Why do we need to provide the best COVID-19 vaccines to developing countries? To save all humanity.

Many individuals have been discussing the need to immunize every human on the planet to ensure that we end the COVID-19 pandemic. This is to make sure there are no humans left susceptible to this virus that could produce mutant strains prolonging the global infection.  While that is true, there is another factor potentially more important to ensuring the end of the pandemic — making sure everyone is immunized with highly effective vaccines.  

Those of you who follow this blog know that I’ve been critical of several vaccines in development, such as the AstraZeneca vaccine. This is partly because of problems with how AZ has conducted their efficacy trials. If we look at the AZ trial results from the groups that were appropriately vaccinated, it is clear that this vaccine is only 60% effective, meaning infections in immunized individuals continues to occur at 40% of initial rates. Why is this important?

A major problem we are now observing is that as the coronavirus infects the human population it mutates. Most of these mutations have related to marginal increases in ease of infection, but not as of yet escaping from vaccine immunity. A reason for this is simply that the worldwide human population for the most part is not immune; therefore, there is no need for the virus to try to get around immunity to infect people. There are more than enough non-immune people for the virus to infect.

However, as more and more individuals get vaccinated, the number of people for the virus to infect will decrease. With a highly protective vaccine, like the Pfizer and Moderna vaccines, this leads to the end of the pandemic because people stop getting infected and stop spreading the virus.

in contrast, if you have a vaccine that is only 60% effective, infections will continue to occur in people with vaccine immunity. This is the “worst-case” scenario because infecting people with immunity will eventually result in a virus that evolves to totally escape vaccine control. It’s almost as if we are purposely breeding the virus in vaccinated individuals in order to develop a coronavirus that will escape immunity.

Since the spike protein used to generate immunity is the same in all these vaccines, resistance to one vaccine would lead to resistance to all vaccines. While Moderna believes they can develop a “booster vaccine” to protect against these mutants, gearing up to immunize the whole world again would be a nightmare. We have already see this in our current vaccination efforts.

In my opinion, there has been too much emphasis on developing rapid or “less expensive” vaccines for developing countries, even if they are not fully protective. The people in these countries are infected with this virus just like people in the developed world.  We have clearly seen we are a global community where people and viruses move from continent to continent in hours. The long-term control of this pandemic is therefore based on the complete protection of every human on this planet. 

The U.K. plan to partially immunize their population with single doses of the vaccines is also setting up a scenario where variant, vaccine resistant viruses can breed. While speed is important, effective protection is more important especially in the long term.

As we attempt to vaccinate everyone around the world, we need to vaccinate the human population with highly effective vaccines that stop infections that could prolong the pandemic and make all of our vaccines useless. Whatever the cost, we should make enough of the RNA vaccines to immunize the world. If Pfizer and Moderna cannot do that, the government should step in and force them to license to other manufacturers. 

Yes, this may violate IP rights and other commercial issues, but we can sort that out after we save the world.