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Vaccine disparities raise alarm as Covid-19 variants multiply

In a race to catch up with emerging coronavirus variants, wealthy countries are already benefiting from potent vaccines. While the U.S., Britain and European Union have given citizens about 24 million doses so far — more than half of the shots administered globally — vast numbers of countries have yet to begin their campaigns.

Disparities in immunity pose a threat to both have and have-not states. Giving the coronavirus an opportunity to advance and generate new mutants would have significant economic and public-health consequences, adding to the pain as the death toll surpasses 2 million.

Countries are relying on effective immunizations to save lives and revive businesses. The World Bank’s projection for 4% growth this year depends on widespread deployment of vaccines. Surging Covid cases and a delay to the delivery of inoculations, however, could limit expansion to just 1.6%.

High-income countries have secured 85% of Pfizer Inc.’s vaccine and all of Moderna Inc.’s, according to London-based research firm Airfinity Ltd. Much of the world will be counting on U.K. drugmaker AstraZeneca Plc, whose vaccine is cheaper and easier to distribute, along with other manufacturers such as China’s Sinovac Biotech Ltd.

Of 42 countries rolling out Covid vaccines as of Jan. 8, 36 were high-income countries and the rest were middle-income, according to World Health Organization Director-General Tedros Adhanom Ghebreyesus. A growing number of countries are pursuing their own supply deals, in addition to participating in a global collaboration known as Covax.

Reducing deaths and illnesses has been seen as the main driver of delivering vaccines rapidly, said Venkayya, who worked in the George W. Bush administration to develop a U.S. pandemic flu plan and directed vaccine delivery for the Gates Foundation.

“We now understand it’s also very, very important to control transmission,” he said, “not just to protect those most vulnerable populations, but also to reduce the evolutionary risk associated with this virus.”

Drugmakers say they could tweak their shots to counter new variants within weeks if needed. The likelihood that such adaptations will be necessary has increased, Venkayya said.

“The longer the virus is allowed to continue in different parts of the world where we don’t have a vaccine,” said Anna Marriott, health policy adviser at the anti-poverty group Oxfam, “the greater the danger of new variants that could be more aggressive, more virulent or transmissible.”

Covid shots have been tested for their ability to prevent symptoms, not transmission. Still, their performance in clinical trials gives an indication of how effective they might be against spread.

“The gap isn’t just about access to vaccines,” said Yanzhong Huang, senior fellow for global health at the Council on Foreign Relations. “It’s also about access to effective vaccines.”

One of the shots lower- and middle-income countries are relying on, from AstraZeneca and the University of Oxford, sparked worries in Australia that it may not be effective enough to generate herd immunity. Health authorities there, however, said they believe it will be comparable to the Pfizer and Moderna shots in preventing people from getting seriously ill.

The vaccine developed by the U.K. partners, introduced in the country earlier this month, delivered an average efficacy rate of 70%. That appeared to climb to 80% with a longer gap between doses, based on limited data available, according to regulators. Lengthening that period to as many as three months from one allows more people to get protected faster, while data show the level of antibodies also increases, an AstraZeneca spokesman said.

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