Vaccinationalism: would you cede your vaccine to a stranger?

Every man for himself. That's the strategy on available vaccines adopted by most countries around the world. The reality is very simple: There are not enough doses – even less if two doses are required – for the nearly 8 billion people on the planet. And rich countries – and others that are not so rich but planned well – are hogging the available vaccines.

Out of the 193 countries in the United Nations, only 66 have report having started some type of vaccinations, according to a New York Times list. That means there are 127 countries without vaccines, without hope of getting some in the short term.

This is what's being called 'vaccinationalism', a term that joins the words vaccine and nationalism. And it basically means “me, and mine first.” It's about governments that can afford to pay the top pharmaceutical companies for the coronavirus vaccines, and are trying to buy as many as possible. So countries like the United States, Canada and members of the European Union have already bought 3.8 billion doses while others, like Haiti, Cambodia and Uganda, have not received a single dose. In Latin America, only eight countries have announced vaccination programs – Argentina, Bolivia, Brazil, Chile, Costa Rica, Ecuador, Mexico and Panama – according to the newspaper El País.

The year 2021 will not see everything return to total normality.

“Without access to the vaccine by all countries, we are not going to control the transmission of covid-19,” Dr. Jarbas Barbosa, deputy director of the Pan American Health Organization, told me in an interview. “Vaccinating at least 70 percent of the (world's) population to reach herd immunity and interrupt the transmission will take many months. We are thinking maybe early 2022.”

But there are other, more discouraging predictions. “A majority of people in low-income countries will be waiting until 2024 for covid-19 vaccinations if high-income countries keep engaging in what some are calling 'vaccinationalism,'” a report by the Duke Global Health Institute cautioned.

The story of the immunizations so far has gone like this: If a government has the money to pay for vaccines, planned well and has good negotiators, it has almost certainly started to vaccinate its people. But the poorer countries are still waiting.

In the face of this blatant health inequality and injustice, the public-private organization COVAX is working with the World Health Organization to obtain 2 billion free doses of Covid-19 vaccines for 92 of the world's poorest countries.

COVAX negotiates directly with vaccine manufacturers and accepts donated doses. It's possible, for example, that Canada and France will have more doses than they need, and will donate them to the organization. Ten countries in Latin America and the Caribbean are in line to receive vaccines from COVAX.

The reality is that right now there are not enough vaccines for everyone. And there won't be for a long time. Ideally, the vaccines should go first to the countries that most urgently need them. But as we have seen, the world doesn't work that way.

Should rich countries give part of their vaccines to the poorer countries, I asked Dr. Barbosa. “It is morally – and from the health point of view – the right thing to do,” he replied.

But of course, what is morally right is not necessarily what the politicians are doing. I have not heard any president announce the suspension of domestic vaccinations in order to send those doses to another country with a less efficient health system.

Vaccinationalism will create some bubble countries, with populations inoculated and relatively protected against Covid-19 but surrounded by other nations exposed to the Corona virus. No, 2021 will not be the year of salvation or normality. More than 2.3 million people have died from Covid-19, and the new variants will kill thousands more before they have access to vaccines.

The real question is whether you would be willing to cede your vaccine to a stranger in another country. The ethics get complicated if you want to cede doses set aside for your parents or your children. Of course, that is a theoretical question because there is no mechanism for one person to pass a vaccine to another person in another country. But someone already made that decision for you. Your luck, and your vaccine, depends totally on where you live.

Vaccinationalism is real.