Booster jabs won’t stop Covid without a huge vaccine rethink

People may need to get a fourth dose of vaccine to protect themselves against the Omicron variant of Covid-19, Tánaiste Leo Varadkar told the Dáil last week. Referring to scientific evidence from Israel, he said immunity against the Delta strain wanes after a third dose of vaccine, meaning a fourth dose – which is to say a second booster – is likely to be needed to protect against the new Omicron variant.

It begs the question: are we about to embark on a Covid-19 immunisation merry-go-round? And if we do, is this really the best way to meet the challenge of an ever-changing virus?

From a global perspective, it appears there is a better way. The global disparity in access to vaccines is stark. Over 54 per cent of the world’s population has been vaccinated, but only 6 per cent of the population in poor countries. While infections spread uncontrolled elsewhere in the world, there is a probability that new variants of the virus will emerge, some of which are likely to carry genetic mutations that allow it to evade vaccine- induced immunity.

If we want to achieve a less reactive Covid-19, infections have to be tackled elsewhere in the world, and this requires a fairer distribution of vaccines. Scientists know that our current cycle of repeated “boostering” will prolong the pandemic – but world leaders are still failing to choose an alternative way out.

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More than 400 leading doctors and scientists have issued a letter to Micheál Martin, requesting a meeting regarding vaccine inequity

An urgent campaign involving over 100 countries, with backing from the World Health Organisation, is seeking to temporarily waive intellectual-property (IP) rights to Covid-19 vaccines and drugs. The design and development of such therapies is concentrated in a relatively small number of countries. But experts say that if IP relief was introduced for the duration of the pandemic, it would kick-start vaccine manufacturing around the world.

In Ireland, more than 400 leading doctors and scientists have issued a letter to An Taoiseach, Micheál Martin, requesting a meeting regarding vaccine inequity. The group is calling on the Government to work towards temporarily suspending patent rules on Covid-19 vaccines, tests and treatments in order to increase their production and thereby, increase access in low- and middle-income countries.

Speaking at the handover of the letter, Prof Cliona O'Farrelly, Professor of Comparative Immunology at Trinity College Dublin, said: "Vaccine inequity is having a profound impact not just on people living in low-income countries who have little or no access to vaccines and vaccine technologies but is effecting everyone on the planet. Variants like Omicron will continue to threaten all health systems including our own here in Ireland, as we struggle to deal with increasing case numbers and our hospitals become too overwhelmed by Covid to cope with other sick patients

"Vaccine inequity is a human rights issue, we have a moral obligation. We have the knowledge and strategies available to protect the lives of millions of people in low-income countries, particularly in the continent of Africa. "

While vaccine inequity among African countries has played a major role in the continent’s low Covid-19 vaccination rate, experts say capacity and logistical challenges, along with vaccine hesitancy, are also creating significant challenges. About 40 per cent of vaccines that have arrived on the continent so far have not been used. Delivery of scarce vaccines often stall at the arrival airport: for many African countries, their health systems do not have the ability to absorb and distribute vaccines, particularly in rural areas.

Is there an opportunity for organisations like Goal and Concern to send out vaccine teams to African countries to meet these logistical problems? It would be a most appropriate Christmas “gift” for the government here to fund such an initiative.

At present, we are taking the least efficient pathway out of the pandemic. The slogan “No one is safe until everyone is safe” represents the only logical and moral way to bring the Covid-19 pandemic to an end.

[ mhouston@irishtimes.com ]