Does the U.S. really need 1.2 billion COVID vaccine doses when poorer countries barely have any?

At a moment when the United States — one of the countries hit hardest by the pandemic — is still averaging 57,000 new cases, 40,000 hospitalized patients and 1,000 deaths from COVID-19 every day, it’s hard for ordinary Americans to think about how much worse most of the rest of the world has it.

But when it comes to vaccination, Americans may soon be forced to do exactly that.

As the world’s wealthiest nation, the U.S. has made sure it will be able to return to normal a lot faster than almost any other country, for two simple reasons: (1) It is administering its current supply of vaccine doses faster than almost any other nation, and (2) it has purchased more vaccine doses, going forward, than almost any other country.

Consider this comparison. The U.S. is currently averaging nearly 2.5 million doses per day, according to Bloomberg. At this pace, it will take another five months to cover 75 percent of the population — a reasonable threshold for herd immunity, which is what happens when the virus starts to run out of unprotected hosts to infect.

At the same time, the U.S. has reserved a total of 1.2 billion doses from various manufacturers, enough to vaccinate its entire population twice over.

The European Union lags far behind. There, residents are being vaccinated at half the U.S. rate: 1.2 million doses per day, on average (despite the fact that the population of the EU exceeds the population of the U.S. by 120 million). Unless things speed up, it will take another 17 months for the EU to immunize 75 percent of its people — a full year longer than in the U.S.

But that’s not even the worst of it.

As a bloc, the 27 countries of the EU have snapped up even more doses than the U.S. — enough, in fact, to fully vaccinate 231 percent of their population. Ultimately, then, Europe should be covered, regardless of how much, or little, progress it has already made in vaccinating residents — as should powerhouses such as China and Russia (which plan to produce as much of their domestically developed vaccines as necessary) and other wealthy nations or regions such as Canada (which has secured enough doses for 335 percent of its population), Australia (235 percent), New Zealand (245 percent), Iceland (156 percent), Hong Kong (155 percent), Israel (138 percent), South Korea (135 percent) and Japan (129 percent).

Poorer nations will not be so fortunate.

Dozens of developing countries will eventually get vaccines through COVAX, a consortium backed by the World Health Organization to ensure equitable vaccine distribution; an arrangement brokered by Mexican billionaire Carlos Slim is set to deliver cheap vaccines throughout Latin America.

But even then, the percentage of these populations covered by current deals is meager, according to Bloomberg, ranging from 76 percent in Brazil to 61 percent in Egypt, 39 percent in South Africa, 23 percent across much of Central America and the Caribbean, and 5 percent throughout most of Africa and the Middle East.

Of the vaccine doses administered globally, about three-quarters have gone to only 10 countries. At least 30 nations have not yet injected a single person. South Africa, to pick one example, is administering fewer than 5,300 doses per day, on average; at that rate, it would take more than 10 years to vaccinate 75 percent of its population. Brazil, with more than 300,000 lives lost, has the second-highest death toll in the world — but so far it has fully vaccinated less than 2 percent of its population.

By Bloomberg’s count, 9.6 billion doses have already been reserved worldwide, enough to cover more than half the global population, if the shots were distributed evenly — which, of course, they’re not. And even if they were, it would still take two and a half years to immunize 75 percent of the people on the planet at the current global rate of vaccination.

A box containing vials of the Janssen COVID-19 vaccine sit on a counter before being transported to a refrigeration unit at Louisville Metro Health and Wellness headquarters on March 4, 2021 in Louisville, Kentucky. (Jon Cherry/Getty Images)
A box containing vials of Johnson & Johnson's Janssen COVID-19 vaccine at Louisville (Ky.) Metro Health and Wellness headquarters. (Jon Cherry/Getty Images)

Meanwhile, nations and regions with growing outbreaks are starting to clamp down on vaccine exports. As the New York Times reported Friday, “India, which had been a major vaccine distributor, is now holding back nearly all of the 2.4 million doses manufactured daily by a private company there,” and the EU has put forward “emergency legislation that would curb vaccine exports for the next six weeks.”

The Biden administration will soon face a difficult decision: what to do when U.S. supply outstrips demand, likely later this spring. Moderna, Pfizer and Johnson & Johnson have pledged to deliver a total of 240 million doses to the U.S. by the end of March, and more than twice that by the end of May — enough to inoculate every adult in America. Likewise, governors and public health officials in more than 40 states have said they will meet or beat President Biden’s goal of making every adult eligible for a vaccine by May 1, according to the New York Times, and at least 30 states plan to start universal eligibility in March or April.

“We want to, largely, be a part of the global solution here,” White House press secretary Jen Psaki said this week — before adding that “there are still a number of factors that are unpredictable that we need to plan for to the best of our ability, including the variants and the impact and what will be most effective, as well as what will work best with children,” for whom no vaccine has yet been approved.

In short, the contours of a new world split between vaccine haves and have-nots is already taking shape. For some, life as normal is on the horizon; for others, the crisis will continue, with all its disruptions and dangers. Meanwhile, the virus will continue to mutate as long as it has somewhere to spread.

The sooner rich countries like the U.S. use their abundant supply to vaccinate their own people, the sooner they can spread the surplus around. And the sooner they can do that, the sooner the COVID-19 crisis can end — not just for the wealthy, fortunate few, but for everyone, everywhere.


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