The WHO wants rich nations to forego boosters until next year so the rest of the world can get its first vaccines. In the battle against Covid, though, it seems to be every nation for itself.
(Originally published Sept. 9 in “What in the World“) The World Health Organization has again spoken out against booster shots for Covid-19, with WHO Director-General Tedros Adhanom Ghebreyesus on Wednesday urging wealthy nations to postpone doling out boosters until next year so that more doses can go to nations that haven’t yet managed to vaccinate even a sliver of their populations.
The WHO is also calling for a stepped-up campaign to vaccinate pregnant women in South America and the Caribbean, where Covid threatens to reverse gains against infant mortality.
The WHO’s renewed criticism of boosters comes as the UN-backed organization trying to vaccinate the world against Covid-19, Covax, slashed by 25% its projections for how many vaccines it would deliver to needy nations this year.
Its message is likely to fall on deaf ears in countries panicking over the recent surge in the Delta strain of the virus—even as that surge ebbs. Israel has already been giving booster shots to its population after briefly becoming the epicenter of the pandemic (that has now shifted to the Balkans, specifically Kosovo and Montenegro). And as the U.S. death rate from Covid creeps back up to March levels, the Biden Administration is today scheduled to launch a new offensive, having already said it plans to make booster shots available this month to Americans, at least those who received Pfizer/BioNTech shots.
In terms of stopping the global pandemic, vaccinating as many people as possible just one time seems advantageous. It reduces infections and with it opportunities for new mutations like the Mu strain first discovered in Colombia, which can then boomerang back into vaccinated populations. It also seems likely to save the most lives, since vaccinated populations may be vulnerable to infection by Delta and subsequent strains as their immunity wanes, but are still less susceptible to death than those with no vaccinations at all.
Other than the obvious selfish reasons for keeping booster shots on hand to buttress the health of one’s own population, however, there are cynical arguments for not sharing vaccine doses with the less fortunate. For starters, the unvaccinated will eventually gain herd immunity through infection anyway, albeit at a potentially devastating cost in human life. And all those unvaccinated hosts will provide the virus with a massive opportunity to mutate into something new. But those mutations aren’t likely to be nearly as hardy as those the virus will have to make to survive in a vaccinated population. That’s why vaccinated populations will need booster shots regularly, just as we now have for the flu. Sharing vaccines, therefore, arguably diminishes their relative advantage over future strains. Like any other resource, its scarcity is what gives it value. It’s like money: if everyone has it, it’s worthless.
I hope this argument is as unappealing to you as it is to me. But for politicians, it will be difficult to trade any amount of domestic health for the global good. And there are those who say the WHO is tilting at a false dichotomy: a dose in one country doesn’t come entirely at the expense of a dose elsewhere. There are two problems: yes, competition for supplies has driven costs higher and rich nations have been sluggish about delivering promised donations of doses. But there’s also a shortage of resources to to deliver doses from the wealthy countries where they’re manufactured to the arms of the neediest in poorer parts of the world. That requires not just money, but infrastructure and people, all of which are in short supply in the places about which the WHO is most concerned. It’s this logistical challenge that needs attention most.