COVID-19 Vaccines: How Countries Are Approaching Vaccinating Their Populations : Consider This from NPR President-Elect Biden's plan to attack COVID-19 includes a $20 billion plan for vaccine distribution in the U.S., hiring 100,000 public health workers to do vaccine outreach and contact tracing, and funding to ensure supplies of crucial vaccine components like small glass vials.

But in order to truly contain and end the COVID-19 pandemic, every country needs to vaccinate its population. As of last week, at least 42 countries had started rolling out safe and effective COVID-19 vaccines, but none of them were low-income countries. The World Health Organization says that's at least in part because rich countries have bought up the majority of the vaccine supply. In South Africa, health official Anban Pillay shares his country's challenge securing doses.

NPR correspondents Rob Schmitz in Berlin, Phil Reeves in Rio de Janeiro and Daniel Estrin in Jerusalem discuss how the vaccine rollout looks in Germany, Brazil and Israel.

In participating regions, you'll also hear a local news segment that will help you make sense of what's going on in your community.

Email us at considerthis@npr.org.
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What The COVID-19 Vaccine Rollout Looks Like Across The World

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What The COVID-19 Vaccine Rollout Looks Like Across The World

What The COVID-19 Vaccine Rollout Looks Like Across The World

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AUDIE CORNISH, HOST:

Peet Viviers has noticed a disturbing trend at his hospital. It's in Pretoria, South Africa. People with COVID-19 are coming in too late.

PEET VIVIERS: Patients that are presenting to the casualty unit already with very low oxygen levels, and within a matter of hours, they deteriorate. And they need mechanical support, or they even die within the first 12 hours.

CORNISH: There's a lot of COVID death in the country right now, more than anywhere else in Africa.

VIVIERS: They're afraid. They're afraid that a hospital is a place where you now go to die.

CORNISH: By now, it's a familiar story. First, cases surge. Then a couple of weeks later, doctors like Viviers see the results as they make their rounds.

VIVIERS: What keeps me up is the fact that we simply don't have the capacity to take in more and more patients as we are doing now. We cannot keep on doubling admissions every five to 10 days.

CORNISH: And nurses in his hospital are already stretched thin, experiencing burnout.

VIVIERS: They can buy a ventilator, you can buy a machine, you can buy more linen, but you cannot replace humans.

CORNISH: That's why many countries are targeting health care workers first as they roll out vaccines. The idea is, take care of the people we need to take care of the rest of us. But that's not happening yet in South Africa. The country is still waiting on its first vaccine doses, and so Dr. Viviers can only watch as his peers in other countries get their shots. And he's got mixed feelings about it.

VIVIERS: Hopeful and jealous at the same time, I think. I think hopeful in terms of - there is something coming that's going to help, and jealous because they got it before us. But, I mean, that's just the way things go.

CORNISH: But should that be the way it goes?

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TEDROS ADHANOM GHEBREYESUS: Vaccine nationalism hurts us all and is self-defeating.

CORNISH: That's Tedros Adhanom Ghebreyesus. He's head of the World Health Organization. And last week, he called out rich countries for locking up the global vaccine supply before low-income nations received a single shot.

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GHEBREYESUS: Ending this pandemic is one of humanity's great races. And whether we like it or not, we will win or lose this race together.

CORNISH: CONSIDER THIS - to truly contain the COVID-19 threat, every country needs to vaccinate its population. And securing doses is just the first of many battles.

(SOUNDBITE OF MUSIC)

CORNISH: From NPR, I'm Audie Cornish. It's Thursday, January 14.

It's CONSIDER THIS FROM NPR. Tonight, President-elect Biden unveils his plan to attack COVID-19. It includes a $20 billion plan for vaccine distribution here in the U.S., hiring 100,000 public health workers to do vaccine outreach and contact tracing and funding to ensure supplies of crucial vaccine components like glass vials. And one of the pillars of his plan, his team says, is equity, making sure every community in the U.S. has equal access to care and to the vaccine.

Now, equity between countries, that's a different story. Here's a stat that the head of the World Health Organization, Tedros, threw out at that press conference last week. Of the 42 countries that had started rolling out safe and effective COVID-19 vaccines, none were low-income countries.

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GHEBREYESUS: Rich countries have bought up the majority of the supply of multiple vaccines.

CORNISH: The WHO has a plan. It's called COVAX, designed to get vaccines to low-income countries, a sort of pooled fund that makes deals with drug companies and distributes the vaccine fairly across borders. But Tedros said one-on-one deals between drug companies and individual countries have undermined that effort.

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GHEBREYESUS: No country is exceptional and should cut the queue and vaccinate all their population while some remain with no supply of the vaccine.

CORNISH: Anban Pillay knows what it's like to be stuck in that queue.

