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Vaccines Q & A

As Africa goes unvaccinated, U.S. remains awash in vaccines

Nearly 60% of the U.S. population is fully vaccinated. All of Africa: just 6%. Yet the United States is expanding boosters and authorizing vaccines for children age 5 to 11 years old – and hoarding and wasting additional doses.

William Moss, Executive Director, International Vaccine Access Center, JHU
November 1, 2021

Global vaccine inequities have always existed and continue to be an international challenge, said William Moss, executive director of the Johns Hopkins International Vaccine Access Center.

There were 23 million unvaccinated or under-vaccinated children in 2020 and 44%, or 10.1 million, of those children live in the World Health Organization’s Africa Region, said Moss, vaccinology lead for the Coronavirus Resource Center. The COVID-19 pandemic has only managed to exacerbate those inequities.

How stark are the global vaccine inequities?

Here in the United States we’ll very shortly start vaccinating young children 5 to 11 years of age at the same time we’re expanding booster doses to people who are fully vaccinated.

Nearly 60% of the U.S. population is fully vaccinated while only 6% of the population of the African continent is vaccinated.

Why is there so much inequality in vaccines?

These vaccine inequities reflect longstanding social, economic, and political inequities between wealthy and poor nations. As of the end of September, high-income countries administered 35 times more doses than low-income countries. It was 62 times in June, so it has come down as vaccine distributions to low-income countries have increased. But it is still a very high ratio that highlights the global inequities in COVID-19 vaccines.

“Nearly 60% of the U.S. is fully vaccinated; In Africa: 6%”

In addition, 56 WHO member countries did not achieve the goal of vaccinating 10% of their populations by the end of September. Those 56 countries comprise 20% of the world’s population, and 70% of these people live in Africa.

WHO Africa said that by the end of 2021, only five countries on the continent will have met the World Health Assembly’s goal of fully vaccinating 40% of their populations.

What would it take to help those nations succeed?

About 550 million doses are needed to help 82 countries in the world hit the 40% vaccinated mark. With 3 billion doses set to be produced by the end of the year, WHO officials said just 10 days of production could help those countries meet the goal.

What can the United States do to provide more doses to the world?

In addition to the donations that the United States and other nations have promised, people need to be aware of two other big problems: vaccine wastage and hoarding in the United States.

“A bigger tragedy lies in the wasting and hoarding of vaccines that could go to nations in desperate need”

NBC News recently reported that between March and September there were 15 million doses wasted in the United States. It is unacceptable that any COVID-19 vaccines are wasted in the United States given the global demand and insufficient supply.

There is also vaccine hoarding. A recent report from Doctors Without Borders estimated there are 500 million excess doses in the United States even if the nation were to give a booster dose to everyone who is eligible.

So high-income countries not only have vaccinated a much higher proportion of their populations they’re also storing – or hoarding – large numbers of vaccine doses that could be distributed to the rest of the world.

And there continue to be these stark global inequities in COVID-19 vaccine coverage while the United States is giving booster doses and vaccinating younger children who are at much lower risk.

But the bigger tragedy lies in the wasting and hoarding of vaccines that could be going to nations who desperately need them around the world.

Note: This Q&A has been updated to reflect how many more vaccine doses high-income nations have administered compared to low-income nations as of the end of September. The figure was 35 times more, not 35 times more per resident.

William Moss, Executive Director, International Vaccine Access Center, JHU

William Moss, MD, MPH, is Executive Director of the International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health.