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The announcement came roughly a year after the first cases of covid-19 were documented in Hubei, China. Since then, the virus has taken a devastating global toll: At least 64 million people have fallen sick, and more than 1.4 million have died. Economies large and small were devastated by lockdowns and border closures.
That a vaccine could be developed, tested and approved in such a time frame is an undeniable feat. During an interview Wednesday morning, Ugur Sahin, chief executive of BioNTech, beamed with pride. “We believe that it is really the start of the end of the pandemic, if we can ensure now a bold rollout of our vaccine,” he told CNN. More countries need to approve the vaccine, he said, but “it’s a good start.”
Sahin was right: This is only the beginning of the end. And exactly how close the end of the pandemic might be depends on your vantage point.
Britain, which has pursued a muddled pandemic response in many other aspects, has been proactive on vaccines. The British government has secured deals with various manufacturers, amounting to more than five doses per person. It has preordered 40 million doses of the Pfizer vaccine and it was faster than both the United States and Germany, homes to the companies that created it, in approving it.
The U.S. Food and Drug Administration and the European Union’s European Medicines Agency now face calls to speed up their timeline. Other countries may also be feeling pressure. On Wednesday, Russian President Vladimir Putin ordered his country to begin vaccinations next week too, even though Russia’s domestically produced vaccine has faced less rigorous testing.
As the vaccine race heats up, poor countries could be left behind. They cannot rival the scientific or economic might of richer nations when it comes to vaccine development or procurement. Estimates from the Duke Global Health Innovation Center in Durham, N.C., suggest that some people in low-income countries may have to wait until 2024 to get vaccinated.
The European Union and five nations have already preordered roughly half of the expected supply of vaccines for 2021, Nature reported this week. Though some middle-income nations have gotten deals — India, which manufactures many vaccines, has secured 2 billion doses — the most successful have been wealthy nations like Canada, which has roughly eight vaccine doses per person.
The World Health Organization and other global groups have tried to address this problem by forming the Covid-19 Vaccines Global Access Facility, also known as Covax. More than 150 countries have joined the program, which aims to develop and equitably distribute 2 billion doses of a vaccine by the end of next year (the United States and Russia are both nonparticipating outliers).
The problems are not just related to supply, but also logistics. The Pfizer vaccine must be kept at an unusually cold temperature: minus-94 degrees Fahrenheit. That is outside the capabilities of many countries at the moment, especially at the scale needed for mass vaccination programs. The United States alone will need at least 50,000 deep freezers for vaccination efforts, according to one manufacturer.
For some nations, that poses a near-insurmountable barrier. The Pfizer vaccine is “probably out of the question for us,” Palau’s president-elect, Surangel Whipps Jr., said in an interview Wednesday. The tiny Pacific island nation, ironically, is one of the only countries to have kept the virus out.
One concern is that even if vaccination programs effectively end the pandemic in some wealthier nations, the virus itself could linger, widespread, in poorer countries — not only posing a risk to the millions living in those nations, but also allowing the possibility of continued spread elsewhere.
Health officials have been grappling with the problem of global distribution for months. Katherine O’Brien, director of the WHO’s immunization department, said in November that the discovery of a highly effective vaccine was like building a base camp on Mount Everest. “The climb to the peak is really about delivering the vaccines,” she said, reacting to positive news about another vaccine made by U.S. firm Moderna.
Some foreign officials on Wednesday accused Britain of rushing that ascent. A health spokesman for the center-right parties in the European Parliament, Peter Liese, called the move “problematic” and urged other European nations to stay cautious. “A few weeks of thorough examination by the European Medicines Agency is better than a hasty emergency marketing authorization of a vaccine,” he said in a statement.
There may be unexpected obstacles ahead. Some experts had concerns that a speedy rollout could undermine trust in immunizations, especially of the type created by Pfizer and Moderna, which use new mRNA technology that could cause short-term side effects. Writing in Foreign Affairs, Josh Michaud and Jen Kates warned of “vaccine disillusionment” should vaccine doses not bring a speedy return to normality.
Britain, in the throes of a winter spike, did not want to wait. But Prime Minister Boris Johnson, not known for his caution, warned the country to not get “carried away with over-optimism” at a 10 Downing Street news conference on Wednesday afternoon. England’s deputy chief medical officer, Jonathan Van-Tam, said it was a matter of “months, not weeks” before vaccination programs really swing into effect.
All eyes will be on Britain as it begins its rollout of the Pfizer vaccine, but this is not a national tale. BioNTech’s Sahin and Ozlem Tureci, his wife and co-founder of the company that developed the vaccine, are the children of Turkish immigrants to Germany who partnered with an American company and sought the approval of the British government.
In a period of vaccine nationalism, the international nature of that feat is worth remembering. Yes, the end of the pandemic is in sight, but it will take continued global effort to get there.