What Does Vaccine Inequality Look Like? See Chart

2021/04/23 Leave a comment

In addition to inequalities within and between Western countries, not to forget the global ones:

Earlier this month, Namibia’s president Hage Geingob was invited to join the WHO’s weekly press briefing to talk about World Health Day. The idea was for him to help explain to the hundreds of reporters from around the world what was happening with COVID immunization efforts in his southern African nation.

In what has become all too common during the pandemic, the video connection was unstable. The Namibian president kept freezing on the screen. The audio would become muffled and incomprehensible, or the sound would drop out entirely.

Then at times there would be bursts of clarity. “It is COVID apartheid!” Geingob shouted.

“We already made our deposit!” He insisted. It became clear that the president was using his time not to speak to the press but to harangue WHO officials in the room to finally deliver the vaccine doses he’d already paid for through COVAX. That’s the WHO-led initiative to procure and equitably distribute vaccines, particularly for low- and middle-income nations.

“We have made the advance payment but there is this exclusion. COVID apartheid is now prevailing,” he said, comparing the inequity in global access to vaccines to the South African Apartheid system that divided the country along racial lines and trapped millions of Black Africans in poverty.

“Up until now, we didn’t get any,” he said of the vaccines Namibia has ordered. The few hundred doses that Namibia has been able to secure is “only because our good friends, China and India, gave us vaccines.”

So far Namibia has given fewer than 3,000 COVID jabs. This is a fraction of what a mass vaccination site in the U.S., like the Javits Center in New York City, administers every day.

In the United States nearly 40% of the population has now gotten at least one dose of a vaccine. In Namibia less than 0.1% of the population has gotten a shot.

The U.S. has administered more COVID vaccinations in to arms than any other country in the world. Ingrid Katz, the associate faculty director at the Harvard Global Health Institute, says the U.S. is now in “somewhat rarified air” in the global vaccination effort. “There are a few other nations out there who are with us.” Globally just 2.3% of the world’s population is now fully vaccinated. In Africa it’s fewer than 1%.

“It you look at the data globally,” Katz says. “You’ll see that about 75% of the vaccines have gone to only 10 countries globally. There’s massive, massive inequality.”

The countries that have managed to get a lot of people vaccinated — the U.S., the U.K., India — all happen to have manufacturing plants that are producing the vaccines. They also have had export restrictions which meant their own citizens have been at the front of the line to get immunized. Important regional players such as South Africa have fully vaccinated only ½ of 1% of their population. In the Philippines it’s less than 0.1%. Even wealthy nations in Europe such as Germany, Spain, Italy and France haven’t yet gotten above 7%.

Katz says this is no way to tackle a global health crisis. “If we assume that it’s fine just to vaccinate American citizens but no one else in the world, we’re going to be in big trouble,” she says.

Katz had a paper in the New England Journal of Medicine. In it she and her colleagues calculated that based on the vaccination rates happening globally at the end of March, it would take 4.6 years for the planet to reach herd immunity against SARS-CoV-2. Since then the number of shots being given each week has increased.

“But we’re still talking years. It’s not going to be months,” until this pandemic is under control, she says. And if the virus continues to spread and mutate for several more years, there’s a good chance that a variant could emerge to which the vaccines provide no protection.

At that point the U.S. would be in no better position than a country that hadn’t vaccinated at all.

Getting the whole world immunized “is an investment in our own self-interest,” Katz says.

Source: What Does Vaccine Inequality Look Like? See Chart

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How to Reach the Unvaccinated: To counter online misinformation, it helps to knock on doors.

2021/03/12 Leave a comment

Of note, likely similar in Canada:

What does it take to get credible information about the coronavirus vaccine, and the vaccines themselves, to more people?

My colleague Sheera Frenkel spoke to experts and followed a community group as it went door to door in an ethnically diverse neighborhood in Northern California to understand the reasons behind the low vaccination rates for Black and Hispanic Americanscompared with non-Hispanic white people.

What Sheera found, as she detailed in an article on Wednesday, was how online vaccine myths reinforce people’s fears and the ways that personal outreach and easier access to doses can make a big difference.

Shira: What surprised you from your reporting?

Sheera: One question I was trying to answer was whether the incorrect narratives floating around online about the vaccines — that they change people’s DNA or are a means of government control — were reaching Black and Hispanic communities and other people of color in the real world. I heard false information like that firsthand. It was eye opening.

