The Covid-19 vaccine has been in the news and always been seen as a ray of hope since the beginning of the pandemic. However, even before the first Covid vaccine was approved in any part of the world, the challenge of ‘vaccine nationalism’ was identified, in which many affluent nations secured far more vaccine doses for their population than needed. Some went up to secure up to five times more than what their population needed. It was criticised but that did not stop the rich nations.
Fortunately, the vaccine scientists have helped us fight some challenges and world over, the success of Covid inoculation research and development resulted in nearly 20 vaccines having received emergency use authorisation in 20 months of the pandemic. Yet, about 80% of the 580 crore Covid vaccines administered worldwide as of mid-September are in high- and upper-middle-income countries. Only 0.5% of the total Covid vaccines have reached low-income countries, though the availability of vaccines is equally important for each nation. Most rich countries have given two doses to up to 80% of the population and are considering third and fourth shots, while in many nations, barely 10% of the population has received one shot. This is a clear example of the blatant ‘vaccine inequity’. The global collaboration of COVAX, co-led by WHO, CEPI (Coalition for Epidemic Preparedness Innovations) and Gavi, the vaccine alliance, has failed to get the jabs it needed. In the past few months, ‘vaccine nationalism’ and ‘vaccine inequity’ show that no matter how much rich countries and the global community talk about cooperation, their claims are hollow and this cycle doesn’t seem to end.
There is a new episode being added to this saga, with travel and vaccination guidelines recently issued by the UK. According to these British travel guidelines, from October 4, citizens of many countries who have completed their full vaccination in their nation will have to undergo a mandatory 10-day quarantine in the UK along with regular RT-PCR tests. This also includes those people who have received two shots of Covishield (Oxford AstraZeneca vaccine manufactured by Serum Institute of India) in India; they will be subjected to all the restrictions that apply to unvaccinated persons. It has to be noted that Covishield is scientifically similar to the vaccine being used in the UK with the only difference being that it is manufactured in India.
Britain’s move is just a sequel to the series of errors that the world community continues to make with regard to Covid vaccination. Otherwise, how can it be explained that the vaccines Britain is providing in its own country are not recognised for the citizens of other nations? Britain sent the Oxford-AZ vaccines to Kenya, but if people from the African nation who have received the vaccine provided by the UK visit Britain, they will be considered unvaccinated. Many countries including India protested and termed the new UK travel policy ‘discriminatory’. Two days later, the UK government said that Covishield is valid but the issue is with the vaccine certificate. The matter is not completely resolved yet, though a solution to this will emerge. However, this incident indicates the need for serious brainstorming on the mistakes being made by the world community in battling the pandemic.
In addition, it is a time of self-reflection for India as well. A lot of information related to Covid vaccine research and use is not easily available and documented. This originates in the fact that the health data recording and reporting system in India are not taken seriously and given due importance. Else, why should the data of a vaccine clinical trial take months to be synthesised? We know that would be needed and things should be planned in advance. Clearly, India seems to be slow in collecting and using data in the health sector. It can be said that if the process of collecting data had been strengthened, then perhaps the issue of approval of the vaccines would have reached WHO earlier than it has happened and a decision on emergency use listing by the global body could have happened. India is facing a situation where on the one hand, Covaxin is not recognised by WHO, while on the other hand, Covishield is facing restrictions in many countries. There is no doubt that India has the capability to do better than this. If this situation continues for a long time, then public enthusiasm about vaccines may be weakened, which has to be avoided at all costs.
‘Vaccine nationalism’, ‘vaccine discrimination’ and ‘vaccine inequity’ are emerging as some of the major challenges in the Covid pandemic. These are not the only ones. On many fronts where solidarity and collaboration are needed, many countries have disappointed the global community. There is still some time. The countries need to share vaccines with the rest of the world and collaborate with COVAX. In this direction, the announcement made by the Government of India that some Covid vaccines will be exported from mid-October is commendable. If countries do not cooperate with each other during the pandemic, then when will they? Time is short but the global community has yet another chance. The coming generation will assess all our steps.
Dr Chandrakant Lahariya
Physician-epidemiologist, and public policy and health systems expert
Dr Lahariya is the co-author of ‘Till We Win: India’s Fight Against The Covid-19 Pandemic’