Omicron raises concerns about global vaccine equity and hesitancy

Global health experts say the emergence of the Omicron variant in southern Africa is a byproduct of unheeded warnings about vaccine inequity they've said could fuel public health crises in the developing world and prolong the Covid-19 pandemic.

Africa remains the most under-vaccinated region of the world, with some 7 percent of its 1.3 billion people fully immunized, while North America has vaccinated about 54 percent of its population, according to Our World in Data. While developed nations committed to donate some of their excess doses and the U.S. bought 1 billion Pfizer-BioNTech shots for the rest of the world, only around half a billion doses overall have reached developing nations so far.

“We will only prevent variants from emerging if we are able to protect all of the world’s population, not just the wealthy parts,” said Seth Berkley, CEO of Gavi, the organization co-leading the COVAX vaccine equity initiative, in an emailed statement.

After waiting on supplies for months, South Africa, at the epicenter of the new outbreak, now has enough doses of Pfizer and Johnson & Johnson vaccines, but the number of people getting shots is about 120,000 per day, less than half of the government’s target of 300,000 per day. Immunizations among 20- to 40 year-olds are lagging, making the young adult cohort particularly vulnerable to the fast-spreading variant.

But some African officials are annoyed that instead of enabling global equity to Covid vaccines, developed nations are slapping southern African nations with travel bans in response to the new variant.

“We advocated, begged, pleaded that high-income countries share doses, support #TRIPS & local production of vaccines on the continent. They largely refused,” tweeted Ayoade Alakija, who co-chairs the African Union’s Covid-19 vaccine delivery alliance. “This was inevitable but completely avoidable. Travel bans are not the answer, urgently vaccinating the world is,” she wrote Friday.

African Union officials have complained about the lack of vaccines since the U.S., United Kingdom and the European Union pre-purchased the bulk of available supplies at the end of 2020. COVAX, coordinated by the World Health Organization and Gavi, has been unable to make up for the shortfall and reach the most at-risk people in poor countries.

Berkley said the supply situation, and the urgency of the new variant, requires an all-out commitment from governments and vaccine manufacturers.

“This means manufacturers and donors providing the visibility for countries to roll out the largest national immunization programs in their history, and it means recipient countries using all resources available to get safe and effective vaccines to those that need them," he said.

Beyond supply concerns, experts are grappling with high rates of vaccine hesitancy fueled by mistrust of government, of the pharmaceutical industry and online misinformation.

The inability to pinpoint how the variant emerged — and a lack of knowledge about how well it stands up to vaccines — makes it difficult to link the new crisis with the broader equity question, said Ingrid Katz, a physician and associate faculty director at Harvard Global Health Institute who has worked on HIV in the region.

“What we know is that South Africa has some of the best scientists in the region and perhaps in the world in terms of sequencing and they're sequencing much more aggressively than we are in the United States,” she said.

Still, regions with less access to the vaccine are most vulnerable if they're in the path of a fast-moving regional outbreak.

“It’s going to propagate in regions of the world that have very low vaccination rates,” Katz said.

South Africa and Africa will need financial, public health and scientific support to ensure the virus doesn’t spread to the rest of the world, tweeted Tulio de Oliveira, the director of the Centre for Epidemic Response and Innovation in South Africa and one of the top experts working on genomic sequencing.

So far, the world’s response to the emergence of Omicron is a lesson on how not to deal with a pandemic, according to Madhukar Pai, a doctor and global health expert who teaches at the McGill School of Population and Global Health in Montreal. “Big panic over a new variant that's not fully understood yet & punishing countries for reporting it. No panic over the 3+ billion people who've had little access to vaccines, tests & therapeutics,” he tweeted.

The Associated Press contributed to this report.