Tom Jones and the Vaccine Wars

Introduction

Viewers of The Graham Norton Show on 29 January may or may not have been shocked to hear that the singer Tom Jones, of whom I have never really been a great fan, has recently turned 80 years old. I understand that he now lives in London, and viewers probably would not have been surprised to learn that he had received his first dose of COVID-19 vaccine. Maybe I am unduly suspicious of favouritism towards the ultra-wealthy, but I, for one, was interested to hear that he had already had his second dose! Sir Tom said that he felt “bulletproof” on being fully vaccinated. The star of The Voice UK, however, mused: “I thought I’d be able to go out and sing some live shows now, but you’ve got to have an audience for that. If they haven’t had the jab, what’s the point?”.

A Global Perspective

Although Sir Tom was looking at the problem from a slightly selfish perspective, his message was similar to that of UN Secretary-General António Guterres in May last year, when global mortality from the virus was a mere 220,000. Guterres commented then, “In an interconnected world, none of us is safe until all of us are safe.” He also said “We have a common vision. Let us now put people first everywhere.”

Vaccine Wars

Things have moved on since then, and the global death toll is now almost 10 times the number in May 2020. In the UK alone, over 100,000 people have died from infection by SARS-CoV-2. Mass vaccination of adults is considered the only way out of the ongoing COVID-19 nightmare. In contrast with the spirit engendered in Guterres’ comments above, the major economic powers in the World have descended into an aggressive, increasingly nationalistic competition to vaccinate their populations. As the graph below shows, the current front-runner, by a long way, is Israel, followed by the United Arab Emirates (partly using China’s Sinopharm vaccine). Quite some way behind, but still over 10%, we find the UK, followed by Bahrain and the United States.

Graph from Our World In Data https://ourworldindata.org/covid-vaccinations

EU Vaccination Problems

The fact that the UK is well ahead of the EU countries was clearly a huge embarrassment for the EU, especially as the UK has just left the Union. Last Friday, the EU announced its intention to suspend part of the Brexit deal agreement on Northern Ireland in a rush to impose restrictions on the export from the bloc of COVID-19 vaccines, or their components. This proposal, which was highly sensitive considering the history of Northern Ireland, was quickly reversed, but it does indicate how politically charged the issue of the vaccine rollout in Europe has become. Vaccine appointments have had to be cancelled in France, Portugal and Spain because of insufficient supplies.

HMG Gets Something Right!

In the UK, virtually every aspect of the Government’s handling of the pandemic has been subject to major criticisms, and crossing the threshold of 100,000 COVID-19 deaths recently clearly is adding to the pressure on Boris Johnson. The rollout of the COVID-19 vaccines in the UK seems to be one of the few things that the Government has got right (probably mainly because they didn’t outsource it to friends of the Tory Party), and there is evidence from opinion polls that it has improved the popularity of the Conservatives.

WHO Do They Think They Are?

The World Health Organisation (WHO) has urged the UK to pause its vaccination after vulnerable groups have received their injections to try and ensure a fairer global rollout of doses. At present, Boris Johnson has said he aims to offer all adults in the UK a first dose by the autumn. The WHO, however, has stated that countries should be aiming for 2 billion doses to be “fairly distributed” around the world by the end of 2021. Margaret Harris, a WHO spokesperson, said she wanted to appeal to people in the UK, telling them “You can wait” because ensuring equitable global distribution is “clearly morally the right thing to do”. Harris says WHO are making the same appeal to all high vaccinating countries.

Recognising that altruism may be in slightly short supply in the middle of the biggest public health crisis of our lifetimes, WHO has pointed out that fairer distribution of vaccines is also the right thing to do for economic reasons. WHO directors have previously said that vaccine nationalism could cost high-income countries $4.5 trillion, while a report commissioned by the International Chamber of Commerce Research Foundation found that the World economy could lose $9.2 trillion if developing countries do not get access to vaccines.

SAGE Advice

Sir Jeremy Farrar, a member of the Government’s Scientific Advisory Group SAGE, has warned that vaccinating many people in a few countries while leaving the virus to replicate unchecked in large parts of the World will lead to more variants developing (with the chance that some of them could be more pathogenic and/or vaccine resistant). He has argued that countries, like the UK, with existing vaccine supply deals could donate a proportion of their doses to the WHO’s Covax global vaccine-sharing fund “without taking away from the national effort to protect the most vulnerable in society and healthcare workers”.

Political Realities

As I have pointed out, Israel is well ahead of the rest of the World in vaccinating its population. However, they have been widely criticised because in the West Bank the vaccine is only being distributed to Jewish settlers and not to the roughly 2.7 million Palestinians living around them. It seems very unlikely to me that the Israelis will be rushing to donate vaccine doses to Covax. In the UK, for the political reasons mentioned above, I think Boris Johnson and his despicable crew are unlikely to want their only domestic success story of the past year to be knocked off track by mere altruistic considerations. They will, instead, point out the fact that the UK has helped raise more than £730 million for the Covax advance market commitment, including £548 million in UK aid, to help distribute 1.3 billion doses of coronavirus vaccines to 92 developing countries this year. In the USA, Biden is just starting to wrestle with the COVID-19 chaos that Trump allowed to develop, as well as trying to build bridges with the “America First” brigade. I think he would find it to be a “hard sell” to the US population that they should pause their vaccination program once they have inoculated at risk groups. I don’t know a lot about the UAE and Bahrain, but my gut feeling is that neither of them would be rushing to take the global moral high ground.

Conclusion

In mid-January, António Guterres said that governments had a responsibility to protect their people, “but ‘vaccinationalism’ is self-defeating and will delay a global recovery”. He also commented “Science is succeeding, but solidarity is failing. Vaccines are reaching high-income countries quickly, while the World’s poorest have none at all.” Politics is a dirty business, and short-term domestic considerations like the popularity of a political party so often trump altruism. It’s immensely sad, but in a very imperfect World “It’s Not Unusual”, as Tom Jones would say.

Medicine Politics

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