Booster shots won’t stop the next COVID-19 variant

Joseph Dana

The delta variant of the coronavirus disease is wreaking havoc around the world and wealthy countries are deploying booster shots as a defense. With remarkable speed, the US has pushed ahead with a plan to offer a third vaccination jab as an attempt to curb the spread within its borders. This response is hardly surprising, but given how many countries are still struggling to get a single dose of vaccine to a significant segment of their populations, the move ignores the long-term threat from vast global disparities in immunity. Plus, the emergence of the mu variant, and behind it C.1.2, further calls into question the prudence of booster shots.

The best strategy for eradicating the delta variant — and the other variants waiting in the wings — is not booster shots in rich countries, but a worldwide vaccination program that gets as many people as possible fully jabbed. Such a program should focus on the local manufacture of vaccines to ensure poorer countries are empowered by the ability to produce the jabs.

Mike Ryan, director of the World Health Organization’s health emergency program, recently compared booster shots to handing out life jackets to people already wearing them. The WHO has been unusually vocal in its opposition to third jabs by calling for a moratorium until the vaccine gap between rich and poor countries closes. The vaccine doses lined up as boosters should be sent to countries where many have not even had a single jab. This is even more urgent considering most booster recipients already have enough protection to avoid hospitalization and death.
American officials say booster shots won’t interfere with vaccination drives worldwide. Jeff Zients, the White House COVID-19 response coordinator, said the US donates twice as many vaccine doses as it uses. But he fails to answer why it could not donate more by not promoting booster shots.

Now that the US Food and Drug Administration has fully authorized the Pfizer vaccine, the ratio Zients mentions is bound to change. The authorization prompted several large institutions, from the US Army to the government of New York state, to pass vaccine mandates for their staff. Coupled with the push for booster shots, the US is about to embark on another massive vaccination drive that will last well into next year.

Israel, one of the most vaccinated countries, last month expanded its booster campaign to everyone aged 12 and over. More than 60 percent of the country’s population is fully vaccinated. This compares to Egypt, for example, where the figure is less than 3 percent. Israeli Prime Minister Naftali Bennett described third jab availability as “a privilege that no other country has” and insisted the campaign was slowing an increase in serious cases.

Whatever wealthy countries say, a booster shot campaign is going to set back global vaccination. And given the mutation pattern of COVID-19, these gaps in vaccination around the globe virtually guarantee the rise of new variants. While the mu variant is now established as a variant of interest, the C.1.2 variant is being closely monitored because it carries changes that have given some previous variants increased transmissibility. First detected in South Africa in May, it has also been detected in seven other countries in Africa, Europe, Asia and Oceania.
It is understandable that Western countries might rush to inoculate their populations fully instead of making decisions about other nations. However, this strategy is broken. We might think of defeating COVID-19 in war terms, but in truth it is global cooperation that is vital for victory. Wealthier countries could use up all the COVID-19 vaccines in existence, only to face a new variant that developed in an unvaccinated country. Thus, theoretically, those booster shots might have more impact if they were sent aboard.

The most effective way to combat the delta, mu and other variants is to expand manufacturing capacity to regions where vaccination rates are low. We must overcome the dismal vaccine rollout in emerging markets to see if we can get a handle on new variants. But this is easier said than done. Lost in the clouds of disinformation surrounding COVID-19 are concerning statements about intellectual property law and the vaccine.
The WHO has been unusually vocal in its opposition to third jabs by calling for a moratorium until the vaccine gap closes.

In April, Bill Gates stated his opposition to expanding the manufacture of the vaccine to developing nations because it would complicate vaccine trials and most countries didn’t have the technical capacity to manufacture these specialized vaccines. Not only is that line of thinking wrong, but it reveals one of the most uncomfortable realities about the vaccines: Pharmaceutical companies are eyeing their bottom lines more than thinking about how we can collectively put a stop to the emergence of variants.

Consider the recent news from South Africa. After the government struck a landmark deal with Johnson & Johnson to finish manufacturing vaccine doses in the country, The New York Times discovered that many locally finished doses were being exported to the EU. Over several months, the EU received as many as 32 million doses from the South Africa operation, even though countries across southern Africa desperately need vaccine supplies. Johnson & Johnson was able to outsource a part of the manufacturing process to South Africa and then export the doses to Europe, which likely netted the company a handsome margin since costs are relatively low in South Africa and European governments can pay a premium for the vaccines.

The situation in some regions is so bad that countries like Taiwan began using its own domestically developed vaccine this month instead of waiting on global vaccines that haven’t materialized. The Taiwanese government ordered 16 million doses of the AstraZeneca and Moderna vaccines early this year, but has only received 4 million so far.

Let it be clear. A sudden shift in vaccine policy where Western countries refocus efforts on a genuinely global vaccination drive is not going to defeat the pandemic by itself. By most accounts, we will have to deal with this virus for some years to come. But pulling the curtain back on the uneven vaccine deployment and resolving the reasons for this sad state of affairs can help us handle the next variant, and pandemic. In this battle, cooperation is the most potent weapon we have.

The writer is the senior editor of Exponential View, a weekly newsletter about technology and its impact on society.