Science & Technology

Are US Booster Shots robbing the world of vaccine supplies?

Fall 2020, Johnson & Johnson Announce transaction With Aspen Pharmacare, a South African-based pharmaceutical company. With Johnson & Johnson approved by the World Health Organization (WHO) and South Africa for the COVID-19 vaccine, Aspen Pharmacare will manufacture millions of doses for use in that country and abroad. The contract included major shipments to South Africa. 31 million doses are enough to inoculate more than half of the country’s population with this one-shot vaccine.

However, when Aspen actually began producing vaccines in the summer of 2021, most of these doses were not used to vaccinate South Africans. Instead, the dose was sent to Europe as South Africa was hit hard by a variant of Delta.

Aspen “has agreed or was forced to agree that the South African government does not impose export restrictions,” said Fatima Hassan, founder of the Health Justice Initiative, a South African-based research and advocacy group. The company’s contract stipulated that “basically, Aspen had to send the vaccine wherever Johnson & Johnson wanted.”

“they [Johnson & Johnson] We have no power to draw such concessions from the US government or the EU, “says Hassan. “But they can do that in Latin America and Africa.”

thanks to Pressure from South African activists And others, New York Times SurveyThe country was finally able to temporarily suspend exports of vaccines. This allowed millions of Johnson & Johnson vaccines to stay in South Africa. As of October 15, the country has been vaccinated about 14 million times. According to Our World in Data..

The Aspen deal is just one example of vaccine inequity brought about by companies that prioritize high-income customers over the rest of the world. Boostershot campaigns are now exacerbating this gap, as limited vaccine supplies continue to go to wealthy countries first and manufacturers in low-income countries are barred from accessing vaccine technology.

Artificial scarcity

Popular Science has spoken to six experts around the world, but the leading pharmaceutical companies that developed the COVID-19 vaccine insist that they primarily control the production of all doses of these vaccines. Therefore, we agreed that the amount we could supply to low-income companies was limited. ..

“Basically, vaccine doses are artificially inadequate,” says Robbie Silberman, a vaccine advocate at Oxfam America. Pharmaceutical companies are controlled “where doses are manufactured, where they are sold, and at what price”. Therefore, global vaccine supply is limited by contracts signed by a few large companies. And many of those contracts are kept secret behind nondisclosure agreements, Hassan says.

WHO spokesman Margaret Harris said that if a company has complete control over where vaccine doses are delivered, it would be in the best interest to send those doses to wealthy countries first. Stated. Wealthy countries are “easy-to-service markets”, are expensive, and have an established infrastructure to deliver doses.

“If that market continues to buy, vaccine companies will be less interested in contracts in other markets,” says Harris.

Booster shots add to the rarity in nature by giving wealthy countries the opportunity to jump back to the forefront of the vaccine line. “Currently available supplies will be diverted for boosters,” says Hassan. “Only to serve the richer North priority customers.”

As a result, countries such as the United States, United Kingdom and Israel have ample supply for booster shot campaigns, while countries such as Botswana Signed contract with Moderna in June— Not receiving a single dose. Shipments to this African country were to arrive in August.

In addition, Hassan states that centralizing all vaccine production to a small number of manufacturers can be dangerous in the event of an error such as contamination. Closed Maryland factory Manufactured Johnson & Johnson vaccine in April. “If there are only a handful of suppliers, problems in Baltimore will affect the entire global supply chain,” Hassan says.

Logistic problem

When booster shot campaigns in wealthy countries delay the shipment of doses to other countries, the delay does not only affect the dose supply itself. These delays also introduce logistic uncertainty, making it difficult for low-income countries to plan effective vaccination campaigns.

“We can’t tell the country what’s coming,” says Harris. Public health leaders need to know when vaccines will be shipped, how many times they will be vaccinated, and other important information. She said, “You need to plan your cold chain, you need to plan your campaign, you need to tell people,” Vaccinations are recently available in these places. Will be. “

Pfizer and Modana vaccines, in particular, require a lot of preparation for mRNA technology, Harris said. To administer these vaccines, the country needs to obtain a special cold freezer and train healthcare professionals to handle the products.

But if people don’t show up to get vaccinated, vaccination storage and staff training make little sense. For a successful vaccine campaign, public health leaders need to have “a huge number of ducks in a row,” Harris says. These details include advance communication with logistics, staff and the community, and the actual implementation of planned vaccination events.

“The day people are told to come, they will show up and without the vaccine they will probably not come back a second time,” she says.

Importance of global vaccination

If the coronavirus continues to spread anywhere in the world, it has the ability to spread everywhere. All new infections offer the opportunity to mutate into the virus and may generate new mutants, such as the delta mutant first identified in India in early 2021.

