A Race to Herd Immunity: The Global Quest to End COVID

It has been just under one year since the CDC officially declared the COVID-19 virus a pandemic. Since the first reported case on December 19, 2019, over two million people worldwide have died of COVID-19. Just ten days after that first reported case, researchers successfully sequenced the genome of the virus, the first step on the road to a vaccine. That rapid pace of innovation, however, has slowed when it has come down to actually getting vaccines in arms.

Today, more than 241 million COVID-19 vaccines have been administered in the world. However, the distribution of vaccinations across the globe has been far from equal; the early stages of the vaccination process have exacerbated global inequities in access to healthcare. Attempts at international cooperation in vaccine development and distribution have posed collaborative and logistical challenges, especially for smaller and poorer nations. Ending the pandemic and reaching global herd immunity to the virus will require a level of international teamwork and global trust in vaccine technology that currently does not exist. 

First, the vaccines that have been developed are available in different regions and with different efficacy rates. While the COVID-19 vaccines developed by pharmaceutical companies Pfizer and Moderna are the biggest names in the game in the United States, other nations have developed their own vaccine variants. China, for example, has two major players: Sinovac and Sinopharm. Sinovac is not an mRNA vaccine, as Moderna and Pfizer vaccines are, but rather uses an deactivated version of the virus, much like a traditional vaccine. Sinovac has been approved in China since July, but its effectiveness has varied wildly across studies from different countries. Trials in Turkey reported 91.25 percent efficacy, while a trial in Brazil reported only about 50 percent efficacy. Sinopharm is reporting 79 percent efficacy for their China-developed vaccine. In comparison, the Pfizer and Moderna vaccines have reported about 95 percent efficacy each against the virus.

Sputnik V, developed by Russia’s Ministry of Health, is another vaccine on the forefront. While Russia reported that it has an efficacy rate of 91.4 percent against the virus, no real scientific evidence or papers have been published to back up this fact. In addition, the vaccine was initially approved by a Russian healthcare regulator before Phase 3 trials, the final stage in vaccine development, even began in Russia. Belarus and Argentina swiftly followed Russia in approving the Sputnik vaccine, and pharmaceutical company AstraZeneca has developed a partnership with Sputnik V in an attempt to make their own vaccine more effective. 

One of several difficulties in attempting to get the vaccines to go global is a lack of information. There is no database of concrete data comparing and contrasting these major vaccines, and clinical trial standards vary widely across countries. In order to end the COVID-19 pandemic, developed countries cannot be the only ones vaccinated. Yet many developed countries, including the United States, have developed an individualistic approach to vaccinating their populations, pushing the goal of global herd immunity farther out into the future. 

One global partnership to try and mitigate the lack of access to vaccines in developing nations has been the COVAX coalition. Led in part by the World Health Organization, COVAX currently has 190 countries participating in the effort to innovate new vaccines, treatments, and diagnostic methods, with a significant focus on the distribution of vaccines to low- and middle-income nations. The United States initially refused to join COVAX. However, under the Biden administration, Dr. Anthony Fauci, US Chief Medical Advisor, said that the United States would be joining COVAX in its plan to distribute 1.3 billion vaccine doses to approximately ninety-two nations. This shift towards bilateral cooperation is notable given that the United States is nowhere near widespread vaccination itself, with only 37.1 million people receiving at least one shot. 

Individual countries have also signaled their willingness to work with developing nations to share their vaccines and technology. China has been one of the biggest contributors to the developing world’s vaccine supply, with Sinovac distributing millions of doses to Turkey and Brazil. Mexico will also receive Chinese-made vaccines. This concept of “vaccine diplomacy” allows China to attempt to make up for their belated notification that the virus was spreading rapidly after its evolution in Wuhan. After the Trump administration’s refusal to join COVAX, China’s commitment to sharing vaccines and technology from the beginning allowed the nation to appear as a friendly partner to developing countries. 

Many developing nations participated in vaccine trials with the understanding that they would receive doses of the vaccine should they be effective and approved, yet issues with global cooperation to distribute vaccines are still numerous. The mRNA vaccines distributed by Moderna and Pfizer require precise storage methods and temperatures, including specific ultracold freezers for the Pfizer vaccine, which must be stored at -94°F. These freezers are not available at most doctors’ offices, not to mention in low-income nations. Manufacturing of the vaccines has also been notoriously slow, especially in the United States. 

Further, distrust about vaccines in general is extremely common globally. Low-income countries have a complicated history with vaccine distribution efforts by developed nations. For instance, a local doctor in Pakistan worked with the United States Central Intelligence Agency for what was believed to be a Hepatitis B vaccine campaign in 2011. While the campaign was real, its true goal was to get access to a compound where now-deceased terrorist Osama Bin Laden was believed to be hiding and to extract his DNA from used vaccine needles. When word got out about the vaccine ruse, distrust in vaccines shot up in Pakistan, leading to an upswing in polio cases due to fear of vaccine campaigns from the West. 

Misinformation and distrust in government are the two biggest fuels in the fire of COVID-19 vaccine fears. A November 2020 survey of twenty-eight nations found fewer than two-thirds of people would be willing to take a COVID-19 vaccine within a year. It will take verifiable, publicly-available, and accessible information about vaccines to assuage people of the risks, especially after the rash of reported and widely publicized allergic reactions to Pfizer and Moderna vaccines. 

With COVAX attempting to ship out its first doses in the next few months, developing nations will begin to get shots in arms sooner rather than later. In order to truly end the COVID-19 pandemic, however, the recent emphasis on global cooperation will have to continue and become stronger in order to combat supply issues and global misinformation. 

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