaccine was 94% effective in preventing intensive care hospitalization and death and 78% effective in reducing COVID-19 infections.

Increasing COVID-19 Cases in Uruguay

COVID-19 vaccination in Uruguay has been very successful so far, with 52% of the population given at least one dose of either the Sinovac, Pfizer or AstraZeneca vaccines. Despite this success, Uruguay is also facing a crisis as COVID-19 infections skyrocket.

For several weeks in late May and early June 2021, Uruguay had one of the highest global COVID-19 related death rates per capita. In the last week of May 2021, the small nation of just 3.5 million residents recorded an average of 55 deaths per day. Many experts blame public health guidelines that have become increasingly lax as the pandemic continues. Not enough of the population is vaccinated to support the less restrictive public health measures and Uruguay is now rushing to further increase its vaccination rates.

Global Support

The United States is working with COVAX to improve the vaccine rollout around the world, which might help Uruguay. COVAX is led by the Coalition for Epidemic Preparedness Innovations, the World Health Organization, Gavi and UNICEF. Its goal is to vaccinate at least 20% of every participating country’s population by the end of 2021. NPR notes that it may not be able to meet this goal due to the global vaccine shortage. Wealthier countries that have already secured enough vaccines for their populations need to step in to help struggling countries with vaccine donations.

Supporting the Global Vaccine Rollout

According to the Stanford Social Innovation Review, there are many ways in which organizations can support the global vaccine rollout. First, it is important that there is a level of trust between citizens and the distributors of the vaccine. Many people are hesitant about vaccines because they do not necessarily trust the intentions of vaccine developers. With trustworthy messengers such as community leaders and trusted organizations working to combat vaccine hesitancy, people may be less reluctant to receive a vaccine.

Second, the delivery of vaccinations requires innovation. A major problem for those in rural and low-income areas is a lack of access. Many cannot travel far to receive a dose, therefore, investing in creative ways to deliver vaccines to remote locations is important. For example, implementing mobile vaccination sites.

Finally, supporting the training of local healthcare workers in contact tracing, COVID-19 education and vaccination means more people will be qualified to address the pandemic. Thus, COVID-19 vaccination in Uruguay can continue long after global organizations leave the area, ensuring efforts are sustainable. With private and public sector groups working together, combating the COVID-19 pandemic and improving global health is not a distant goal.

Jessica Li
Photo: Flickr

Vaccine Diplomacy in AfricaGlobal COVID-19 vaccine distributions aim to combat the pandemic. However, not all rollouts are equally fast and smooth and coverage is inconsistent. The COVID-19 vaccine rollout in Africa is indicative of vaccine inequity. Vaccine nationalism and vaccine inequity will only prolong the pandemic in the long run. Vaccine diplomacy in Africa is important to ensure that no continent goes overlooked.

Diplomacy in Global Health

According to Dr. Peter Hotez, a leading expert in global health, vaccine diplomacy employs vaccine delivery and distribution to advance global health by eliminating diseases. It also has the potential to advance international relations and neutralize conflict, among other pragmatic uses. Governments recognize that COVID-19 negatively impacts economic development, national security and foreign policy interests.

Global health is increasingly important in an age of globalization as governments become more connected. Governments use vaccine diplomacy to improve relations with other countries. Hotez recognizes the three elements of global health diplomacy as core diplomacy, multistakeholder diplomacy and informal diplomacy. Core and multistakeholder diplomacy can best describe COVID-19 vaccine diplomacy in Africa.

The Initial Success of COVAX

The Global Alliance for Vaccines and Immunization (GAVI) co-leads the COVAX initiative aiming to develop and distribute COVID-19 vaccines equitably across the world. This is an example of multistakeholder vaccine diplomacy in Africa. Since the COVAX rollout began, GAVI has reported on its successes and shortfalls in Africa. Africa’s preparedness has paid off.

GAVI reported that nearly 40 African countries had national vaccination plans in place before rollouts began, smoothing the way for rapid and smooth rollouts. However, a lack of preparedness among some countries and dwindling vaccine supplies create challenges. GAVI emphasizes that as of April 2021, “less than 2% of the 780 million COVID-19 vaccine doses given globally have been administered in Africa.” Ongoing vaccine donations will be necessary to sustain COVAX’s strong start in Africa.

Vaccine Diplomacy in Africa

In addition to initiatives like COVAX, several countries have employed the concept of core diplomacy to donate millions of vaccines more directly. China is a major participant in this type of vaccine diplomacy in Africa. According to Think Global Health, several African countries have received pledges of free doses from multiple donors. In May 2021, in an act of diplomacy, China announced that it was donating COVID-19 vaccines to at least 40 African countries.

Distribution often ties closely to political agendas rather than a country’s actual needs. Of the 72 total beneficiary countries chosen by China, 70 are partners in China’s Belt and Road Initiative, “an ambitious global infrastructure project that aims to increase Chinese influence, develop new investment opportunities and strengthen economic and trade cooperation.”

Prioritizing Africa

In a move toward vaccine equity, on June 3, 2021, the White House announced its plan to donate 80 million vaccine doses by the end of June 2021, most of which is promised to COVAX. While the donation is immensely helpful, of the first 19 million donated doses, Africa will receive the smallest portion of five million doses despite experiencing a 20% weekly surge in COVID-19 cases.

Vaccine diplomacy in Africa is important to ensure the continent does not go overlooked. As cases in Africa surge, the need for vaccine equity grows more urgent. If one continent goes unvaccinated, all continents are unprotected. With more countries in support of vaccine diplomacy, efforts to combat the pandemic will have greater success.