The other surprise was how effective it was for someone to stand on a person’s doorstep and talk about their own experience getting a coronavirus vaccine and answer questions. The outreach group talked to each household for half an hour or longer sometimes. That may make more of a difference than any online health campaign ever could.

But it’s laborious to go door to door. Can reliable information ever travel as far and fast as misinformation?

Internet platforms amplify misinformation, and countering it isn’t simple. It takes more than a celebrity posting a vaccine selfie on Instagram.

Are we overstating the impact of vaccine hesitancy? The pediatrician Rhea Boyd recently wrote in our Opinion section that the primary barrier to Covid-19 vaccinations among Black Americans is a lack of access, not wariness about getting the shot.

It’s both.

Two things struck me from my reporting. First, false vaccine information is persuasive because it builds on something that people know to be true: The medical community has mistreatedpeople of color, and the bias continues. And second, vaccine hesitancy is different in each community.

That makes reaching Black Americans different than reaching new immigrants who are reading articles in Vietnamese or Chinese that make them concerned about vaccine safety. It’s an opportunity for community leaders to address what’s keeping people who trust them from getting vaccinated.YOUR CORONAVIRUS TRACKER: We’ll send you the latest data for places you care about each day.Sign Up

You’ve written about Russian propaganda in Latin America that fanned concerns about European and American coronavirus vaccines. Is that also reaching people in the United States?

Yes. Two Russian state-backed media networks, Sputnik and Russia Today, have among the most popular Spanish-language Facebook pages in the world. Their news reaches Spanish speakers in the United States.

I heard people ask in my reporting, Why should they get an American vaccine when the Russian one is better? (Those articles tend to cite real statistics but in misleading contexts.) I asked one man I met, George Rodriguez, where he had read that, and we figured out that it was from one of those Russian news sites.

What has been effective at increasing the coronavirus vaccination rates among Black and Latino Americans?

It seems effective to hold walk-in vaccination clinics. People can show up, ask questions they have and get a shot.

What about Republicans? Surveysshow that they are among the wariest Americans about coronavirus vaccines.

There have been concerns among some Republicans that people will be forced to get vaccinated, but that isn’t happening. 

It’s clear that among Republicans and other groups with vaccine hesitancy, once we know more people who are getting vaccinated, we’re more willing to do it, too.

How do you see this moving forward?

In just the last few weeks, I’ve gotten more optimistic about closing the vaccination gap. There have been huge strides in reaching people, getting those walk-in vaccination clinics open or taking vaccines to people, and addressing people’s concerns.

Source: https://www.nytimes.com/2021/03/10/technology/vaccine-misinformation-access.html

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Concern among Muslims over halal status of COVID-19 vaccine

2020/12/21 Leave a comment

Sigh over those who interpret these vaccines as being haram compared to the majority consensus:

In October, Indonesian diplomats and Muslim clerics stepped off a plane in China. While the diplomats were there to finalize deals to ensure millions of doses reached Indonesian citizens, the clerics had a much different concern: Whether the COVID-19 vaccine was permissible for use under Islamic law.

As companies race to develop a COVID-19 vaccine and countries scramble to secure doses, questions about the use of pork products — banned by some religious groups — has raised concerns about the possibility of disrupted immunization campaigns.

Pork-derived gelatin has been widely used as a stabilizer to ensure vaccines remain safe and effective during storage and transport. Some companies have worked for years to develop pork-free vaccines: Swiss pharmaceutical company Novartis has produced a pork-free meningitis vaccine, while Saudi- and Malaysia-based AJ Pharma is currently working on one of their own.

But demand, existing supply chains, cost and the shorter shelf life of vaccines not containing porcine gelatin means the ingredient is likely to continue to be used in a majority of vaccines for years, said Dr. Salman Waqar, general secretary of the British Islamic Medical Association.

Spokespeople for Pfizer, Moderna and AstraZeneca have said that pork products are not part of their COVID-19 vaccines. But limited supply and preexisting deals worth millions of dollars with other companies means that some countries with large Muslim populations, such as Indonesia, will receive vaccines that have not yet been certified to be gelatin-free.

