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COVID Booster Shots Are Coming. But Most Of The World Hasn't Gotten Its First Vaccine


Booster shots are ahead for millions of Americans who are already vaccinated. Pfizer is seeking FDA approval for a third dose that would bolster the vaccine's effectiveness, which they say wanes after eight months. But most people in the world still wait for their first shot. The Duke Global Health and Innovation Center found that the world's 92 poorest countries won't be able to reach a vaccination rate of 60% until 2023 or more. Dr. Krishna Udayakumar is director of that center and he joins us now. Dr. Udayakumar, thanks so much for being with us.

KRISHNA UDAYAKUMAR: Hi, Scott. Good to be with you.

SIMON: From what you see, what does the global vaccine distribution landscape appear to be like?

UDAYAKUMAR: Well, we now have multiple safe and effective vaccines, but we are in extreme challenged position when we think about access to those vaccines, depending on where you live in the world. In the U.S., we're talking about more than half of all Americans that are fully vaccinated. And yet if you look at the entire continent of Africa, less than 3% of that population has that same ability to be fully vaccinated.

SIMON: COVAX is the global program that was supposed to deliver vaccines to low- and middle-income countries, but its distribution target has fallen behind. What are some of the reasons?

UDAYAKUMAR: COVAX was a very well-intentioned attempt to make sure that we were thinking about equity and access for the poorest countries in the world. It has now raised enough money to be able to go out and buy over 2 billion doses of vaccine. The problem now is they can't get access to those vaccines because high-income countries and the upper-middle-income countries in the world have gotten to the line faster to get access to the vaccines as they're being produced.

SIMON: Is that because they pay more?

UDAYAKUMAR: It's partially because they paid more. It's also partially because they invested very early into the research and development of the vaccines. And we've seen that the site of manufacturing really makes a difference. So high-income countries have manufacturing, like in the U.S., like parts of Europe. And we've seen the U.S. and others start to apply export restrictions to make sure that their own populations got earlier access to vaccines.

SIMON: The World Health Organization has said that booster shot shouldn't be given while much of the world hasn't gotten even one vaccination. But I have to ask, does that really add up? If someone in America doesn't get a booster shot, does that really make it available for someone elsewhere in the world?

UDAYAKUMAR: The real picture is much more complex. What we're seeing is that the supply is ramping up considerably. In the next two or three months, we're going to be producing almost a billion doses of vaccine every month. So hopefully, we can reasonably roll out boosters and do even more to make sure that we're getting vaccines to the rest of the world at the same time because we still have at least tens of millions of unused vaccines in the U.S., some of them at risk of expiring. And those can't be taken back and shipped overseas. So it's not exactly the case that every single dose here takes away a dose somewhere else.

SIMON: The U.S. has pledged to send 500 million doses of vaccine overseas to help people, which is more than China or Russia or any other country. What more can the U.S. be doing?

UDAYAKUMAR: The problem is that response doesn't really match either the scope or the urgency of the global situation. The world needs more than 10 billion doses to put an end to this pandemic. So we need stronger leadership from the U.S. We need to make sure that we're getting more doses out more quickly, that we're helping other countries build up their own manufacturing capacity and, really importantly, that low- and middle-income countries see capacity and investment to build up their distribution and delivery systems. It would be a real shame if in two or three months, we started to see supply really increase, and we don't have the systems in place in order to get them where they need to go and turn them into vaccinations.

SIMON: Doctor, what about those Americans or Europeans who might be thinking, well, I think what's happening overseas is terrible, but it's got nothing to do with us?

UDAYAKUMAR: This terrible surge we're suffering from in the U.S. is largely from the delta variant, which emerged in a place where we didn't have control of infections around the world. The idea of boosters is very much a temporizing measure. We can't just keep going with boosters in the U.S. and ignore the rest of the world. It's really a matter of time until we see more and more variants emerge, one of which will surely pierce our vaccine immunity. And then we're back to square one.

SIMON: Dr. Krishna Udayakumar, director of the Duke Global Health Innovation Center, thanks so much for being with us.

UDAYAKUMAR: Thank you. Transcript provided by NPR, Copyright NPR.

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