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Opinion

COVID-19 Vaccination: The Barriers to Achieving Global Herd Immunity

The writer is Professor of Medicine, Endocrinology & Nutrition, Director CardioMetabolic Institute, USA

COVID-19 vaccinations are key to overcoming the pandemic, says the World Health Organizations (WHO). The UN agency has approved the Chinese Sinopharm vaccine for emergency use, which is a prerequisite for inclusion in the global vaccine solidarity initiative, COVAX. Credit: Unsplash/Ivan Diaz via UN News

NEW JERSEY, USA, May 17 2021 (IPS) - The global community is conducting a rapid vaccination program against the SARS.Cov-2 virus, using several vaccines, authorised for emergency use. To date, the percentages of adults vaccinated vary between less than 2% to over 90% in different countries.

Vast socio-economic variation is primarily responsible for this disparity. Moreover, while the industrialised countries have secured more than adequate COVID vaccines, the middle- and low-income countries (MLIC) are significantly lagging.

Globally, the vaccination rate is slowing down, scarcity in some countries and refusal in others. At the current rate of vaccination, less than half of adults in MLIC countries will be vaccinated by the end of 2021.

Therefore, the focus of WHO and MLIC countries must be directed to improving this grim situation.

Concerns about achieving herd immunity

The increasing virulence of new mutations (i.e., variants) of SARS-CoV-2 [i.e., increasing reproductive number (R0)] increased R0 from original SARS.Cov-2higher infectivity, and the human behaviour, achieving a global herd immunity needs vaccinating approximately 85% of adults, in the absence of vaccinating children under 12 years.

Considering that between 15 and 30% of adults and adolescents (and parents of younger children) are reluctant to be vaccinated, and children up to 16 years are not approved for COVID vaccination in most countries, achieving herd immunity is impossible soon.

On May 5th, the FDA and the CDC approved vaccination of children between 12 and 15 years in the USA. However, vaccination of even 70% of children between 12 and 18 is insufficient for achieving herd immunity.

Although millions of people have recovered from COVID infection, at the current rate, accomplishing herd immunity collectively from immunisation and post-infection immunity) is hard.

In addition, there are concerns about short-term and long-term ill-effects, known and unknown, and to what degree is vaccinating children justified given their generally low (in the absence of obesity and deficient vitamin D) probability of being seriously harmed or killed by COVID-19.

Based on the availability of vaccines and the reasonable immune responses to defend against current and likely future variants, vaccination of adults and adolescents has become an ongoing process.

Barriers to achieving herd immunity

The collective effects of those mentioned above likely to prevent a sufficient percentage of people fully immunised within a given period to achieve and maintain herd immunity. Failure will allow the virus to spread within and from country to country for years to come, as it disseminated across the world during the early part of the pandemic.

It demonstrates the importance of honest and open collaborations of all counties, working coherently to achieve global herd immunity, enabling the elimination of SARS.Cov-2 from the world.

Herd immunity cannot be achieved through vaccination and actual infection unless (A) pharmaceutical (vaccine) companies eliminate their greed, (B) revoke or share restrictive patents related to COVID vaccines and their production for a greater good, (C) provide adequate doses of effective vaccines free or at a discount for the MLICs, (D) motivate and incentivise those who are reluctant to get vaccinated, and (E) maintain wearing facemasks and avoiding mass gatherings for months to come.

Even if the mentioned barriers are overcome, the inability to access, secure or purchase COVID-vaccines by most MLICs will prevent achieving herd immunity. Despite vast propaganda, the World Health Organization (WHO), GAVI institute, and industrialised (G-20) countries seem not to pay attention to overcome these critical barriers promptly.

Vaccination of children

The recently started vaccine clinical trials in children between age 5 and 16 years is expected to be completed by the end of summer/fall 2021. Assuming there are no complications or unexpected developments, COVID vaccines for children ages five upwards are likely to be approved towards the end of the year.

Despite rhetoric by vaccine companies and certain administrators, the scenario could worsen because both the natural and vaccine-induced immunity fail to sustain for more than one year.

Still, concerns remain about currently unknown longer-term ill-effects of vaccine and the degree to which these uncertainties can be justified, depending on the near-term likelihood of COVID-19 infection versus harm to a child.

While clinical trials are ongoing in children, the wealthy countries should consider (A) waiving patents related to the COVID vaccine, (B ) postponing vaccination of children under 16 years, and (C) divert millions of doses of surplus vaccines and those ear-marked for younger children to MLIC countries immediately.

The approval status of COVID vaccines

COVID vaccines are currently using, via “emergency use authorisation” (EUA) by regulatory authorities, including the FDA. EUA is required by federal law when the intended agent is not licensed and there is no effective treatment.

However, this temporary approval status under the EUA for COVID-vaccines will be- or arguably should be-rescinded when alternative agents, such as vitamin D3, ivermectin, etc., are approved for prevention or treatment of COVID.

It is noteworthy that none of the COVID vaccines is licensed for the prevention or treatment of COVID. Consequently, COVID-19 vaccine consent forms and promotional material mandated to indicate that vaccine has not been approved or licensed by the Federal Drug Administration (FDA) but authorised only for emergency use (see below).

Moreover, federal law prohibits mandating investigational agents (i.e., COVID vaccines) by states, employers, school administrators, etc.: i.e., medicines authorised under the EUA rule cannot be legally mandated. Thus, people have the right to refuse.

While organisations and entities are encouraged to facilitate and provide vaccination to employees and students, the law prevents them from making vaccination compulsory. While vaccination is likely to prevent complications and deaths, employee and students have the right to decline. If the regulators, such as the FDA, eventually licensed vaccines, guidelines will change.

Industry disclaimers associated with COVID vaccine

The US Federal government and the FDA have mandated the inclusion of specific disclaimers by manufacturers and state governments on COVID-19 vaccines. The following statements appear in the consent forms informing the recipients prior to getting the vaccine and advertisements.

The disclaimer states, “I have informed that this COVID-19 vaccine is an unapproved drug permitted under an Emergency Use Authorisation from the FDA. I have been informed of alternatives to receiving the COVID-19 vaccine and the risks and benefits of alternatives. I have also been informed of the significant known and potential risks and benefits of this COVID-19 vaccine and the extent to which such risks and benefits are unknown.”

Nevertheless, no one reads these small-print consent forms in detail since they are eager to get vaccinated. The second half of the above disclaimer is not adhered to by the vast majority of vaccination staff, and most have no clue about it.

Consequently, vaccination teams neither inform recipients of alternative options nor potential risks, benefits, or available alternatives to recipients to make an informed choice.

Contact information: Sunil J. Wimalawansa, MD, PhD, MBA, DSc: suniljw@hotmail.com

 


  
 
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