The director-general for the World Health Organization on Wednesday called for a longer moratorium on high-income countries administering COVID-19 booster shots—extending the agency’s requested moratorium from the end of September to at least the end of 2021.
The call is likely to raise more scientific and ethical questions on the need and timing for boosters as many high-income countries are already beginning or at least planning to roll them out. In the US, the Biden administration said it is prepared to offer third doses the week of September 20. However, the decision has already drawn criticism from US experts who say the medical need for third doses is not yet clear, and the decision to offer them overstepped review by the Food and Drug Administration and expert advisers for the Centers for Disease Control and Prevention.
Cons of boosting
The WHO maintains that, so far, clinical evidence does not indicate that booster doses are needed to prevent severe outcomes and death from COVID-19, a point that US officials do not dispute. “The vaccines are holding up very, very well against the severe end of the disease spectrum,” Kate O’Brien, director of the WHO’s Department of Immunization, Vaccines, and Biologicals, said in a press briefing Wednesday. “We’re not asking to withhold something for which there is a strong set of evidence that it is needed.”
Meanwhile, in low-income countries, initial doses of vaccines have yet to reach even the elderly and frontline health workers—those most vulnerable to severe outcomes and death. In a press briefing earlier this month, the executive director of WHO’s Health Emergencies Programme, Mike Ryan, likened giving boosters in high-income countries to “hand[ing] out extra life jackets to people who already have life jackets while we’re leaving other people to drown.”
Another argument against booster doses is that they won’t make the world safer, the WHO says. As long as the pandemic coronavirus has largely unvaccinated countries in which to thrive, it will pose a risk to every country. Transmission can easily spread over borders, and high-transmission areas are breeding grounds for new variants, potentially some that could thwart our current generation of vaccines.
“Saying that no one is safe until everyone is safe—it’s not a slogan, it’s science,” O’Brien said.
Director-General Dr. Tedros Adhanom Ghebreyesus condensed all of these concerns into his opening remarks at the briefing Wednesday while once again highlighting the vast inequity in vaccine distribution between high- and low-income countries. Of the 5.5 billion vaccine doses administered worldwide, 80 percent have been given in high- and upper-middle-income countries, Dr. Tedros noted. And while almost 90 percent of high-income countries have at least reached the WHO’s first goal of having 10 percent of their populations vaccinated, not a single low-income country has reached that 10 percent goal.
High-income countries have promised to donate more than 1 billion doses, but less than 15 percent of those doses have materialized, Dr. Tedros added. And while low-income countries have been rolling out the doses they have been able to get, the supply is highly constrained. “Because manufacturers have prioritized or been legally obliged to fulfill bilateral deals with rich countries willing to pay top dollar, low-income countries have been deprived of the tools to protect their people,” Dr. Tedros said.
Dr. Tedros said he was “appalled” by the inequity and blasted world leaders for hollow advocacy and broken promises. “There has been a lot of talk about vaccine equity but too little action,” Dr. Tedros said. “We don’t want any more promises. We just want the vaccines.”
In announcing an extension to the moratorium call, Dr. Tedros said he hoped it would provide time to try to get every country up to 40 percent vaccinated.