Most covid-19 vaccines have been used in rich countries – The Economist

Jan 4th 2022

SINCE OMICRON, a new and highly contagious variant of SARS-CoV-2, emerged in November, governments have urged their citizens to get vaccinated. In rich countries that usually means a third, booster, dose. But in poorer countries it often means getting a first.

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Data collected by the World Bank and Our World in Data, an online publication based at the University of Oxford, show that rich countries have received enough doses to vaccinate their population many times over. But poorer countries have been unable to inoculate their citizens even partially. Among countries with a gross national income (GNI) of above $12,500 (classified as high income) or between $4,000 and $12,500 per capita (upper- middle income) more than 160 vaccine doses were administered per 100 people. (This figure includes second doses and booster jabs.) Lower-middle income countries, with a GNI per head between $1,000 and $4,000, have administered about 85 doses per 100 people. Countries with a GNI of below $1,036 per capita, the low-income bracket, received 12 doses per 100 people.

Vaccine inequality began early on in the pandemic. Richer countries could afford to risk investing in drugs before their efficacy had even been proven. And COVAX, the organisation tasked with divvying up doses to poorer countries, has struggled to source the supplies with which to do so. At the end of last year supplies of vaccines to Africa, where many of the lowest income countries are, did start increasing. But distribution remains difficult. Some vaccines have to be stored at very low temperatures, which makes them unsuitable for places with unreliable electricity. CARE, a charity, estimates that for each $1 spent on the vaccine itself, $5 more will be spent on its distribution. For those who fall ill with covid-19 in poorer countries medical care tends to be worse. And vaccine-hesitancy is a problem in poor countries as well as rich ones. A survey of five west African countries last year by Afrobarometer found that on average only 39% were likely to try to get vaccinated.

The impact of the pandemic varies by income in other ways too. The Economists excess death model estimates that lower-middle income countries, which received only half as many shots per 100 people as the upper-middle and high-income countries, have the highest excess-death ratio. But the low-income countries, which administered fewer than 12 doses per 100 people, have an excess-death rate lower than even that of upper-middle income and high-income countries.

Young populations are less susceptible to severe disease from covid. And where the disease has already spread widely, some populations have achieved some natural immunity, which protects against severe covid, though less so against catching the virus (rates of re-infection with Omicron are higher than with previous variants, but previous infection still offers some protection against severe disease). So the disease has probably caused fewer deaths in sub-Saharan Africa, which has a median age of less than 20, than in older places such as Europe, which has a median age of 43 and where the prevalence of conditions such as obesity and diabetes put individuals at higher risk. And there is evidence that previous infections with malaria, which is common in much of sub-Saharan Africa, may lessen the severity of a subsequent covid infection. That is some good news for people there who are still unable or unwilling to be vaccinated.

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Most covid-19 vaccines have been used in rich countries - The Economist