Everybody is talking about vaccines, but who on earth gets them?
We are witnessing the largest vaccination campaign in history. Although the number of doses that have been administered so far are enough to fully vaccinate about 5% of the global population against COVID-19, the distribution has been highly unequal. 11% of the global population in the wealthiest nations have been administered 40% of the COVID-19 vaccine doses, whereas 11% of the least-wealthy nations have only been administered 1.6% of the doses.
The World Health Organization’s director-general Tedros Adhanom Ghebeyesus described the current imbalance in COVID-19 vaccine distribution between rich and poor countries as a ‘catastrophic moral failure’. He explained that ‘on average, in high-income countries, almost one in four people have received a COVID-19 vaccine. In low-income countries, it's one in more than 500’.
Vaccine inequality is not an issue limited to COVID-19 alone. In a recent article in the journal “Environment and Planning A”, we examined data from the medical literature about global vaccine distribution, and we find that seasonal influenza vaccine distribution suffers from similar disparities.
Worldwide, 3 to 5 million people fall seriously ill with seasonal flu each year. The annual death toll is estimated to be between 290,000 and 650,000. According to an editorial by lead author Anthony S. Fauci (Chief Medical Advisor to the US President), the true death rate of COVID-19 is comparable to that of severe seasonal influenza: around 0.1%. Because seasonal influenza activity peaks in ‘flu season’, when the climate in each hemisphere gets colder, seasonal influenza occurs in annual epidemics across the globe. Therefore, the yearly medical and economic burden of influenza is substantial.
Seasonal influenza vaccines provide moderate to high protection (40% - 60% efficacy) against seasonal influenza infection. For this reason, they have been on the World Health Organization’s Model List of Essential Medicines since 1979. Approximately 490 million doses of seasonal influenza vaccine are manufactured each year, but our investigation reveals enormous geographic disparities. We present these data in two maps: (a) a conventional world map with colors representing vaccine doses per capita by country, and (b) a cartogram with the area representing the absolute number of vaccine doses. In tandem, these maps show that large parts of Africa and Asia vaccinate a much smaller part of their population when compared to wealthier regions such as North America, Western Europe, and Japan.
The maps reveal shortcomings of previous global vaccine distribution models. When securing enough vaccine doses is left to each individual country, lower-income countries struggle to protect their population against seasonal influenza. The same pattern is now emerging for COVID-19: high-income countries have purchased more than half (54%) of all vaccine doses, despite only accounting for 19% of the global adult population. Low- and middle-income countries have only secured 33% of doses, despite accounting for 81% of adults. The international COVAX initiative aims to procure and deliver COVID-19 vaccines to both higher- and lower-income countries. However, even if we allocated all 1.12 billion COVAX doses to low- and middle-income countries, 41% of adults in the world will not get vaccinated.
By highlighting vaccine inequality, we hope our article will raise awareness and encourage policymakers to initiate a new international system for distributing vaccines that can be extended to future pandemics. Fair allocation of vaccines to all countries would mitigate the burden of infectious diseases on healthcare services and the global economy.
Articles Details
Mapping the inequality of the global distribution of seasonal influenza vaccine
Yen Ching Yau, Michael T Gastner
First Published March 8, 2021 Research Article
DOI: 10.1177/0308518X21998356
Environment and Planning A: Economy and Space
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