– McKenzie Howell
Photo: Flickr

vaccines abroadThe Biden administration has initiated plans to distribute an initial 25 million surplus vaccines abroad, marking the first steps in the administration’s commitment to share up to 80 million doses by the end of June 2021. The doses will first prioritize areas of extreme vaccine inequity in Latin America, the Caribbean, Africa and South Asia. The wealthiest nations of the world must take decisive and united actions to combat COVID-19 in areas of the world lacking basic medical infrastructures and the means to independently produce vaccines. Currently, low-income countries have received less than 1% of COVID-19 vaccine doses. Global health organizations forewarn that the pandemic will persist through variant strains unless vaccination efforts are significantly increased. Sending 25 million COVID-19 vaccines abroad will work toward stabilizing infection rates in the world’s most marginalized communities.

The Fight Toward Ending Vaccine Inequity

A large majority (about 75%) of the initial 25 million vaccines distributed abroad will be administered through the international vaccine initiative referred to as COVAX. The initiative’s priority is addressing vaccine equity by helping lower-income countries secure vaccines despite limited monetary capacity. Remarkably, as of early June 2021, only 31 million Africans “have received at least one dose” on a continent that measures a population of about 1.3 billion people. Resources have proven extremely scarce, with countries like Ghana and Rwanda already running through their first shipments of vaccines delivered through COVAX.

A mere 1,386 Kenyans out of a 50 million person population have received two doses of a vaccine —  a glaring testament to the vaccine inequity found throughout the global south. Apart from a lack of material resources, many countries have seen vaccine hesitancy negatively impact their vaccination rates. Concerns over blood clots and doubts surrounding inoculation capacity have greatly diminished the efficiency of vaccine distribution in countries like Malawi and the Democratic Republic of Congo. Distributing 25 million vaccines abroad will partially cushion already weak healthcare systems with limited beds, ventilators and oxygen.

The Road Ahead

Though U.S. efforts to donate vaccines abroad are significantly helpful, to properly address vaccine inequity, larger-scale efforts are necessary. Researchers from Duke University estimate 11 billion doses will be required to vaccinate 70% of the world’s population. However, this is just the beginning of the long and calculated global response to COVID-19. Jeffrey Zients, the COVID-19 response coordinator for the Biden administration, has said to “expect a regular cadence of shipments around the world across the next several weeks.”

The U.S. will hopefully continue to embrace its responsibility as a world leader and facilitate even greater donations of vaccines abroad. In the end, quelling the pandemic will require “working with allies and partners to expand the production of vaccines and raw materials, including here at home,” said Jake Sullivan, President Biden’s national security adviser. As the world takes on the next chapter in the fight against COVID-19, the leaders of the world must stand together to form a strong, collaborative response.

– Conor Green
Photo: Flickr

COVID-19 Vaccinations in Africa
COVID-19 vaccinations in Africa account for only 2% of vaccinations the world administers. Meanwhile, other countries are close to vaccinating the majority of their populations. This is a glaring example of the dangerous vaccine inequity burdening developing countries. The United Nations Security Council recently called for accelerated availability of COVID-19 vaccinations in Africa. A statement that all 15 members endorsed emphasized the need for “equitable access” to quality, affordable COVID-19 tests, treatments and vaccines. With wealthy nations buying a disproportionately large amount of the world’s vaccine supply, it is imperative that developing African countries receive the proper aid and resources to implement proper vaccination programs across the continent. That is where China comes in.

China’s Efforts

China has thus far set the precedent in the global response towards increasing COVID-19 vaccinations in Africa, pledging to provide vaccines to over 40 African countries. China has described its actions as purely altruistic. To back this up, China has either been donating or selling the vaccines at favorable prices. Foreign Ministry official Wu Peng told reporters that “We believe that it is, of course, necessary to ensure that the Chinese people get vaccinated as soon as possible, but for other countries in need, we also try our best to provide vaccine help.” So far, the Chinese efforts to counter vaccine inequity have been quite successful. China has already committed half a billion doses of vaccines to African countries. By engaging in “vaccine diplomacy,” China has been able to expand its influence in Africa through tactful, yet charitable actions.

However, Wu makes the important distinction that “Aid alone cannot solve Africa’s vaccine issues. We must support local manufacturing of vaccines in Africa, even though this is difficult due to (low) levels of industrialization.” While difficult, initiating the local manufacturing of vaccines will have monumentally positive effects in curbing the disease. Starting in June 2021, Egypt will be able to start locally producing China’s Sinovac vaccine. Sinovac has not only provided Egypt with advanced technical guidance in producing the vaccine, but also the rights to manufacture and pack the vaccine domestically. China hopes to replicate this in other African countries.

US-China Rivalry

Boasting claims of being able to produce at least 2.6 billion doses by the end of 2021, China will likely continue to lead the way in vaccinating a large portion of the world’s population. In light of China’s generous distribution of COVID-19 vaccines, many have criticized the U.S. for hoarding vaccines. In response to this, President Joe Biden has now pledged to donate an additional 20 million vaccine doses. Certainly, the continued proliferation of aid from wealthy nations will help to increase the rate of COVID-19 vaccinations in Africa. Developed nations cannot hoard vaccines or vaccine technology and expect the pandemic to end. The pandemic will not end until the current state of vaccine inequity disappears.

– Conor Green
Photo: Flickr