While America struggles to entice the hesitant toward a COVID-19 vaccine, millions of people around the world lack the luxury of accessing the lifesaving shots.
Some 82 percent of shots have been administered in high- and upper-middle-income countries, according to the University of Oxford’s Our World in Data project, while 0.4 percent have gone to people in low-income countries.
The United States has procured 4.6 doses for each person who lives here, and that’s on the low end compared to Canada (10.5 doses per resident) and the United Kingdom (8.2 doses per resident). China and Pakistan, meanwhile, have 0.3 doses per resident. Honduras and Zimbabwe have 0.2 doses per resident.
A new NBC News report found that since March 1, pharmacies and state governments in the U.S. have thrown away at least 15.1 million COVID-19 vaccine doses — more shots than some countries have secured for their entire populations.
“It’s a public health issue,” said Clayton Thomason, chairperson of Rush University’s department of religion, health and human values and director of the school’s health care ethics program. “The populations of many middle- and low-income countries remain predominantly unprotected, and variants develop in unprotected populations.”
We won’t get rid of COVID-19, in other words, by hogging vaccines for wealthy nations.
Vaccine inequity also poses enormous ethical and moral questions, particularly with COVID-19 boosters being made available to most Americans later this month — even as populations around the globe wait for their first doses.
“The concern is large-scale vaccine booster campaigns are just going to exacerbate the global inequities,” Thomason said.
I called Thomason because I wanted to know how a medical ethicist is grappling with this moment.
I’m delighted to have access to COVID-19 boosters for myself and my family. I had the virus last October. It damaged my heart, left me hospitalized for days and out of work for six weeks. I spent most of the last 18 months writing about the ravages of the virus on families and communities and livelihoods. I want to do anything in my power to vanquish this beast.
I also know from checking my childrens’ vaccines records that inoculations are rarely one-and-done. My children, ages 12 and 15, have each received four polio vaccine shots, five DTaP vaccine shots, three Hepatitis B vaccine shots and four shots of something called pneumococcal conjugate to protect against something called Streptococcus pneumoniae, which I’ve never had to pronounce out loud or worry about because we’re vaccinated against it.
We’ll take as many COVID-19 boosters as our doctors tell us to.
But my delight is tampered by the knowledge my family’s third doses will take place against a backdrop of grave inequity around the world.
Forgoing a booster is not the answer, Thomason said.
“Refusing a booster won’t redistribute that dose to someone who needs a first dose,” he said.
The doses are purchased, distributed and carefully stored for a distinct period of time for a distinct population, and those logistics are arranged on a federal level. (The Biden administration did arrange a donation agreement with Moderna and Covax — an abbreviation for COVID-19 Vaccines Global Access, an alliance of global health organizations — to distribute 80 million vaccine doses to about 50 countries around the world, it’s worth noting.)
But neither are we powerless against inequity.
“One can be grateful for the privilege and protect one’s self, one’s community, one’s family, and at the same time advocate for the equitable treatment of others,” Thomason said. “There’s certainly room for advocacy at the national and local level.”
We can start by encouraging our vaccine-hesitant acquaintances to receive their dose, which slows the virus’ spread and reduces the number of wasted doses. We can contact our local elected officials and community leaders and push for equitable distribution of vaccine information and vaccine doses in our own cities and states.
We can support organizations working to fund vaccine distributions around the world. I checked in with UNICEF USA, which is working with Covax to procure and distribute shots around the world.
UNICEF USA Midwest Regional Managing Director Beth McCostlin pointed me to a call of action at www.unicefusa.org/endthepandemic, which walks you through the steps required to get vaccines into communities around the world — sometimes by donkey or drone.
The site includes a place to donate money to support equitable vaccine distribution, testing and treatments as well as a link to urge Congress to support UNICEF’s vaccine distribution efforts.
“The ethical basis of the protection of public health,” Thomason said, “is that we all do have in common the commonwealth, the common good.”
I want to believe that this terrible chapter of history, this chapter that’s leaving us broken and diminished, will also leave us with a truer, clearer understanding of our connectedness — within our communities and around the globe.
I want to believe that as we’re picking up the pieces of our shattered psyches and shattered hopes and shattered hearts that we’ll put them back together with our eyes trained on our neighbors as well as ourselves. That we will have witnessed and will remember how things spread — a virus, sure. But also awareness. Also help. Also the acknowledgment of that common good, and the understanding that we hold it in our grip.
There’s potential for tremendous good there.