Covid-19 and vaccine distribution: high hopes and stark realities

In record time, 18 vaccines have reached the ultimate testing stages, and five are already in early or limited use. At present, Pfizer-BioNTech and Moderna lead the race of the distribution competition. There are 64 vaccines in clinical trials, and at least 85 more vaccines are in the  animal testing phase. The world was not ready in the first year of the pandemic. With more vaccines being readied, is the world prepared for the next step, namely vaccine distribution?

There is only a limited supply of the vaccines at this juncture. Thus, public health officials around the globe have different ways of defining prioritised groups. The WHO prioritised health workers, older age groups, and people with underlying medical conditions that would put them at risk of disease or death. The US authorities, through their multibillion-dollar federal program Operation Warp Speed, are putting through a plan that seems to be entirely dependent on vaccine availability. While US authorities acknowledge that health workers, nursing homes, and long-term care facilities would be the first to get a vaccine, there are some concerns about the impartiality of this process.

Some US activists raised concerns about racial discrimination, hinting that the prioritising process would ignore “the actual needs of racial minorities.” Similarly, if the priority is given to working-age people instead of the elderly, then the most vulnerable group, African American seniors, will be left behind. Asian, Hispanic, Black, and Native Americans’ mortality rate is higher than that of white people. For the most part, minorities, who do not have equal access to health care or insurance, fill service sector jobs that require interactions with people. This means that their risk of infection is higher.

Britain is struggling with similar problems. Minority groups constitute a  higher percentage of Covid-19 infections. Compared to white men, Black African men face double the risk of dying from the virus. While they face considerable risks, British nationals from non-white ethnic backgrounds seem to have little trust in the system;they are afraid of being used as “medical guinea pigs”. According to a recent poll, only 39 percent of London’s ethnic minorities are likely to have a positive approach toward taking a vaccine, compared to 70 percent of white people in the city.

In the meantime, such scepticisms are reinforced by rising anti-vaccination movements worldwide. According to the London-based Centre for Countering Digital Hate (CCDH), anti-vaxxers have strengthened their social media presence, gaining about 8 million new followers on different social media sites since last year. In the middle of heated debates over the need for vaccination, Brazil plunged into a media crisis by a politician’s tweet. Roberto Jefferson, a former congressman and supporter of the president, tweeted that “globalists were preparing a vaccine to change our DNA.” Such statements feed the anti-vaccine frenzy in the country. In a similar vein, a new Gallup poll has revealed that 37 percent of Americans would not be willing to receive a vaccine. While authorities race against the clock to distribute vaccines adequately, they have to deal with all kinds of conspiracy theories and suspicions.

Furthermore, the distribution process faces core logistical issues. Britain, which plans to vaccinate up to 25 million people throughout 2021, already faces delivery problems. Because the vaccine is not just a magic potion that can be easily absorbed, there is a need for serious considerations about logistical challenges which are part of the process.

While humanity has experienced a ‘decade of vaccines,’ the current vaccine supply chain is not prepared to take on a pandemic crisis. First, there is a massive necessity for accessories – protective equipment, syringes, needles, rubber gloves, and alcohol swabs. In Brazil, there are already worries about the availability of sufficient quantities of vials and syringes.

Second, the vaccines must be stored according to their expiry dates and at the required temperatures. Once thawed, the Pfizer vaccine can last five days. Conversely, stored in a fridge, the Moderna vaccine can survive for 30 days (or 12 hours at room temperature). While the former can be stored in a regular refrigerator, the latter must be kept at -70 C; thus, these requirements pose a huge challenge.

Third, the focus on one illness while ignoring others could have serious consequences especially in some developing countries.Mozambique and Thailand witnessed similar issues in the past. The  

Last, but not least, there are worries that the vaccine’s distribution will be in favour of high-income countries. During the 2009 H1N1 pandemic, developed countries acquired all vaccine stocks. If history repeats itself, and considering the global demand’s scope, the process could leave the poorer countries waiting for years.

For preventing such a course World Health Organization, the Coalition for Epidemic Preparedness Innovations, and Gavi have founded Covax. Its primary responsibilities are to build manufacturing capabilities, buy supplies, and provide an infrastructure for the fair distribution of 2 billion doses by the end of 2021. In the background of a global pandemic, successfully applied, this project can save millions of lives. But first, it must take serious steps to solve all the issues mentioned above. 

The distribution process is currently confused and unprepared to manage the supplies of vaccines. Also, it struggles to decide to whom and how the vaccine delivery will take place.

Long story short, all people are equal, but some people are a bit more equal. Therefore, vaccine delivery is most likely to face crucial ethical, medical and logistical problems both on a regional and global basis.