About a year since mostly wealthy nations began rolling out coronavirus vaccines, more than half of the world population has been fully vaccinated, but the global rollout remains uneven, with poor countries reporting much lower vaccination rates than rich countries.
Public health experts have been warning that vaccine inequity is helping prolong the pandemic, as the focus of those seeking to speed up global vaccine coverage begins to shift from filling a shortfall of vaccine supply to distributing the doses and persuading people to get them.
Nearly 54% of the world population is fully vaccinated against the coronavirus, according to Our World in Data, an information partnership between the University of Oxford and the Global Change Data Lab charity.
Nearly 62% has received at least one vaccine dose. Yet, less than 11% of people in low-income countries have received at least one dose, Our World in Data says.
That number jumps to about 55% for lower-middle-income countries and nearly 80% for both upper-middle-income and high-income nations.
The United States, countries of the European Union and others were criticized for buying up most of the early global supply of coronavirus vaccines.
Covax, a United Nations-backed global vaccine-sharing initiative, was created in April 2020 as a way of ensuring that the rest of the world could access the vaccines it needed. It initially struggled to secure enough doses, because supplies were limited and went to the highest bidder.
Now, vaccine doses are less scarce. Covax shipped its billionth dose in mid-January, and according to the World Health Organization, African countries were sent twice the number of vaccine doses in January as were shipped six months ago.
As the supply grows, there are other reasons some countries are not hitting vaccination targets, public health experts say.
The WHO said last month that nearly 90 countries had not reached the public health agency's national vaccination target for late 2021 and were not on track to reach its target for mid-2022. Many of those countries are in Africa, where 85% of people have not received a dose of coronavirus vaccine.
WHO officials said at a news conference last month that countries that are lagging face several challenges in administering vaccines, including a lack of "leadership and coordination," "health worker shortages" and vaccine hesitancy.
The officials blamed the inequitable rollout of vaccines, in part, on wealthy countries.
Developed nations "did not share vaccines for six months, seven months, eight months," Bruce Aylward, senior adviser to the WHO's director general, said during a Jan. 12 news conference.
"What we did share was a lot of misinformation, a lot of bad practice, a lot of problems," he said.
"[W]e've made it twice as hard or three times as hard for low-income countries, many of them, to be able to achieve high coverage," Aylward said, adding that poorer countries were struggling with vaccine hesitancy, a lack of financing and donated vaccines with very short shelf lives.
At a conference of the European Union's health and foreign ministers Wednesday, officials appeared to acknowledge that donating vaccines to the developing world is not enough.
"[D]onating vaccines is one thing," EU Health Commissioner Stella Kyriakides said. "Ensuring we vaccinate people is another."
Countries that are struggling to vaccinate their populations need more health care professionals and medical equipment, larger investments in medical research and "state-of-the-art manufacturing capabilities" for domestic vaccine production, Kyriakides said, citing an EU pledge of about $1.1 billion for a "Team Europe initiative on manufacturing and access to vaccines, medicines and health technologies in Africa."
At a Thursday news briefing of the WHO Regional Office for Africa, public health officials were cautiously optimistic about African countries' pandemic outlook. If "current trends continue, the continent can control the pandemic in 2022," the office said in a news release, adding that "continued vigilance is key" to deal with outbreaks and monitor the possible emergence of new variants.
"Although Africa still lags behind on vaccination, with only 11% of the adult population fully vaccinated, we now have a steady supply of doses flowing in," said Matshidiso Moeti, WHO regional director for Africa.
Now, she said, efforts should be focused on "scaling-up covid-19 vaccine uptake" in African countries, as well as increasing the capacity for testing and surveillance of coronavirus variants.
SHOTS MANDATE
A federal appeals court has declined, for now, to allow the Biden administration to require covid-19 vaccinations for federal employees.
The 5th U.S. Circuit Court of Appeals in New Orleans ruled 2-1 Wednesday to maintain a block on the mandate that a Texas-based federal judge had issued on Jan. 21. The administration had asked the New Orleans court for an injunction allowing the federal worker mandate to move forward pending appeal.
President Joe Biden announced in September that more than 3.5 million federal workers were required to get vaccinations, with no option to get regularly tested instead, unless they secured approved medical or religious exemptions. The requirement kicked in November.
White House press secretary Jen Psaki said last month that 98% of federal workers are vaccinated.
Judge Jeffrey Brown, who was appointed for the Southern District of Texas by then-President Donald Trump, issued an injunction against the requirement last month, saying the Biden administration exceeded its authority.
The 5th Circuit panel's order didn't address the merits of the case. It was a brief order by judges Jerry Smith and Don Willett putting off a decision on whether to lift the injunction pending further proceedings, and ordering the expedited filing of briefs.
Judge Stephen Higginson issued a 10-page dissent noting that 12 other district judges had declined to block the rule.
Higginson said many private businesses had adopted vaccination mandates, adding "the public interest is not served by a single ... district judge, lacking public health expertise and made unaccountable through life tenure, telling the President of the United States, in his capacity as CEO of the federal workforce, that he cannot take the same lifesaving workplace safety measures as these private sector CEOs."
Information for this article was contributed by Annabelle Timsit of The Washington Post and by Kevin McGill of The Associated Press.