As the Virus Ravages Poorer Countries, Rich Nations Are Springing Back to Life

Many countries, prepared for the sort of childhood vaccination campaigns they carry out regularly, were startled to find that they could not rely on people simply to show up for a coronavirus vaccine.

“A lot of vaccine hesitancy issues could be addressed, though not all of them overcome, with timely operational funding in place,” said Benjamin Schreiber, the coordinator for Covid-19 vaccines at UNICEF, which is leading Covax delivery efforts.

Amid a race to fund vaccine purchases, though, money for getting them into people’s arms has been overlooked. Of the 92 poorer nations being supplied by Covax, eight have cut their health budgets because of virus-related economic losses, and several others are struggling to fund their health systems in part because they do not qualify for grants or more generous loans, Mr. Schreiber said.

The World Bank has promised $12 billion for vaccine rollouts, but has so far approved $2 billion in projects. In mid-March, the bank found that less than a third of low- and middle-income nations reported having plans to train enough vaccinators or campaigns in place to fight vaccine hesitancy, said Mamta Murthi, the bank’s vice president for human development.

Many countries’ needs are even simpler. Some cannot pay to print immunization cards. Malawi, which is planning to destroy 16,000 doses that arrived only shortly before they expired, has struggled to cover lunch allowances for health workers traveling from one facility to another to give vaccines.

The outlook is uncertain. More doses will breed more vaccine confidence, said Freddy Nkosi, the country director in the Democratic Republic of Congo for VillageReach, a health nonprofit. But if India’s outbreak keeps surging, the chief executive of the Serum Institute of India said recently, “We are going to have to keep supplying to India, and not anywhere else.”

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A vaccine scare ripples around the world: The week in Covid-19 news.

Safety worries about the AstraZeneca and Johnson & Johnson Covid-19 vaccines in the United States and Europe have reverberated around the world, undercutting faith in two sorely needed shots and threatening to prolong the coronavirus pandemic in poorer countries that cannot afford to be choosy about vaccines. With new infections surging on nearly every continent, signs that the vaccination drive is in peril are emerging, most disconcertingly in the continent of Africa.

In many African countries, vaccination campaigns have been hindered by factors like science skepticism, limited or no efforts to educate the public, inefficient distribution systems and concerns over the extremely rare but serious cases of blood clots being investigated among a small number of people who received the AstraZeneca and Johnson & Johnson vaccines. Those two vaccines, which require less stringent refrigeration, are crucial to efforts to immunize populations in poorer countries.

But in Malawi, some people are asking doctors how to flush the AstraZeneca vaccine from their bodies. In South Africa, health officials have stopped giving the Johnson & Johnson shot, two months after dropping the AstraZeneca vaccine because it was less effective against the dominant variant there.

Across the continent, public confusion over whether to get inoculated — and if so when and where to do so — has contributed to the expiration of doses. South Sudan saw 59,000 unused doses expire this month, and in the Democratic Republic of Congo, 1.7 million AstraZeneca doses have gone unused.

Pew Research Center — accounting for a majority of the 54 million who slipped out of the middle class worldwide. A second wave of Covid-19 is threatening the dreams of millions more looking for a better life.

  • Keeping the middle seats vacant during a flight could reduce passengers’ exposure to airborne coronavirus by 23 to 57 percent, researchers reported in a new study. This reduction in risk stemmed from increasing the distance between an infectious passenger and others as well as from reducing the total number of people in the cabin. But the study may have overestimated the benefits of empty middle seats because it did not take into account mask-wearing by passengers.

  • More exercise means less risk of developing severe Covid, according to a compelling new study of physical activity and coronavirus hospitalizations. The study found that those who had been the most active before falling ill were the least likely to be hospitalized or die as a result of their illness.

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    Vaccine Hesitancy Leaves Doses to Expire in Some African Countries

    With growing community transmission and high average mortality rates from the coronavirus in Malawi, there was widespread concern among the country’s health care advocates this week when the authorities announced that they would throw away 16,000 vaccine doses that had expired.

    They were part of a total of 512,000 AstraZeneca vaccine doses that the landlocked southeast African nation had received from India, the African Union and Covax, the global initiative to procure and distribute vaccines. Health officials didn’t specify why the vaccines had expired, but said the doses went void on Tuesday “due to varying expiry dates of the received vaccine consignments.”

    Health experts and campaigners warned that vaccine hesitancy, along with rumors that out-of-date jabs were being administered, might have contributed to the slow distribution of the vaccine doses and their eventual expiration.

    In many African countries, vaccination campaigns have been hindered by factors like science skepticism, limited or no efforts to educate the public, inefficient distribution systems and concerns over the extremely rare but serious cases of blood clots being investigated among a small number of people who received the AstraZeneca and Johnson & Johnson vaccines. Those two vaccines, which require less stringent refrigeration, are crucial to efforts to immunize populations in poorer countries.

    stopped plans to secure the AstraZeneca vaccine — a decision one official said was made to avoid duplicating the efforts of Covax, which will still supply AstraZeneca to African nations. But even though the decision was not linked to concerns over blood clotting, experts said it could still magnify misinformation about the vaccine. And the African Union is shifting its focus to the Johnson & Johnson vaccine, which could add to the problem. Its use has been paused in the United States.

    In African countries, public confusion over whether to get inoculated, and if so when and where to do so, has contributed to the expiration of doses. Like Malawi, South Sudan saw 59,000 unused doses expire this month.

    The problem is not unique to African countries. Tens of thousands of jabs have also been thrown away in countries like France and the United States. But African countries face far more serious supply shortages. According to a New York Times database, Africa has the slowest vaccination rate of any continent, with many countries yet to start mass vaccination campaigns.

    Countries like Ghana, which was the first African nation to receive doses from Covax, is about to run out of its initial supplies with no sense of when the next batch may come.

    “This inequality negatively affects the entire world,” said Dr. Ngozi Erondu, an infectious disease specialist and a senior health scholar at the O’Neill Institute at Georgetown University. If “entire regions and countries remain insufficiently vaccinated,” she said, “it will continue to ravage populations with persistent morbidity and leave the larger global health community always vulnerable to the virus.”

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    My Family’s Global Vaccine Journey

    On Feb. 22, Mom texted that she and Dad had booked a March 11 appointment to get their first shots, followed by second doses in April. A day later, she reported that Dad hadn’t pressed the button to confirm the appointment on the online booking system and had lost the slots.

    The next week, they texted again: They had walked to a private clinic that was dispensing Sinovac shots. After a short wait, they received the vaccine. On April 2, they told us that they had gotten their second dose of Sinovac and were feeling fine. Mom groused that even though they had an appointment, they “still need to wait for half an hour.”

    Our responses were more enthusiastic.

    “Great news,” I wrote.

    “Yay!” Pui-Ying texted, followed by celebratory emojis.

    “Congrats!” Pui Ling said.

    Pui-Ying had moved with her family to Malawi in 2016 to work as a doctor and conduct clinical research on children’s health. Resources at the Queen Elizabeth Central Hospital, where she works, were limited. When Madonna’s charity helped finance the construction of a new children’s wing at the hospital, which opened in 2017, it was big news.

    Staffing was tight even before the coronavirus, Pui-Ying said. When the pandemic came, the hospital decided on a one-week-on, one-week-off routine to reduce staff exposure to Covid-19 while ensuring that enough medical professionals would be working at all times. Masks, gloves and other protective equipment were scarce.

    In pediatrics, Pui-Ying and her colleagues set up a “respiratory zone” for children with Covid-19. It was essentially a two-room ward, with about a dozen beds in the main room. The second room, which was an isolation unit, had space for four children.

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