This presents a dilemma for religious communities, including Orthodox Jews and Muslims, where the consumption of pork products is deemed religiously unclean, and how the ban is applied to medicine, he said.

“There’s a difference of opinion amongst Islamic scholars as to whether you take something like pork gelatin and make it undergo a rigorous chemical transformation,” Waqar said. “Is that still considered to be religiously impure for you to take?”

The majority consensus from past debates over pork gelatin use in vaccines is that it is permissible under Islamic law, as “greater harm” would occur if the vaccines weren’t used, said Dr. Harunor Rashid, an associate professor at the University of Sydney.

There’s a similar assessment by a broad consensus of religious leaders in the Orthodox Jewish community as well.

“According to the Jewish law, the prohibition on eating pork or using pork is only forbidden when it’s a natural way of eating it,” said Rabbi David Stav, chairman of Tzohar, a rabbinical organization in Israel.

If “it’s injected into the body, not (eaten) through the mouth,” then there is “no prohibition and no problem, especially when we are concerned about sicknesses,” he said.

Yet there have been dissenting opinions on the issue — some with serious health consequences for Indonesia, which has the world’s largest Muslim population, some 225 million.

In 2018, the Indonesian Ulema Council, the Muslim clerical body that issues certifications that a product is halal, or permissible under Islamic law, decreed that the measles and rubella vaccines were “haram,” or unlawful, because of the gelatin. Religious and community leaders began to urge parents to not allow their children to be vaccinated.

“Measles cases subsequently spiked, giving Indonesia the third-highest rate of measles in the world,” said Rachel Howard, director of the health care market research group Research Partnership.

A decree was later issued by the Muslim clerical body saying it was permissible to receive the vaccine, but cultural taboos still led to continued low vaccination rates, Howard said.

“Our studies have found that some Muslims in Indonesia feel uncomfortable with accepting vaccinations containing these ingredients,” even when the Muslim authority issues guidelines saying they are permitted, she said.

Governments have taken steps to address the issue. In Malaysia, where the halal status of vaccines has been identified as the biggest issueamong Muslim parents, stricter laws have been enacted so that parents must vaccinate their children or face fines and jail time. In Pakistan, where there has been waning vaccine confidencefor religious and political reasons, parents have been jailed for refusing to vaccinate their children against polio.

But with rising vaccine hesitancy and misinformation spreading around the globe, including in religious communities, Rashid said community engagement is “absolutely necessary.”

“It could be disastrous,” if there is not strong community engagement from governments and health care workers, he said.

In Indonesia, the government has already said it will include the Muslim clerical body in the COVID-19 vaccine procurement and certification process.

“Public communication regarding the halal status, price, quality and distribution must be well-prepared,” Indonesian President Joko Widodo said in October.

While they were in China in the fall, the Indonesian clerics inspected China’s Sinovac Biotech facilities, and clinical trials involving some 1,620 volunteers are also underway in Indonesia for the company’s vaccine. The government has announced several COVID-19 vaccine procurement deals with the company totaling millions of doses.

Sinovac Biotech, as well as Chinese companies Sinopharm and CanSino Biologics — which all have COVID-19 vaccines in late-stage clinical trials and deals selling millions of doses around the world — did not respond to Associated Press requests for ingredient information.

In China, none of the COVID-19 vaccines has been granted final market approval, but more than 1 million health care workers and others who have been deemed at high risk of infection have received vaccines under emergency use permission. The companies have yet to disclose how effective the vaccines are or possible side effects.

Pakistan is late-stage clinical trials of the CanSino Biologics vaccine. Bangladesh previously had an agreement with Sinovac Biotech to conduct clinical trials in the country, but the trials have been delayed due to a funding dispute. Both countries have some of the largest Muslim populations in the world.

While health care workers on the ground in Indonesia are still largely engaged in efforts to contain the virus as numbers continue to surge, Waqar said government efforts to reassure Indonesians will be key to a successful immunization campaign as COVID-19 vaccines are approved for use.

But, he said, companies producing the vaccines must also be part of such community outreach.

“The more they are transparent, the more they are open and honest about their product, the more likely it is that there are communities that have confidence in the product and will be able to have informed discussions about what it is they want to do,” he said.

“Because, ultimately, it is the choice of individuals.”

Source: Concern among Muslims over halal status of COVID-19 vaccine

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