The Whole World Needs Vaccines Before a Worse Variant Than Delta Arrives


Когда количество вакцинированных американцев стремительно росло, а число заражений сокращалось, казалось, что Америка может вернуться к нормальной жизни. Однако штамм Дельта всё изменил. Среднее количество новых случаев достигло 150 тысяч в день, что означает введение новых ограничений. Если распространение болезни не остановить, не исключено появление и более опасных штаммов, чем Дельта. До тех пор пока весь мир не будет полностью вакцинирован, никто не может чувствовать себя в безопасности. Foreign Policy разбирается в новой ситуации, когда Америка вынуждена решать глобальную проблему

Not long ago in the United States, COVID-19 cases were plummeting, vaccine rates were soaring, and the U.S. Centers for Disease Control and Prevention (CDC) issued “mask-off” guidance for the vaccinated. July 4 was supposed to be “Freedom Day.” Not so fast. The seven-day daily average of COVID-19 cases has spiked to 150,000 and is rising fast, and the CDC has said vaccinated individuals with breakthrough infections have high viral loads capable of efficient transmission.

Science gave us the tools to end the COVID-19 pandemic, but we have been poor stewards, from vaccine hesitancy to states banning mask and vaccination mandates. Americans expected a one-way path to herd immunity and a return to normal. Instead, they face an exponentially worsening delta variant-driven spike, with many months of restrictions on the way. Yet without forceful action, an even worse prospect looms: variants that partially or fully evade our best vaccines.

The delta variant has prompted the White House to announce that if the U.S. Food and Drug Administration (FDA) authorizes the move, starting on Sept. 20 a booster shot will become available for Americans eight months after their second shot of the Pfizer-BioNTech or Moderna vaccine (a decision on the one-shot Johnson & Johnson vaccine will come after the results of a clinical trial)—nursing home residents and health care and emergency workers first, followed by older Americans and then everyone else. To be sure, boosters will help protect against delta and other variants. But giving additional shots to already vaccinated Americans en masse, instead of getting them to the rest of the world, where most people have not had a first shot, is a misallocation of a still globally limited supply of vaccines. If the Biden administration wants Americans to live free of fear of further variants, it needs to vaccinate the world, not only the United States.

Variants arise all the time when viruses replicate and then mutate to become “fitter” pathogens. Most mutations are harmless, but some give the virus an advantage in surviving—as with delta. If SARS-CoV-2 mutates to enable it to evade vaccines, it will be more likely to survive, replicate—and dominate.

If enough people are vaccinated, there will be very few infections and chances for vaccine-evading or other dangerous new variants to arise. The bigger the pool of infected individuals, the quicker variants emerge. And it doesn’t matter where they emerge—they’ll reach the United States. The only way to avoid the very real risk of the nightmare scenario of COVID-19 variants that defeat today’s vaccines, then, is to get the world vaccinated now. The all-too-possible alternative: a reset of the COVID-19 clock, perhaps millions more deaths as scientists race to produce new vaccines, and our reliving the immense economic and social harm that we thought was behind us.

The danger is real. This year, a People’s Vaccine Alliance survey of epidemiologists and infectious disease experts in 28 countries found that two-thirds of respondents expected that mutations would render current vaccines ineffective within a year. Here’s what we need to do now to give ourselves the best chance of keeping this nightmare confined to the stuff of our darkest dreams, not real life.

In the United States, the path forward begins with mandates. As some have done, all states and municipalities should mandate vaccines for government employees, health workers, teachers and other school employees, and older students—and all students once the FDA approves COVID-19 vaccination in younger children. Private employers should issue comparable mandates for their employees. The FDA’s full approval of the Pfizer-BioNTech vaccine for people 16 and older has enabled a number of mandates to take force—but far more are needed.

The Biden administration should expand on its recent move to withhold Medicare and Medicaid funds from nursing homes that do not require their employees to be vaccinated and similarly withhold certain funds—also in a tailored approach to pass constitutional muster—from universities and other private entities without such mandates, as well as incentivize state mandates. Vaccine mandates should be coupled with vaccine passports, requiring vaccines to engage in certain activities. States and localities should continue to expand incentives, and the CDC could share real-time data on promising approaches.

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