(SOUNDBITE OF ARCHIVED NPR BROADCAST)

ANBAN PILLAY: It's a bit, like, you know, boarding an aircraft. It seems that you'll have to stand by and watch everybody in business class get in.

CORNISH: He's one of the South African health officials working to get his country vaccines. And he told me he realized from his early conversations with drug companies that it was going to be hard for South Africa to compete with richer nations.

(SOUNDBITE OF ARCHIVED NPR BROADCAST)

PILLAY: We were having a discussion about procuring a vaccine that hadn't gone through the clinical trials yet. There was no certainty about its success, and yet we were already talking about placing orders and payment of money linked to that.

CORNISH: Instead, they bought into COVAX, the global effort backed by the WHO. So far, he says, the idea of global solidarity has not panned out in practice.

(SOUNDBITE OF ARCHIVED NPR BROADCAST)

PILLAY: The amount that we're being offered is a drop in the ocean. We're being offered 0.25% of our populations to have access to vaccines for health care workers. We have about six or seven times that number in terms of frontline health care workers.

CORNISH: We reached out to Gavi, one of the partner organizations behind COVAX. They say that they anticipate having enough doses for participating countries, including South Africa, to vaccinate 3% of their population in the first half of this year.

Some estimates say billions of people throughout the world won't be vaccinated until 2022 or 2023. Meanwhile, South Africa has announced other deals for vaccines, 20 million doses expected to start arriving this month. At this moment, though, the only South Africans able to get shots are those participating in clinical trials. Several pharmaceutical companies have tested prospective vaccines in the country. Pillay told me that doesn't even guarantee South Africa will get any doses.

(SOUNDBITE OF ARCHIVED NPR BROADCAST)

PILLAY: Basically, that means that they've used South Africans to get data in order for them to register the product and thereafter forgotten about South Africans in terms of providing them with access to a drug.

CORNISH: I understand there's also a drug manufacturer that works with Johnson & Johnson in South Africa. Is that true? Is it Aspen?

PILLAY: That's right. Aspen Pharmacare is doing the filling into vials and sealing and labeling and packaging. And then the product has to be shipped off. We have no right to access that product, as we understand. We would have to negotiate for our place in the queue in order to access the product.

CORNISH: So there could be vaccines tested on South Africans. South Africans would make the vaccine, and South Africans would not get the benefit of any of that.

PILLAY: Sadly, yes. That's basically what the situation is currently.

CORNISH: Anban Pillay, deputy director general of South Africa's Department of Health.

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CORNISH: Even if your country has cleared the first hurdle and successfully sourced a vaccine, there's still a lot that has to go right to get those shots into people's arms. And with dozens of countries rolling out vaccines, we're starting to see a lot of examples of what works and what doesn't. We're going to hear about three of those examples now from NPR's Rob Schmitz in Berlin.

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CORNISH: Hey there, Rob.

ROB SCHMITZ: Hey, Audie.

CORNISH: Daniel Estrin in Jerusalem, welcome back.

DANIEL ESTRIN: Thank you.

CORNISH: And Philip Reeves in Rio de Janeiro.

PHILIP REEVES: Hi.

CORNISH: Daniel, I want to start with you in Jerusalem. You're seeing two very different pictures - one in Israel and, of course, the other in Palestinian territories. Starting with Israel, it's been an example for a good part of the world, right? They've vaccinated a good portion of their population.

ESTRIN: Oh, they've vaccinated a bigger percentage of their population than any other country in the world. About 20% of Israelis have been vaccinated so far. The majority of Israelis over 60 years old have already been vaccinated. And Israel says Pfizer has actually expedited shipments of the vaccine to Israel. And so I asked, how did Israel get this stock? I asked the Israeli health minister, Yuli Edelstein, today. First, Israel paid a high premium for these vaccines, but that's not it. He said Israel has also made an offer to Pfizer.

YULI EDELSTEIN: We said to Pfizer and to other companies, too, that the moment they give us the vaccine, we'll be able to vaccinate at the speed they've never heard of.

ESTRIN: And so he says Pfizer is interested to see a country vaccinated very quickly, to start opening up the economy, to show how it can be done. And Israel is also giving Pfizer access to its medical data of the millions of Israelis who are getting vaccinated, and already Israel says that that data proves itself. It's showing signs, for instance, that the COVID vaccine can begin to work two weeks after getting the first shot.

CORNISH: So why is it not the case for Palestinians - right? - in areas under Israeli control? What's going on there?

ESTRIN: Well, there's a dispute about that. U.N. experts, international rights groups, Palestinian officials - they all say Israel has an obligation as the occupying power in the West Bank to ensure that Palestinians get access to vaccines. Israel had been under pressure especially to vaccinate Palestinian prisoners in Israeli jails. The health minister told me that they would start doing that next week. But Israel is not providing Palestinians in the West Bank and Gaza vaccines.

