Seven years to towards global herd immunity? Depends on many factors

Firstly, most countries are just starting its vaccination campaigns and according to Bloomberg, two-thirds of the countries monitored under its vaccine calculator have yet to even start.

Malaysia is set to receive its first batch this Sunday (Feb 26) and countries like Canada (which has ordered vaccines covering four times over its population) are expected to have their vaccination rate increased once more doses arrive.

Increased vaccination efforts would also happen around the world. Vaccination rate isn’t linear and is expected to fluctuate and then increase until the countries’ respective handling/distribution threshold, which would theoretically plateau until there is an increase in manpower and infrastructure.

Vaccine production capacity is also likely to increase given worldwide demands that haven’t been met. According to FiercePharma, a pharmaceutical industry news portal, Pfizer-BioNTech increased their 2021 output target to two billion doses from 1.3 billion doses. Large advanced purchases by richer countries and the likely need for booster shots may drive other producers to scale-up production.

Lastly, as mentioned by Bloomberg, its calculator did not account for possible cases of natural immunity attained after recovering from an infection. Cases of re-infection such as recently reported in Singapore supports the need for vaccination. At the moment the impact could be minimal given that vaccination on recovered patients is still recommended, with reports mentioning at least one dose.

As reported in The Straits Times, the global collective effort is held back by late deliveries of vaccines in poorer nations and by longer durations that may be required by countries with really large population such as China, India and Russia.

Another hiccup could be immunity being retained shorter than anticipated, requiring more doses faster than expected. Only time will tell but for now, there are reports indicating this to be a 1-year retainment, which could mean something similar to the annual flu jab.

There is also a real concern on the potential reduced effectiveness against continuously-emerging strains which may drive demand for new batches of updated vaccines.

For example, Malaysia’s second phase is expected to be supplied with approximately 30 per cent of Oxford-AstraZeneca’s vaccine, which has been recently reported to show "disappointing" results against the South African variant.

If this remains true and the South African strain spreads in Malaysia by the second phase, it could set back vaccination plans if we received a non-updated version. It’s been reported that other vaccine developers have observed reduced efficacy against some of the new strains.

The above factors would exacerbate stalled vaccination plans caused by potential strains on global supply chains such as shortages in raw materials needed for increased production capacity.

Throughout the global vaccination journey, we could see new short and long-term side effects or serious adverse events being reported. As more people get vaccinated and over a longer period of time, it not unusual that something unexpected emerges and derail the plan.

There could also be a significant population of anti-vaccination groups which could threaten the targeted percentage of population needed to achieve herd immunity. Adverse events that may emerge throughout vaccination campaigns would likely add fuel existing fears in anti-vaccination groups.

Lastly, children and teenagers also have to be vaccinated. Though children are known to be less affected by the virus (making up a small percentage of cases and less likely to show symptoms than adults), they could be “a reservoir of the virus in the population which could continue to seed further outbreaks”, as reported in MIT Technology Review. Vaccine testing for those below 16 are only happening now.

Children vaccination is already considered in the seven-year estimate by Bloomberg and although it may not add to the timeline, it highlights how countries could have underestimated its time towards herd immunity. The above are some key influencing factors but it is non-exhaustive and are subject to change as global vaccination progresses.

Based on how the seven-year estimate was calculated, the average global pace can be improved by increasing global vaccine roll-out capacity, especially by countries with large populations such as India, China, Russia and Indonesia. However, this is just one part of the equation and the increased vaccine production capacity has to be met with better equitable access to low and middle-income countries. Unfortunately, despite all the buzz on “global solidarity”, countries that are known as vanguards of global democracy and proponents of liberated economies appear to have secured large vaccine doses in advance, negatively impacting equitable vaccine access to poorer nations.

For example, according to Bloomberg data as of December last year, Canada has ordered vaccine doses that can cover 410 per cent of its population, followed by the U.K. at 295 per cent and Australia at 269 per cent. These are the top three and all subsequent top 30 countries have ordered doses that cover 120 per cent or more of their population.

As jointly reported by prominent economists Professor Jomo Kwame Sundaram and Professor Anis Chowdhury, more than 85 poor nations will not have sufficient vaccine access before end of 2023 at current rates and only 10 per cent of the population will be vaccinated in 70 lower income countries. In a stark contrast, richer countries with only 16 per cent of the world population has secured nearly 60 per cent of available doses.

The United Nations reported that its Secretary-General António Guterres emphasised on vaccines as “global public good, available to everyone, everywhere”, and mentioned how “vaccinationalism” is counter-productive and would slow down global recovery.

The issue of “vaccinationalism” may have been fuelled by vaccine scarcity, which, as jointly pointed out by Sundaram and Chawdhury, has been further contributed by intellectual property (IP) rights of COVID-19 vaccines, ultimately contributing to significant loss of lives and livelihoods globally.

That being said, it is also true that vaccine and drug makers have spent considerable time and resources and therefore, it’s reasonable to be rewarded for producing innovative products that could save lives and end the pandemic. However, the global health crisis provides clear humanitarian grounds for special considerations.

Regardless of the debate on IP rights, nations should always stand with what is right for the masses. Thus, Malaysia should find a way to be fully supportive of equitable vaccine access to middle and low-income countries. It’s best to do this strategically by considering all aspects.

Whether this is through supporting the patent waiver proposal presented to the World Trade Organization (WTO) Trade-Related Aspects of Intellectual Property (TRIPS) or other means, it will require experts in economy, foreign relations, trade, health and international law to formulate balanced strategic moves for Malaysia.

As reported in The Lancet, the TRIPS waiver calls for temporary suspension on IP rights on COVID-19 vaccines and other new technologies, claiming that it would ultimately allow better (cheaper and faster) access to vaccines and other related technologies by poorer countries.

Malaysia’s Prime Minister Tan Sri Muhyiddin Yassin launched the National Covid-19 Immunisation Programme handbook today (Feb 16) and it has been reported that that the programme, led by Minister of Science, Technology and Innovation Khairy Jamaluddin has gained the government’s approval to include free vaccination for both its citizens and non-citizens – a micro example of logical economic and humanitarian consideration.

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Ameen Kamal is the Head of Science & Technology at EMIR Research, an independent think tank focused on strategic policy recommendations based on rigorous research.