Vaccine inequality: Wealthy nations had vaccine options after AstraZeneca and J&J faced clot reports. Others may not have this luxury

This is not only because developed countries, such as those in Western Europe, had purchased a large number of doses of AstraZeneca to get out of the pandemic, but more consequently, because much of the developing world relied on this vaccine to do the same.

The double whammy is that the image emerges that the AstraZeneca vaccine, which appears to have caused a very rare, sometimes fatal, condition of severe clotting with a low number of platelets in the blood, may affect younger adults more than the elderly. Developing countries generally have significantly younger populations than their richer counterparts.

No link has been officially confirmed between the rare blood clots and the J&J vaccine, but U.S. officials want to pause and use alternate shots as they work to determine if there is a connection and, if so, to what extent it may be prevalent. Europe is waiting to see what an investigation finds.

But much of the developing world does not have this luxury. New types of mRNA-based vaccines, such as the Pfizer / BioNTech and Moderna vaccines, widely used in the United States, are typically three to four times more expensive than AstraZeneca vaccines, which are manufactured on a non-profit basis, or the shot of J&J, given that the vaccine requires only one dose. Pfizer, however, is offering these vaccines at lower prices in the African Union, Reuters reports.

Many developing nations have to wait longer than richer countries to receive these vaccines. In the early stages of their development, mRNA vaccines had to be kept at such cold temperatures, most developing countries could not use them without buying new and expensive equipment to store them. These requirements improve (the Pfizer vaccine can now be stored at normal freezer temperatures when transported), but the storage challenge of months ago meant that most developing countries would focus on shots like AstraZeneca and J&J in the time to make purchase agreements with pharmaceutical companies.

Dr Peter Drobac, director of the Skoll Center for Social Entrepreneurship at Oxford Saïd Business School, said that despite the rarity of blood clots in both AstraZeneca and Johnson & Johnson vaccines, any adverse effects could worsen vaccination hesitation and even misinformation.

“It can feed conspiracy theories around the world about a two-tier society. If rich countries say they’ll just have a ‘gold standard’ with the most expensive vaccines and say AstraZeneca isn’t good enough for us in the north global, but good enough for the global south, it could reduce vaccine uptake and hamper efforts to vaccinate the world, “he told CNN.

The African Centers for Disease Control and Prevention (CDC) says it has no plans to discourage the implementation or acquisition of traits, saying cases are too rare to change course now.

“For Covid-19 vaccines, the benefits outweigh the possible side effects,” Benjamin Djoudalbaye, head of the CDC’s Africa Policy, Health Diplomacy and Communication, told CNN on Monday.

But the picture is more nuanced than that. The UK has data suggesting that while the benefits outweigh the risks in general, they do not necessarily do so for every age group in all circumstances.

Last week, its drug regulator warned people under the age of 30 to be offered alternative vaccines, arguing that people in this age group are more likely to suffer serious harm from the AstraZeneca vaccine than not. they could prevent serious illness. This is only in a situation where the exposure to the virus is low. Any return to normalcy will increase exposure. Other European countries and Australia have limited vaccine use in older age groups.

Denmark is so advanced in its vaccination program that it announced on Wednesday that it would withdraw AstraZeneca’s shot from its inoculation program. You just don’t need it, as you’ve also gotten enough other vaccines to trust them.
The United States could have an additional 300 million vaccines.  Why not share?
The picture is very different across Africa. The continent has lagged behind the rest of the world in vaccinating its populations and relied heavily on COVAX, a vaccine-sharing scheme that helps developing economies access doses, to get free doses or discounts. AstraZeneca vaccine.
But COVAX’s next line of defense was also J&J’s shot. It aimed to acquire 500 million doses of J&J next year, as part of its effort to provide a vaccine to 20% of people in low- and middle-income countries. The WHO-backed scheme was expected to provide Africa with 600 million shots by the end of the year.

To date, COVAX has delivered 17.4 million Covid-19 vaccines to 36 African countries, including more than 17 million shots of AstraZeneca, manufactured by the Serum Institute of India, and some 200,000 doses of Pfizer vaccine, according to data sent Wednesday to WHO officials on CNN.

The WHO says Africa accounts for less than 2% of vaccines given in the world and that many African nations are running out of shots quickly.

