Sunday, December 10

The benefit of hoarding COVID vaccines: Rich countries saved almost twice as many lives as the poor world

COVID vaccines averted 19.8 million deaths worldwide in their first year of application, According to a study published by The Lancet. However, the authors point out the great inequity in access to vaccines between rich and poor countries: if the objectives proposed by the World Health Organization (WHO) of inoculating at least 40% of the population of each country with two or more doses, another 600,000 deaths could have been prevented, the report says.

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“Our findings offer the most comprehensive assessment to date of the remarkable global impact that vaccination has had on the COVID-19 pandemic,” said Oliver Watson of Imperial College London and lead author of the study. “Of the nearly 20 million deaths estimated to have been averted in the first year after the introduction of vaccines, nearly 7.5 million deaths were averted in countries covered by [el mecanismo de donación de vacunas] COVAX. (…) However, more could have been done. Had the targets set by the WHO been achieved, we estimate that roughly one in five estimated lives lost due to COVID-19 in low-income countries could have been prevented,” he adds.

The breakdown by country shows how all this impact, these unavoided deaths, is restricted to Africa and part of Southeast Asia. Congo, Nigeria, Ethiopia, Pakistan and India are the countries where the vaccines could have had the most effect with about 30,000 preventable deaths in each of these countries, except Nigeria, where it shoots up to 90,000, as seen on the map . To a lesser extent, this situation is extended to some Latin American countries.

56% of the population has at least one dose

On December 8, 2020, the world began to reverse the course of the SARS-CoV-2 pandemic with the application of the first vaccine to the general population. During the following 365 days, the authors of the report calculate, the inoculation of the preparations prevented between 14.4 and 19.8 million deaths in 185 countries. The variability in the figures responds to what data on the fatal incidence of COVID are considered, whether those confirmed by tests or the excess deaths detected in each country (this second is considered more reliable worldwide because there are countries that did not have reliable systems detection of cases, although there are also those that do not have a good record of excess deaths and others, such as China, that do not want to share it).

One year after the application of the first dose of a COVID vaccine, in the United Kingdom, 55.9% of the world’s population has received at least one dose, the report explains. 45.5% had two punctures and only 4.3% had received a booster dose (the second or third inoculation depending on the vaccine originally received). This data is, globally, higher than the 40% set by the WHO as a goal for the end of 2021, but it hides nuances: while 45.5% is the world average, the UN health arm referred to a minimum by country.

And the world average hides large differences between countries, warn the authors of the report, who are critical of rich countries and pharmaceutical companies in the management of doses: “As a result of multiple challenges, especially the limited supply of vaccines to COVAX (exacerbated by the fact that some countries have obtained a large share of the global vaccine supply, because pharmaceutical companies have not fulfilled their contractual obligations with COVAX, and because of unforeseeable delays in the supply of vaccines with short expiration windows), many low- and middle-income countries have not reached this goal” of community immunization, they write.

The world map of vaccination effectively shows a very unequal access to vaccines on the planet. The map (in the graph above) is tinted dark green, indicating a high dose of vaccination in the so-called West, while it barely goes beyond white – very few inoculated doses – in Africa and certain Asian countries.

In this regard, the portrait when the countries are grouped by income is very illuminating: in the high and medium-high income countries, the highest percentages of vaccinated are found on the right side of the graph, which indicates a large proportion of inoculated, while in the low-income low the vast majority are unvaccinated.

The vaccination gap in each country by income level

Percentage of the population with the complete vaccination schedule in each country, grouped by income levels. The size of the bubble indicates the population of the country. Featured the Spain vaccination

Source: Our World in Data, World Bank

The authors of the report explain that three quarters of the almost 20 million deaths prevented would be attributed to the direct protection offered by vaccines and the rest to the circle of virtue that originates: “indirect protection” rises due to the drop in circulation of the virus derived from greater general immunity, which results in less hospital pressure and the possibility of better caring for the sick.

The report also speculates on the evolution of the different moments of the pandemic and where the benefit of vaccines has been most notable. Thus, the study maintains that most of the deaths avoided in the first half of 2021 were in poor countries, “as a result of the significant wave in India that caused the emergence of the Delta variant,” they maintain. Hence the benefit passed to the rich countries with the opening of mobility, “which led to greater transmission of the virus.”

But globally, rich countries have benefited the most, and non-compliance with the WHO’s objectives has prevented another 600,000 deaths from being saved worldwide, a circumstance that low- and middle-income countries have suffered especially, according to the study. 60% of these deaths that could have been avoided but were not (347,500 of the total of 599,300) correspond to these nations, located mostly in Africa and the Eastern Mediterranean.

Graphics made by Ana Ordaz.