One year ago this month Sandra Lindsay received the nation’s first COVID-19 vaccine, one of two speedily developed mRNA vaccines that offered up to 95% protection from symptomatic illness during clinical trials.
A year after that triumph, Maine’s Franklin, Aroostook and Piscataquis counties, with only 59% to 64% of their population fully vaccinated, are among the top 10 counties with the highest per capita COVID-19 cases nationwide. The vast majority of those seriously ill are unvaccinated. And the national COVID death toll, about 300,000 a year ago, hit 600,000 in mid-June, 700,000 on Oct. 1 and 800,000 on Dec. 14. Millions are alive today because they got vaccinated. Millions of others declined the offer of a safe, free vaccine, and multitudes are needlessly dying. Why?
The new vaccines’ scientific triumph sank into the swamp of politics, ideology, patent rules, commerce and conspiracy theories. More than 8 billion vaccinations have been given worldwide, enough to fully vaccinate people over age 60, health care workers and those suffering from underlying conditions that can worsen COVID-19. Instead, while some rich-country teenagers have received three shots, higher risk people elsewhere are still waiting for their first.
Producing and distributing billions of shots posed huge logistical challenges and the initial protection began to wane as new virus variants appeared in quick succession. The World Health Organization’s COVID-19 Vaccines Global Access (COVAX) program tried buying vaccines in bulk and providing them free to poor countries. Rich countries did donate money but also bought up the vaccine supply. So, only about 650 million doses have been shipped to low- and middle-income countries so far.
Much of the public expected something like the measles or rubella vaccines, which offer complete, lifetime protection. Overall, the vaccines did prove safe, but a very rare but potentially deadly clotting disorder emerged in recipients of the adenovirus vector-based AstraZeneca and Johnson & Johnson vaccines. Their risk-benefit ratio is still very good, but several rich countries stopped using those shots, damaging confidence in vectored vaccines in general, creating a perception that poorer countries that received large shipments of the AstraZeneca vaccine were given inferior vaccines.
So far, all approved vaccines have held up well against new variants, from alpha to delta. But the continuing spread allows the virus to evolve, finding better ways around human immunity, as omicron seems to be doing. Waning vaccine protection in face of the more infectious delta variant spreading across the world confirmed that “herd immunity” (so many people protected that the virus has nowhere to spread) appears to have been an overhyped pipe-dream.
Scientists and political “leaders” failed to speak with one voice about the virus. Profiteers from unorthodox remedies, half-truths and lies about the risks of vaccines exploited the resulting confusion, aided by social media that prioritize “engagement” (and advertising revenue) over veracity. Public health agencies neglected to approach those most vulnerable to misinformation before they were bombarded with lies.
Many people now feel more comfortable swallowing an unproven drug used to deworm horses or taking their chance with the deadly virus than getting a free vaccine proven to protect against severe disease and death. Others don’t have the luxury of choosing whether to get the shots. Only 8% of Africa’s population is fully vaccinated.
Countries with vaccine access developed a premature sense that “the worst is over,” reducing the urgency to ramp up vaccine production and delivery to more places and relaxing such commonsense protective protocols as mask-wearing and social distancing. Now the pandemic is back with a vengeance, even in countries with high vaccination coverage.
Nonbiomedical research could help. Studies of how people make medical decisions, how misinformation spreads, and how it can be countered. Vaccinating first those most at risk across the globe would be more just, and avert more deaths, WHO epidemiologist Maria van Kerkhove insists. Booster shots bolster waning immunity, but in addition to immunizing, we must also curb transmission. If rich countries had fewer doses, they might follow WHO’s advice not to relax public health measures such as mask wearing and limits on gatherings, which could have blunted recent surges and the evolution of new variants.
Long term, we may need a new generation of vaccines, such as one that ramps up the immune response in the respiratory tract’s mucosa, where coronaviruses first take hold. A pancoronavirus vaccine would not only thwart new variants, but future new viruses as well.
But all the world’s vaccines could be for naught if we fail to use them, guided by ethics, logic, and commonsense. So far in this pandemic, the virus has done most of the evolving. It’s high time for humanity to catch up.
(Paul Kando is a co-founder of the Midcoast Green Collaborative, which promotes environmental protection and economic development via energy conservation. For more information, go to midcoastgreencollaborative.org.)
