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The Covid omicron variant symbolizes the pitfalls of vaccine inequity

New variants are destined to unravel our pandemic progress unless we spread vaccines far more widely.
Photo illustration: Gloved hands holding Coronavirus testing swabs and hands pulling syringes out of vials handoverlapping each other to form a chain.
New variants are destined to unravel our pandemic progress unless we spread vaccines far more widely across the world.Anjali Nair / Getty Images; MSNBC

The emergence of the omicron variant of the coronavirus has raised concerns around the world about the possibility of yet another surge in Covid-19 cases and questions over how effective vaccines will be in fighting them off.

Much about the seemingly exceptionally contagious variant remains unclear, and public health officials are calling for calm as they gather more data. But this latest round of hand-wringing — as we approach two years of suffering and anxiety over the virus — is a clear reminder of the short-sightedness of inattention to global vaccine inequity.

The game changer in the near term isn’t going to be some miraculous medical breakthrough but rather a tool we already have: social solidarity.

Currently we’re pitting scientific innovations against the virus, primarily in the form of vaccines, against the virus’s own innovations, in the form of mutations that give it greater transmissibility and the capacity to circumvent our technological advances. But humanity is going to have a great deal of trouble winning this race without making sure that steps are taken to actually share technology beyond rich countries, reducing the possibility of dangerous new variants’ emerging and spreading among populations with virtually no access to the vaccines. The game changer in the near term isn’t going to be some miraculous medical breakthrough but rather a tool we already have: social solidarity.

Epidemiologists and virologists have long pointed out that Covid-19 infections among unvaccinated people and unvaccinated populations increase the likelihood of dangerous mutations' spreading. "Unvaccinated people are potential variant factories," Dr. William Schaffner, a professor of infectious diseases at Vanderbilt University Medical Center, told CNN this summer. "The more unvaccinated people there are, the more opportunities for the virus to multiply."

Meru Sheel, a senior research fellow at the National Center for Epidemiology and Population Health at the Australian National University, explained to The Guardian how the omicron variant might have been less likely had the world been more evenly vaccinated:

Science tells us we could have avoided the emergence of this new variant of concern. Viral mutations are a part of natural selection and are common. When the virus enters a cell, it can make copies of itself that go off and infect other cells and then pass to another person.

Sometimes during this process of copying in non-immune persons, it may introduce an “error” or mutation, and at times these mutations can offer competitive advantage to the viruses to spread from one non-immune person to another.

But if a person is already immune (say from vaccination), then the virus cannot spread between people, preventing the emergence of new variants.

Omicron was first detected in South Africa. That doesn’t mean it originated there, but South Africa’s 27 percent vaccination rate — which skews heavily urban; the rates are in the single digits in some rural areas — means the country’s population was not well-protected against its spread.

South Africa actually has one of the better vaccination rates on the continent; in Africa just 10 percent of people have received one dose of a vaccine. The region provides what public health experts consider an optimal environment for generating new variants.

Low vaccination rates in Africa typify a broader problem among the world’s poorer nations: While 66 percent of people in high-income countries are fully vaccinated, a mere 2.5 percent in low-income countries are fully protected. The gap is particularly obscene when one considers how rich countries like the U.S. are offering boosters to their adult populations while about 3.5 billion people in the world have yet to receive one dose.

The omicron news is a reminder that vaccine inequity isn’t just a moral catastrophe but also a strategic one. Countries with huge unvaccinated populations are hotbeds for dangerous variants to emerge and spread, which will devastate their populations’ health and economies. But there is almost no way to stop them from spreading around the world, as well, and unraveling some of the progress made in heavily vaccinated countries. In other words, making sure the whole world gets vaccinated is more than just ethical — it’s one of the most obvious ways to reduce the likelihood of wave after wave of new variant-fueled surges.

While poorer countries face unique logistical obstacles when it comes to getting shots into people’s arms, a number of experts have argued that the crux of the crisis is that these countries aren’t getting enough doses of vaccines. “The problem is not now in production (2 billion doses of vaccine are being manufactured every month), but in the unfairness of distribution,” Gordon Brown, the World Health Organization’s ambassador for global health financing, wrote in The Guardian last week. “The stranglehold exercised by the G20 richest countries is such that they have monopolized 89 percent of vaccines, and even now, 71 percent of future deliveries are scheduled for them.”

In addition to arguing that rich countries should be sending more vaccine doses to poorer countries, advocates for vaccine equity have called for pharmaceutical companies and governments to share their intellectual property with other drug manufacturers that could make the vaccines in poorer countries, and to assist less affluent countries in building up their own manufacturing capacity — as quickly as possible.

Doing more to vaccinate the world is clearly the right thing to do. But if that isn't enough to convince you, then remember it's ultimately in everyone's self-interest to shed the myopia of vaccine nationalism.