The extent of the risk of these rare blood clot events after vaccination against AstraZeneca and potentially against J&J vaccines is not yet clear, but if it is confirmed that young people are more likely to experience them, this means that the developing world and its younger populations be more vulnerable to clots, even if they are less vulnerable to Covid-19 to begin with.

About three-quarters of Africa’s population is under the age of 35, according to UN data, and the average age is just under 20, which is less than half the average in Europe, with 42 years. In the United States, it is around 38. Only 6% of Africans are over 60 years old.

Meanwhile, countries such as the United States and the United Kingdom continue with their vaccine programs and share very few doses with other countries that need it.

The United States has shared a small number of the AstraZeneca vaccine, which has not yet been approved there, with neighbors in Mexico and Canada, but says it will not share it more widely until its own supplies are secure. A Duke University report estimates Thursday that the United States could have 300 million overdoses by the end of July.

“Fair access to vaccines must be a reality if we want to take a collective stand against this pandemic,” WHO Regional Director for Africa Matshidiso Moeti said in a statement last week.

A Nigerian public health doctor and consultant, Kingsley Douglas, said “protectionist” tendencies in the developed world were working against a positive overall outcome.

“Western countries first look for their citizens before looking for them elsewhere. I don’t fool them into being protectionist in their approach,” Douglas told CNN. “However, it is in everyone’s interest that the critical mass of the world’s population be vaccinated and protected against Covid. Vaccines should be distributed evenly and equitably.”

A health worker receives a Sinopharm vaccine in Yaoundé, Cameroon, on April 12.
Despite advice from the African CDC to continue with all approved vaccines against Covid-19, South Africa, the only African Union country that administers doses of J&J, announced a temporary suspension of firing. He had already suspended the launch of the AstraZeneca vaccine two months earlier, not because of blood clot problems, but because its effectiveness against a new variant first identified in South Africa was found to be low.
Some African nations have begun supplying supplies of Covid-19 vaccine to other global donors. On Sunday, Cameroon’s health ministry said it had received 200,000 doses of the Chinese Sinopharm vaccine, the first shots to land in the country, Reuters reported.
China has also donated hundreds of thousands of Sinopharm shots to Zimbabwe and the government has pledged to buy more than a million more.
Zimbabwe expects to vaccinate 60% of its population of 14 million, according to public media. He said the health ministry more than 231,000 Zimbabweans had been vaccinated since Wednesday.

A top Chinese health official admitted over the weekend that China’s vaccines did not have very high efficacy rates and that Beijing was considering acquiring new types of vaccines based on mRNA technology, such as Pfizer injections. and Modern, an analysis he made. he was forced to water down after his comments were widely shared on social media and international news websites.

The effectiveness of the Chinese vaccine Covid-19

Samuel Matsikure, a resident of Harare, the capital of Zimbabwe, said he has heard many young people express skepticism about vaccines made in China.

“Many citizens are afraid of getting vaccinated,” he told CNN. “They don’t trust China’s vaccine, in part because they think its effectiveness is low, and it’s not as popular as other vaccines. So you find that young, work-able people don’t get as vaccinated as people. great, ”Matsikure said.

Matsikure hopes Zimbabwe will acquire more vaccines so that some of the country’s strict coronavirus-related restrictions can be relaxed.

“Many Zimbabweans have suffered financially due to the Covid closures. Most Zimbabweans belong to the informal sector … they rely on selling their products on the street or at designated outlets. But all of these were closed during the closures. … crying for food aid and unable to pay their rents, “Matsikure told CNN.

The ramifications are similar for developing countries in Latin America and Asia, many of which depend heavily on the shooting of AstraZeneca through the COVAX plan and also have younger populations.

Brazil, for example, has already received more than a million doses of AstraZeneca through COVAX, and as cases rise there, it doesn’t seem to be heading for limited use.

“Blood clots are worrisome,” said Sergio Litewka of the University of Miami’s Ethics Programs, which focuses its research on Latin America. “But I don’t think the number of clot cases justifies the suspension of vaccine use.”

He said Latin American countries simply do not have enough other options to launch shots like AstraZeneca and J&J, and he believes vaccine vacillation in the region could increase as a result.

“Denmark has said no to AstraZeneca and there are other countries studying what they will do and what happens with Johnson & Johnson,” he said. “But in Latin America, people have very few options. Some say I’d rather take risks, but some are more hesitant.”

CNN’s Christopher Johnson contributed to this report.

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