The US ought to give extra doses sooner, consultants say

In the next month, the United States could begin a process of spreading COVID-19 vaccines around the world that will save millions of lives, maintain its position as a beacon for the world, and make the nation itself safer. But it has to be done quickly, say experts,and more cans must be donated to the cause.

“There’s no time to waste,” said Dr. Krishna Udayakumar, director of the Duke Global Health Innovation Center at Duke University.

Amplified by donating millions of doses of vaccine that it bought but not needed, and as a role model for itother countries, America could change the course of the pandemic, experts said USA TODAY.

President Joe Biden has started the process. On Monday, he announced that the US would send 20 million cans overseas in addition to the 60 million it recently promised to India.

Tracking global COVID-19 vaccination rates: How many people were vaccinated?

“Rampant diseases and deaths in other countries can destabilize them and also pose a risk to us. New variants could emerge overseas that could put us at higher risk,” said Biden. Helping other countries is “the right thing. It’s the smart thing. It’s the strong one.”

But speed – and volume – are of the essence, experts say.

“The supply constraint is now and will be most felt in the next six to nine months,” said Orin Levine, director of global vaccine delivery programs at the Bill and Melinda Gates Foundation.

Bringing the vaccine out now will also do the best, as pandemic vaccines are very similar to compound interest.

“Saving early pays off in the long run. Getting vaccinated early pays off a lot,” said Levine.

Wait for an outbreak to rage like it is now in India and it’s too late to make a big difference with vaccines, said William Moss, vaccines expert at the Johns Hopkins Bloomberg School of Public Health.

Most shots take about six weeks after the first of two doses to be fully effective, and that’s after they’re shipped to a country and distributed to communities, he said.

Three international meetings in the next month could be turning points, said Dr. Tom Kenyon, director of the nonprofit international health organization Project HOPE and former director of global health for the Centers for Disease Control and Prevention.

This week is the G20 Global Health Summit. The World Health Assembly will take place next week, and the G7 summit of heads of state and government will take place in the second week of June.

“US involvement could be the turning point,” said Kenyon. “We need something to rally because we clearly fail to vaccinate the world.”

Vaccine diplomacy

The United States is in the enviable position of having more vaccines than it can use.

Back then, when it wasn’t clear which vaccines would be the winners, US taxpayers paid to develop and produce about 500 million dosesaren’t needed to vaccinate Americans, at least in the short term.

Globally, the United States, the United Kingdom, Canada, Australia, Japan and the European Union could have dose excesses of 1 billion by the end of 2021, Levine said.

“Donating this vaccine would greatly reduce vaccine inequality and speed control of the virus everywhere,” he said.

Paramedics from the Special Infection Unit and a doctor unload a man with symptoms of the COVID-19 coronavirus into the isolation chamber, which is equipped with a vacuum filter system, from his home in northern Pretoria, South Africa, on January 15, 2021.

Currently only 9% of the world are vaccinated. Only 1.9% of the African population are vaccinated, 17% in Asia and 23% in South America.

In the long term, the US must help increase vaccine production capacity around the world, experts say.

“Currently the African continent has almost no production capacities for vaccines. That has to change,” said Udayakumar.

Ideally, all of the U.S. surplus vaccine would go to COVAX, an international group created specifically to bring COVID-19 vaccines to the poorest and most vulnerable countries, said Lawrence Gostin, director of the O’Neill Institute for National at Georgetown University Global Health Law.

Udayakumar said the United States and other nations should also help meet COVAX’s $ 2 billion budget deficit on vaccine purchases, including by promoting commitments at upcoming global summits.

The group has built-in mechanisms to ensure that countries receiving vaccines have the infrastructure to get them to their people and that they are not skimmed off by the rich and powerful.

COVAX has promised to provide vaccines to 20% of residents in participating low and middle income countries by the end of the year. However, so far, most countries have not even received enough shots to vaccinate 3% of their highest risk residents and healthcare workers.

COVAX-assisted COVID-19 vaccines arrive in Cabo Verde in March 2021.

Gostin assumes that the United States will give some of its vaccines to nations in its sphere of influence, in part to counteract similar Chinese and Russian efforts.

“I hope we will prioritize the countries with the greatest need,” he said. “Surely India, Mexico and Brazil would be three countries within the US’s sphere of influence that have extraordinarily high needs,” he said.

Whatever the United States does, it should make a splash.

“We should look big and bold at the global COVID vaccination campaign,” he said.

The Biden administration’s efforts to get vaccines for poorer countries are seen by many as a signal that the United States is asserting its long-standing role as the global health leader. The move comes after the Trump administration tries to pull out of the World Health Organization.

“It’s an important moment for the world when the US is sitting back,” said Levine.

Other ways to share cans with the world

Another way to get the vaccine to the rest of the world quickly would bebe it for the US to give up its place in line. At the start of the pandemic, the United States prepaid the cans and put them at the top of the queue to make.

Exchanging places with countries like Mexico, Peru, Indonesia, and the Philippines that have also pre-purchased vaccines but are behind the US could bring billions of doses to middle-income countries that need them now.

“We could essentially forego our place in line now and still have the option of getting those cans when we need them,” said Udayakumar.

On February 26, 2021, a plane landed in Abidjan with 504,000 doses of COVID-19 vaccines distributed by the COVAX facility.

It is possible that when additional doses are ready, Americans may need them as booster vaccinations. However, some have raised ethical questions about whether healthy Americans will get boosters before many high-risk people around the world get their first shots.

“Please don’t get boosters until the world has its vaccine,” said Annelies Wilder-Smith, World Health Organization advisor and professor of emerging infectious diseases at the London School of Hygiene and Tropical Medicine.

think in other directions

The US has a lot to consider when deciding what to do with its additional doses.

“There are some really difficult allocation problems that need to be fully resolved and agreed if you are to best serve others,” said Art Caplan, bioethicist at New York University. “I want to get the biggest bang for the buck.”

To distribute the vaccines fairly, Moss of Johns Hopkins said he wants the US to adopt a semi-joking bombas approach after the sock company donates a pair of socks to those in need for every pair a customer purchases.

“I would like to see a proposal from the US government that they donate a dose of a vaccine for every person under the age of 18 who has been vaccinated in the US,” he said. “You could say that to teenagers – if they are vaccinated they can help another person.”

A campaign launched this week by the World Health Organization Foundation is calling on people to donate $ 7 if they receive a COVID-19 shot. Donations for the Go Give One campaign go directly to COVAX.

Nouf Albarakati (left) comforts her 14-year-old son Manaf Albarakati before receiving a COVID-19 vaccine from nurse Alicia Jimenez at a vaccination clinic in King of Prussia, Pennsylvania.

Caplan said he saw one more reason the US should give up extra doses: This could encourage unvaccinated Americans to roll up their sleeves.

Back when the supply of vaccines in the US was low, people tried to cross the line. However, demand fell as supply increased. Perhaps shipping vaccines overseas could make them attractive to Americans again.

“They tell them, ‘We have tons of vaccines and we’re sending them overseas,'” said Caplan, “and they say, ‘Wait what? Where can I get them?'”

Contact Karen Weintraub at [email protected] and Elizabeth Weise at [email protected]

U.S. TODAY health and patient safety coverage is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide any editorial contributions.

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