“Mutations occur when infected,” says Senjuti Saha, a microbiologist who works on coronavirus sequencing and heads the Bangladesh Pediatric Health Research Foundation. “The fewer vaccinations we have around the world, the more likely we are to get variants and new variants are on the market sooner.”

Saha is now concerned that many low-vaccination countries are also densely populated and ready for a continuing coronavirus epidemic. According to Our World in Data, in Bangladesh, about 23% of the country receives at least one dose. In many African countries, this number is less than 5%.

In addition, many Current vaccine campaign In low-income countries, it depends on the dose of Sinovac and Sinopharm vaccines. These two vaccines, manufactured in China, “have proven to be far less effective than other vaccines,” said Peter Maibalduk, director of a non-profit public citizen based in Washington, DC. Says. actual, Recently recommended by WHO Recipients of these two vaccines over the age of 60 must receive a booster dose of the same or different vaccines. “We are now in the era of second-class vaccines for second-class people,” says Maybalduk.

Harris argues that vaccination of people in low-income countries could actually be a better return on investment for the United States than providing booster shots at home. Americans who are willing to line up for booster shots have already been vaccinated once or twice, she says. And low-income countries.

“All the work you do in a good country [vaccine] We need to cover vaccination of unvaccinated people, “says Harris.

Open technology

The Biden administration argued that the United States could both immunize the world and provide booster shots at home. But so far, the administration has focused on donation pledges. Experts say this is not a long-term solution from a pandemic.

“We have made many pledges,” says Harris. “We haven’t seen many of the outcomes of those pledges.” For example, Biden’s donation pledge. 1 billion pfizer dose Even if the deadline is reached, it will not be realized until the end of 2022. As of late September, there were less than 200 million donations from the United States.

“The only way we can perform booster shots and vaccinate the world is to actually open up the technology and scale up production,” says Hassan.

Saha agrees: “Increasing production is the only way.” Currently, a few companies dominate the production of the COVID-19 vaccine, but it doesn’t have to stay that way. She says countries like the United States “can step in and say,’Moderna, Pfizer, and local businesses need to make and export at low prices.'”

Modena may be specifically prepared for such pressure by the United States Invest $ 2.5 billion Marcellavieira, Medical Access Project Coordinator at the Graduate Institute for International Development Studies in Geneva, Switzerland, said in the development and manufacture of vaccines. The company has sent fewer doses to low-income countries than any other vaccine manufacturer. And the Biden administration is urging Modana to send more doses abroad, According to the New York Times..

VIERA says there is much more that the Biden administration can do to put pressure on Modana. One option is a confiscation contract that “conditions public funding for research and development.” [research & development].. In other words, Moderna needs to make its technology more widely available to other manufacturers in order to receive more funding from the US government.

Another option is called, says VIERA March-in right.. “When a company receives a large amount of government funding to obtain a patent, the government can exercise its march-in rights and claim ownership of the technology,” she says. The US government was able to invest enough money in Moderna’s vaccine to essentially acquire the technology and share it with manufacturers in other countries.

Noubar Afeyan, Chairman of Moderna, said: Vaccine production will be the most “reliable” If the company controls all manufacturing. However, both VIERA and Saha claim that many companies in the Global North and Global South have already been set up to manufacture other vaccines. Can be pivoted quickly To make a COVID-19 vaccine if they have access to the technology.Some companies Made direct offers to Johnson & Johnson and AstraZeneca— It’s just rejected.

Systematic problem

Popular Science spoke with Saha on October 14 when the Food and Drug Administration’s Vaccine Advisory Board discussed approval of a booster shot of Moderna’s vaccine. She wasn’t surprised that US experts talked about boosters, but was disappointed, but people in low-income countries, including healthcare professionals and other vulnerable groups, had the first or second shot. It remains absent.

“I can’t get angry with people getting those booster shots,” she says. “It’s not a personal matter. If one person in the United States doesn’t take a booster shot, the vaccine won’t reach Bangladesh or be vaccinated in Malawi.”

Instead, Saha says booster shots in the United States and other wealthy countries provide another example of the global health inequalities faced throughout her career working on childhood vaccination in Bangladesh. .. “Our experience of working with policy makers at home and abroad has taught us that not all life is valued equally around the world,” she says. ..

This is a systematic policy issue and cannot be changed overnight, Saha says. However, if the solution is implemented, for example, opening up COVID-19 vaccine technology for production in low-income countries, this shift could impact future global health crises.

“It’s not just this pandemic,” she says. “There are other pediatric vaccines that are still in short supply, and children are not traveling around the world. The same facility [that make COVID-19 vaccines] It can then be used to make other vaccines and to make vaccines for the next pandemic. “

Are US Booster Shots robbing the world of vaccine supplies? Are US Booster Shots robbing the world of vaccine supplies?

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