And so Palestinian officials are just now managing to sign deals for vaccines from Russia, from some other companies, the World Health Organization. Those vaccines will only arrive in a few months. So this whole situation really reflects what's happening around the world because you've got some governments with the power, the influence, the money to get in the front of the line, and then you have poorer areas without the resources. They're left behind. And you see that contrast very starkly when it comes to the Israelis and the Palestinians.

CORNISH: Rob, in Germany, we're hearing that the vaccine has become a major political controversy. What's the fight over?

SCHMITZ: Yeah, Germans are fighting over how slowly they think their government and the EU is moving on this front. Before the holiday season, they saw a video of Americans and Israelis and Brits getting the shots, but it took the EU a few more weeks to approve those same vaccinations. Yesterday, German Health Minister Jens Spahn was defending the process, saying the reason for the slow rollout is due to, what he said, a global shortage of supply of the vaccine. Here's what he said.

(SOUNDBITE OF ARCHIVED RECORDING)

JENS SPAHN: (Speaking German).

SCHMITZ: And, Audie, he's asking for people to be patient and that eventually there will be enough vaccines for everyone. And as it stands today, he says they will likely be able to offer the vaccine to everyone by the summer. Suffice it to say that German media and politicians here are still complaining. So it's been quite a year for Germany. Early on in the pandemic, the country was seen as a model for how to manage the virus, and it went into the autumn with a little hubris on how it performed. But now we're seeing some cracks in that model image.

CORNISH: Stepping back on the continent, if the EU is supposed to be coordinating the European vaccination effort, can you describe how that's actually working?

SCHMITZ: Yeah, so the EU is in charge of purchasing the vaccines for its 27 member states, and it made its orders back in the summer by choosing kind of a range of vaccines from different companies. Some of those companies are not finished with the approval process yet, so that's why we're seeing a slow rollout.

Now, EU countries are in charge of distributing and administering the vaccines, and that's where we're seeing the differences in the rollout on a local basis. Countries in Europe that were slammed hard at the start are now ahead in vaccinating, and that includes the U.K. - now officially out of the EU, of course. It rushed through its approvals. Italy and Spain are also slightly ahead in their vaccination programs. Meanwhile, in other countries like Germany, people are stuck blaming the EU's slow bureaucracy for what they see as a slow rollout.

CORNISH: Philip Reeves, there's another big political fight over vaccines, of course, where you are, in Brazil. What's going on?

REEVES: A lot of what's happening here is about the president, Jair Bolsonaro. He's repeatedly said he's not going to get vaccinated. He's come out against mandatory vaccines. He once said in a tweet that they're for dogs. And he's raised unspecified concerns about vaccine safety. And Brazil's medical community is very frustrated and very upset about this. They say that Brazil has a proud history of successful nationwide immunization programs. But with COVID, you know, it's lagging behind, and they're accusing Bolsonaro of encouraging people not to get vaccinated, just as deaths and cases are soaring again in Brazil.

However, Bolsonaro's health ministry does now have a national plan. And government regulators haven't actually approved any vaccines yet here, but they're expected to decide on two of these this weekend. And if they give the go-ahead, officials say they hope to start vaccinating Brazil in about a week.

CORNISH: Brazil is second only to the U.S. in number of coronavirus deaths. More than 200,000 hospitals are full. Are the country's vaccine advocates still able to move ahead?

REEVES: Yeah. But, you know, it's chaotic here and tangled up with politics. I mean, right now there is an extraordinary race going on. The Bolsonaro federal government is promoting the AstraZeneca vaccine. The trouble is, they don't have any, so they're sending a plane to India to pick up 2 million doses. That plane returns on Saturday. And they're hoping that AstraZeneca will indeed be approved for emergency use the next day and that they'll be ready to roll.

The other player in this race is Bolsonaro's big political rival, the governor of the mighty Brazilian state of Sao Paolo, Joao Doria. He's teamed up with the Chinese to produce the vaccine CoronaVac. They've already got 6 million doses of this here in Brazil. And that is also awaiting approval from regulators this weekend. So the question is, who gets their vaccine out first?

SCHMITZ: And, Audie, this is Rob in Berlin, and I want to jump in here. You know, I think it's important to remember here that this virus is far from its final phase, as we've heard from Phil. So even the countries that are seemingly ahead of the rest may soon see problems as their populations begin to mix again. And as we've seen, politics are, of course, a big part of this. And what's key is that everyone has to stay on top of this.

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CORNISH: NPR's Rob Schmitz in Berlin, Philip Reeves in Rio de Janeiro and Daniel Estrin. He's stationed in Jerusalem.

You're listening to CONSIDER THIS FROM NPR. I'm Audie Cornish.

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