Vaccine inequity: glut, greed and the privilege we waste

In the United States, whether we acknowledge it or not, we are privileged to have access to free and safe vaccines -- the most effective way to prevent severe disease and death from COVID-19.

However, like all forms of privilege, ours comes at the expense of others.

About 77% of all COVID-19 vaccines have been administered in high-income countries, which make up only 16% of the global population. Though vaccination rates in those countries have largely stalled, they continue to buy the bulk of the world’s vaccine supply -- enough to offer booster shots, cajole the vaccine-hesitant, and have plenty to waste in the attempt.

In stark contrast, more than 90% of people on the continent of Africa are still waiting for their first dose.

Given that viruses are not confined by borders, it is in everyone’s best interest to ensure equal access to COVID-19 vaccines. Our failure to do so is murder-suicide. Vaccine inequity shifts the burden of disease and death onto the world’s most vulnerable people, and simultaneously allows for new and more contagious variants to arise, which can both render our current vaccines useless and prolong the pandemic indefinitely.

All year, leaders in under-vaccinated countries have implored rich nations to stop hoarding vaccines and fulfill their pledges to COVAX, an international program set up to share the world’s limited supply of vaccines and distribute them equitably among high-risk groups in every country.

Early on in the pandemic, countries such as the United States wielded their wealth to negotiate deals directly with vaccine manufacturers, a luxury that low-income nations don’t have. High-income countries bought the majority of doses, thereby significantly undermining the power of COVAX to secure and deliver vaccines to low- and middle-income countries. The current trickle rate of donations to COVAX is not enough.

Meanwhile, pharmaceutical companies monopolize vaccine technology and profit from our suffering. For instance, the producer of the Moderna mRNA vaccine is projected to make $14 billion in profits this year. Unsurprisingly, they are unwilling to share their vaccine formula voluntarily.

It is time to disrupt the profitability of disaster and make life-saving vaccine technology widely available. More than 100 countries, including the U.S., support a temporary waiver to Trade-Related Aspects of Intellectual Property Rights (TRIPS) from the World Trade Organization in response to the pandemic. A TRIPS waiver would lift patents on COVID-19 vaccines and other essential medical supplies. Sharing vaccine technology with capable manufacturers around the world will allow for increased supply to meet global demand, and ultimately make COVID-19 vaccines affordable.

Critics say that pressuring vaccine producers, such as Pfizer-BioNTech and Moderna, to share their intellectual property or trade secrets will stifle innovation for future drug therapies.

It is worth pointing out, however, that pharmaceutical companies rely heavily on government investments. Moderna especially could not have developed their successful vaccine without $1.3 billion in U.S. taxpayer funding. This is in addition to $1.5 billion in pre-orders and research from publicly funded institutions. Moderna even received $900,000 from the Coalition for Epidemic Preparedness Innovations, one of the nonprofits that coordinates COVAX, with the understanding that they would provide their vaccine to high-risk populations at an affordable price.

Yet, Moderna has so far failed to deliver the 34 million doses it pledged to COVAX. They are willing to sell vaccines to the U.S. at a discount for doses that will be donated to COVAX, but this is not good enough. The public already paid their share.

Large-scale vaccine production, organized distribution and overcoming vaccine hesitancy are big enough public health challenges without being compounded by glut and greed.

If we want the COVID-19 pandemic to end, wealthy countries must stop hoarding vaccines and redistribute excess doses to where they are needed most. It is also imperative for the international community to join the growing call to demand that pharmaceutical companies share life-saving COVID-19 vaccine technology.

The injustice of this pandemic is not that we, the privileged few, are asked to follow basic public health measures to protect ourselves and each other; it is that we have the means to save lives and fail to do so.

Laurel Carlsen is a registered nurse. She lives in Palmer.

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