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Smallpox

Vaccine Hesitancy Hurts Covid Fight in Poorer Countries

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JOHANNESBURG — The detection of the Omicron variant in southern Africa signals the next stage of the battle against Covid-19: getting many more people inoculated in poorer nations where vaccines have been scarcest in order to deter new mutations from developing.

But while world leaders sometimes talk about this as if it were largely a matter of delivering doses overseas, the experience of South Africa, at least, hints at a far more complex set of challenges.

Like many poor countries, South Africa was made to wait months for vaccines as wealthier countries monopolized them. Many countries still do not have anywhere near enough vaccines to inoculate their populations.

The problems have not ended as shots began arriving in greater numbers.

Neglected and underfunded public health infrastructure has slowed their delivery, especially to rural areas, where storage and staffing problems are common.

turned away shipments of doses from Pfizer-BioNTech and Johnson & Johnson, worried that their stockpile of 16 million shots might spoil amid insufficient demand.

Dr. Saad Omer, a Yale University epidemiologist, and they have had a deeper effect.

have said. In several countries, fewer than half say they intend to get vaccinated.

sometimes-violent resistance in rural communities. Vaccine hesitancy rates there approach 50 percent among those who have not completed high school. In some parts of the country, more than a third of doses spoil amid the low demand.

Still, many are eager to be vaccinated. When doses first became widely available in South Africa earlier this year, a third of the country’s adults swiftly got inoculated, a pattern that is repeating elsewhere.

allegations of corruption amid last year’s lockdown, have heightened public unease.

“There’s a lack of confidence in the public health system’s ability to provide vaccines,” said Chris Vick, the founder of Covid Comms, a South African nonprofit group.

The group has been holding vaccine information sessions, but overcoming skepticism is not easy. After a session in the Pretoria township of Atteridgeville, one 20-year-old who attended said she had not been persuaded.

briefly pause delivery of the Johnson & Johnson vaccine, leading South Africa to delay its rollout to health care workers. Both countries decided to resume the shots after concluding that they were safe.

The South African government held regular briefings, but these were on television and in English, when radio remains the most powerful medium and most South Africans do not speak English as their mother tongue.

a recent study found. That is in part because of mistrust of the Black-led government, but also because American Covid conspiracists have found wide reach among white South Africans on social media, according to Mr. Vick of Covid Comms.

Covid pill from Merck for high-risk adults, the first in a new class of antiviral drugs that could work against a wide range of variants, including Omicron. The pill could be authorized within days, and available by year’s end.

The first modern, worldwide campaign, begun in 1959 against smallpox, provoked deep skepticism in parts of Africa and Asia, where it was seen as a continuation of colonial-era medical abuses. Some W.H.O. officials used physical force to vaccinate people, deepening distrust. The campaign took 28 years.

The effort to eradicate polio, which finally ramped up in poor countries in the 1980s and is still ongoing, has run into similar resistance. A study in the science journal Nature found that vaccine avoidance was highest among poor or marginalized groups, who believed that the health authorities, and especially Western governments, would never voluntarily help them.

In Nigeria in the early 2000s, amid a spike in religious tensions, unfounded rumors circulated that foreign health workers were using polio vaccines as cover to sterilize the country’s Muslim population. Boycotts and local bans led to a polio resurgence, with cases spreading to 15 other countries, as far as Southeast Asia.

survey by the Africa Center for Disease Control found that 43 percent of those polled believe Africans are used as guinea pigs in vaccine trials — a legacy of Western drug companies’ doing exactly this in the 1990s.

Even within their own borders, Western governments are struggling to overcome vaccine resistance. So it is hard to imagine them doing better in faraway societies where they lack local understanding.

Any appearance of Western powers forcing unwanted vaccines into African or Asian arms risks deepening the backlash.

“If the objective is to keep the U.S. and the rest of the world safe, it should be pretty obvious that the success of the domestic program depends on what happens internationally,” Dr. Omer said.

Declan Walsh contributed reporting from Nairobi.

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Alaska to Offer Covid Vaccines at Airports

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To some, Alaska’s announcement that it would try to entice travelers by offering Covid-19 vaccinations at its airports might signal the state’s plucky resolve and determination to revive a tourism industry that has been devastated by the pandemic.

To others, it’s a sign of everything that is wrong with the way that the United States is distributing its vaccines, as calls for more doses in surge-stricken Michigan are rebuffed.

“It’s hard for me to believe that we’ve so maldistributed a vaccine as to make this necessary,” said Dr. Larry Brilliant, an epidemiologist who was part of the effort to eradicate smallpox in the 1970s. “You don’t want to exchange a bad carbon footprint for a vaccination.”

