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In It to Win It: Vaccination Edition


2021 already has high expectations to meet. No one wants a year similar to the last and following promising developments in COVID-19 vaccination schemes, many people have become optimistic that the worst of the pandemic is behind us. Whilst this may seem futile as COVID cases increase every day, the promise of a vaccine rollout still provides many with the belief that things will go back to ‘normal.’ And for some countries it may. But as vaccination rollouts begin, it becomes clear that vaccinations are only a promising end in sight for the fortunate ones.

For a country like Australia which has stayed fairly on top of the pandemic by keeping the virus contained to a point where restrictions have begun to ease, the implementation of a vaccination rollout has not been made under the same urgency as other countries. Following the approval of the Pfizer vaccine by the Therapeutic Goods Administration (TGA), the Australian Government has released a National Rollout Strategy, aiming to have as many Australians vaccinated as possible throughout the year. Limited numbers of vaccines available for Australia have seen priority groups divided into five categories, in the aim to provide safe and effective vaccines to higher risk groups. These groups were categorised following advice from the Australian Technical Advisory Group on Immunisation and the World Health Organisation, and up to 1.4 million doses will be available from early 2021 to individuals included in phase 1a.

Australia’s COVID-19 vaccination rollout will be voluntary, but Prime Minister Scott Morrison has repeatedly stressed the importance that as many Australians as possible get vaccinated. However, with two doses per person it is becoming increasingly evident that the 10 million Pfizer vaccines Australia has bought will not be enough.

In response to the limited amount of Pfizer vaccines the Australian government has secured, the current national plan is to vaccinate first priority Australians in phase 1a of the rollout. The four following phases are dependent on the AstraZeneca vaccine, a slightly less effective drug that has the ability to be manufactured in Australia. To date, 53.8 million doses have already been bought.

Australia’s current COVID-19 climate has allowed a slow and assessed rollout. For other countries, this is not the case. In the United Kingdom, almost 11.7 per cent of the population have already received their first dose of the shot. With almost 8 million people already vaccinated, Britain has enforced one of the fastest paces of vaccination alongside Israel and the United Arab Emirates. The swift rollout was a necessity for a country whose death toll has recently surpassed 100,000 and similar fast passed rollouts have been enforced in the United States, where an estimated 30.5 million shots have been administered whilst COVID-19 related deaths have reached 437,000.

With more than 94.4 million doses administered across 62 countries, vaccination rollouts have gained momentum. But even at such an early stage, it is clear some countries are falling behind.

As South Africa battles a new highly infectious mutation of the virus, questions have begun to be asked about the unequal rollout of vaccines. Whilst the UK plans to vaccinate all adults with the first dose by autumn of 2021, healthcare workers and the elderly have not even begun to receive vaccinations in South Africa. With a population of 58.5 million people, they presently have enough vaccines in order to vaccinate only 10 million. Zimbabwe still has no clear time frame on when they will receive vaccines, whilst other countries such as Mexico and Pakistan continuously battle to secure numbers.

The irregular pace of vaccine rollouts across countries is not a new issue. Throughout the '90s, HIV prevention saw antiretroviral treatment available only to those who could afford it, with thousands dying from AIDS in Zimbabwe and other African countries, as US mortality rates drastically dropped. It took over 6 years for the treatment to become available in Africa following its launch in America.

But who decides which countries receive vaccines? And why do countries like Canada have enough vaccines to vaccinate their population almost 5 times over while other countries have none?

Before vaccines were approved, numerous countries started purchasing them in advanced bulk orders. This advanced purchasing has seen an estimated 6.4 billion doses of potential vaccine already bought and whilst it does incentivise the development of products and funds trials, it allows those who can pay at the earliest stage of production first entitlement. This risk of buying vaccines that have not been properly tested is not a choice for many countries, posing a major financial risk. Whilst some countries are still waiting, others have bought multiple options.

In an effort to redistribute some of the vaccines globally, the COVAX initiative has been developed by the World Health Organisation (WHO) and the Vaccine Alliance. The COVAX global vaccine plan aims to unite countries so they have more power to negotiate with drug companies and ensure an equal distribution of vaccines. 189 countries have signed up and 92 of them are low-income or middle-income countries and will have their vaccines paid for by sponsored donors.

Whilst the COVAX initiative is good in theory, there is a long way to go.

Whereas the UK has donated around half a billion dollars to the fund, countries such as Russia and America have not contributed at all. Whilst the initiative has secured deals for COVID-19 vaccines it will only cover doses for 20% of a country’s population and will only purchase vaccines already approved by the World Health Organisation (WHO).

The global rollout of vaccines has also showcased the political nature of the negotiations. It has been revealed that different countries have been charged different prices for the same product.

Israel, a country leading the way in vaccination rates paid a significantly higher price for vaccines to acquire early shipments. The South African government paid $5.25 for each dose of the AstraZeneca vaccine whilst the European Union paid $2.15. Countries that financially supported the development of vaccines obtained lower unit prices and brought to light the privilege needed to obtain a lifesaving prevention plan.

The politicisation of vaccines has impacted countries agreements with manufacturers, and whilst the COVAX initiative is still developing, countries have relied on diplomatic relations. Pakistani universities have aided clinical trials of Chinese firms in an effort to secure a supply whilst India has secured more than 2 billion doses by providing manufacturing capabilities.

Meanwhile countries have relied on these diplomatic relations to access vaccines outside the constraints of the COVAX initiatives, other countries such as China and Russia have used their position to strengthen diplomatic relations. China has offered financial support to Latin America and Africa to acquire vaccines, whilst Russia has agreed to deals with Argentina and Brazil in exchange for production and trials.

In the meantime, it is clear 2021 has the opportunity to confront and challenge the pandemic, slowing its course and allowing improvement, it has become increasingly apparent the unequal opportunities available globally. The pandemic is global and only once everyone is vaccinated will the risk actually decrease. Wealthier nations hoarding vaccine supplies, politically driven negotiations, and bulk pre-orders have all revealed the prioritisation of vaccines and what it takes to be a fortunate country in the face of a pandemic.


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