Yale experts weigh in on challenges in achieving global vaccine equity
Public health researchers shared their thoughts on the equity of global vaccine distribution at a June event hosted by the School of Medicine.
Regina Sung, Staff Photographer
Global health experts came together this summer at a panel hosted by the School of Medicine to discuss the ways in which global vaccine distribution efforts have succeeded and how they have fallen short in terms of equity.
Yale’s Department of Internal Medicine hosted a Clubhouse event in June in order to answer questions on achieving global vaccine equity, advancing global health and the significance of efforts to do so. The speakers were Saad Omer, director of the Yale Institute for Global Health; Kaveh Khoshnood, associate professor of epidemiology and Kristina Talbert-Slagle, associate director of the Institute for Global Health. The conversation covered ongoing issues surrounding the global distribution of vaccines and the challenges facing the equity of this process among different countries.
“As long as the virus is going around, nobody can be perfectly or reasonably safe because of the instant probability of variants emerging,” Omer said in an interview with the News. “History will judge us, and part of what we will be judged on is what we were doing when low- and middle-income countries had dismally low vaccine uptake, substantial supply and access issues around vaccines and so on and so forth. For both of these reasons, it is a global health problem.”
Omer listed three strategies to employ in order to achieve global vaccine equity. First, he believes that the administration should consider scaling up the manufacturing of vaccines to up to eight billion doses per year, for the next couple of years.
He also said that to ramp up global vaccine production, the United States also needs to make sure companies receive government funding for vaccine development work with other companies outside of the country. And finally, Omer believes that the United States should be donating more vaccines to low- and middle-income countries.
“Right now, in low- and middle-income countries, it is the supply that is the main issue,” Omer said.
Under the Biden administration, the United States, which currently has a surplus of vaccines, has pledged to distribute 500 to 600 million vaccine doses to low- and middle-income countries. 75 percent of these doses go to COVAX, an alliance formed by various groups including the World Health Organization and Gavi. The remaining 25 percent of the vaccines will go to countries on the basis of expert recommendation, which Omer says is “a reasonable formula.”
Omer added that other high-income nations in addition to the United States can do more to help the cause of global vaccine equity.
“I think we have been giving the E.U. a little too much of a pass, so it’s not just the U.S,” Omer said. “Other economies could be doing substantially more than what they have been doing.”
Khoshnood added that the term global health refers to caring for the health of everyone around the world, but the way governments currently operate “does not adhere to those principles.”
According to Khoshnood, the WHO has recommended that at least 40 percent of the global population be vaccinated. And in order to reach this goal, a much greater contribution is required by high-income countries, Khoshnood said.
But some high-income nations, such as Canada, lack the infrastructure needed for vaccine development. Khoshnood believes that in those cases, the United States can be doing more to combat vaccination challenges in other countries by sharing its expertise and resources to support vaccine manufacturing infrastructure.
“With this pandemic, we are being reminded over and over again how interconnected we are, globally,” Khoshnood said, emphasizing that global vaccination is especially crucial with the advent of highly transmissible variants. “In order for you to accomplish the health of your own population, you have to make sure this pandemic is under control everywhere else, not just in your own country because it’s going to come back and we’ve been observing that over and over again.”
If a very small percentage of the population is vaccinated against COVID-19, then the virus has a much greater opportunity to evolve and mutate into new highly contagious variants, according to Khoshnood.
“It is very likely, unfortunately, that we are going to see new variants,” Khoshnood said. “These new variants could potentially be much more virulent and disease-causing. We don’t have a choice, we have to make sure every other population is vaccinated.”
Sheela Shenoi, associate director of the Office of Global Health and moderator of the talk in June, said that to achieve vaccine equity globally, a combination of vaccine supply, infrastructure and access is necessary. Shenoi also noted that it is also especially important to address vaccine hesitancy.
“Vaccine hesitancy, unfortunately we’ve seen this in our own country, has contributed to lack of control and rising case rates and unnecessary and preventable mortality. We need to address that in other countries as well, because even if we address all the other challenges, we will not be successful.”
According to Khoshnood, high-income countries exhibit higher levels of vaccine hesitancy than low-income countries. He added that getting vaccinated is a privilege.
Additionally, Shenoi urged countries to battle misinformation related to the vaccine. She said that it is especially difficult to do this when people are more concerned about their individual freedoms than public health.
The event ran for about an hour, according to Shenoi.