Vaccine equity is not just about ensuring more doses. It's about more doses into more arms
Vaccines don't inject themselves. Funding for distribution and vaccination crucial
Vaccines that arrive free just before expiration will be feared to be a dump of what others do not want
Some areas where vaccination rates are the lowest are also those where substandard excess have been dumped as donations in the past. The protective response has long been jettisoning anything close to the expiration date.
Malawi has already incinerated 20K doses of thee vaccine that arrived less than 3 wks before expiry. WHO and AU had encouraged keeping doses as considered fine until July
Concern was also expressed and hesitancy formed as European countries set pauses and restrictions on AstraZeneca, the vaccine was being sent to less well resourced countries, where populations are younger and health staff often young women who are more likely affected.
Haiti did not apply initially for vaccines, citing low caseloads and concerns over AZ clotting and pauses elsewhere as well as the ability to carryout 2 dose vaccination
Haiti is experiencing a COVID surge now
Vaccines have not yet arrived
Vaccine equity needs to account for the realities
a) transparent information on expiration data (no one wants to feel their receiving a dump of bad goods, but likely expiration dates overly cautious)
b) support for distribution and vaccination campaigns
...
c) recognition of factors that can foster vaccine hesitancy
d) continued discussion around vaccine concerns, risks/benefits
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Bahrain has a problem. Cases and deaths are rising despite early adoption and use of Sinopharm vaccine. The country also has a diverse vaccine array offered (Pfizer, Sputnik,J&J, AZ), with over 50% population having one shot.
It seems like the social determinants of health are being overlooked here in the conversations about masking.
Public Health isn't about dangling health above the public and hoping everyone jumps high enough to get it. It's about dealing with realities and meeting those realities
In NYC, the elderly are still not vaccinated. Less than half of of 85+ year olds are fully vaccinated in NYC. In London, the same population has almost all received at least one dose.
Here in the UK, vaccinations among the 80+ crowd (96%). It's possible to meet the elderly and lower the bar to make it accessible. (UK has had different lag times between 1st and 2nd doses) opensafely.org/research/2021/…
For those who had the J&J vaccine, on a personal level, this is like lightning
J&J vax associated with clotting syndrome (cerebral venous sinus thrombosis+low platelets)
- 6 in 6.8 M
- about 1 in a million
Chance of being struck by lightning this year
- about 2 in a million
All six cases occurred among women between the ages of 18 and 48, and symptoms occurred 6 to 13 days after vaccination fda.gov/news-events/pr…
Alabama, Colorado, Florida, Georgia, Missouri, New Jersey, North Carolina, Ohio, Pennsylvania, and Texas have the most lightning deaths and injuries. Florida is considered the “lightning capital” of the country...cdc.gov/disasters/ligh…
Mexico saw an O2 tank shortage. Black markets + overpricing affected supply.
According to a NYT report, “part of the reason why so many people are dying now, doctors and government officials say, is shortages: there simply are not enough oxygen tanks.” mexicobusiness.news/health/news/ox…
Rwanda, where peaks have been tight and controlled quickly, is on the upswing. Most of its peak mirror Kenya's with a slight lag.
Malawi also faced a steep surge in cases following South Africa's B.1.351 triggered wave.
Although countries like Malawi have controlled surge after B.1.351 spread through South Africa and the region, there's still a problem here. Although the best vaccine is a vaccine in the arm, not all vaccines are quite the same.