Starting on June 1, any tourist traveling to Alaska will be able to receive a Pfizer or Moderna vaccine at the Anchorage, Fairbanks, Juneau or Ketchikan airports. It’s part of a larger multimillion-dollar marketing campaign, funded by federal stimulus money, to attract tourists back to the state, Gov. Mike Dunleavy of Alaska, a Republican, announced.

news conference on Friday.

Alaska is the latest state to announce plans to extend vaccine eligibility to nonresidents as production and distribution have increased around the country. Twenty-one other states do not have residency requirements for vaccination, according to the Kaiser Family Foundation.

Some U.S. experts have worried for months about the growth in “vaccine tourism” — Americans crossing state lines to get a vaccine where there are excess doses. Virologists like Dr. Brilliant say that rather than incentivizing people to fly to Alaska to get a shot from the state’s abundant vaccine supply, doses should be redistributed to states most in need and no longer be allocated strictly by population.

Alaska is not lacking vaccines, said Heidi Hedberg, the state’s director of public health. Health administrators will begin the airport vaccine program for tourists at the Ted Stevens Anchorage International Airport, with a five-day trial at the end of April to gauge interest. Some visitors may have to get their second dose of mRNA vaccines in their home states, depending on how long they remain in Alaska.

Almost 40 percent of Alaskans have received at least one dose of a coronavirus vaccine, according to a New York Times database. Thirty-two percent of the state’s population is fully vaccinated. The state has used 68 percent of its doses.

first state to open up vaccine eligibility to anyone 16 or older living or working in the state, on March 9. At the time of the announcement, Alaska had the highest vaccination rate in the country.

The United States has continued to speed up vaccination efforts, and is now averaging 3.2 million doses a day, up from roughly two million a day in early March. The Centers for Disease Control and Prevention said on Saturday that about 129.5 million people had received at least one dose of a Covid-19 vaccine.

Dr. Brilliant said states like Michigan, the center of the country’s worst surge, should be receiving larger allocations of doses.

The Biden administration and Gov. Gretchen Whitmer of Michigan, a Democrat, have been at odds over her calls for an increase in her state’s vaccine supply. But the Biden administration held fast to distributing vaccines by state population, not by triage.

“The vaccine should go where it will do the most good,” Dr. Brilliant said. “Given the scarcity of vaccine in the world, every dose should be given in a way that is most effective at stopping this pandemic.”

But the issue could be moot by the time that Alaska’s tourist vaccination program begins in earnest on June 1: most Americans who want to be vaccinated might already have received at least one dose by then, said Dr. Peter Hotez, a vaccine scientist at the National School of Tropical Medicine at Baylor College of Medicine in Houston.

“We’re going to reach a point where people don’t need to fly to Alaska to get vaccinated,” he said. “I think it’s going to be more of the case that, here’s an opportunity to visit Alaska and it’s convenient to get vaccinated.”

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Edward Jenner Pioneered Vaccination. Will His Museum Survive a Pandemic?

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BERKELEY, England — It has been called the birthplace of modern vaccination.

More than 220 years ago, the residents of an English village lined up outside a small wooden hut to have their arms scratched with a lancet as they were given the first vaccine for smallpox.

The pioneering local doctor administering the vaccine, Edward Jenner, called the modest building in his garden the “Temple of Vaccinia,” and from this place grew a public health movement that would see smallpox declared eradicated globally by 1980.

But a new scourge has left this place — where the gnarled wooden walls of Dr. Jenner’s hut still stand at a museum at the home and garden dedicated to his legacy — shuttered to the public, its future on shaky ground. Even as Dr. Jenner’s work was cited time and again as the world raced toward a coronavirus vaccine, the museum at his former home has struggled to survive.

“I think the issue has been an underfunding of museums for many, many years in this country,” said Owen Gower, the manager of Dr. Jenner’s House, Museum and Garden. “Covid has really shone a light on those problems, as it has with so many different issues.”

built upon a technique called variolation that was practiced in Africa and Asia for centuries, and his approach also leaned on local knowledge. His vaccine used samples of the milder disease cowpox — as it was long known in his rural community that women who were exposed to that illness in dairies were immune to smallpox.

nations scramble for limited vaccine supplies and anti-vaccine campaigns take root, the story behind how we got here is more important than ever.

“He did remarkable things — and the number of lives saved and changed as a result of vaccination — it all started here,” Mr. Gower said. “But I think it’s also the idea that it’s not just something of the past, it’s something that is ongoing.”

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