With the world clearly divided between those vaccinated against COVID-19 and those who are not, ethicists, public health specialists and politicians have become more preoccupied by the prospect of booster shots.
The rush to promote boosters in certain countries has not impressed the World Health Organization’s director-general Tedros Adhanom Ghebreyesus. By 9 August, a meagre 12.6 million of the globe’s 4.46 billion COVID-19 vaccine doses were administered in low-income countries. High-income and upper-income states had received 3.65 billion. The WHO had every reason to be concerned.
In an address that month, Ghebreyesus spoke of the plight of Harriet Nayiga, a Ugandan midwife who ‘was one of many health workers in Africa and around the world who was still waiting for her turn to be vaccinated.’ While Uganda had been initially spared the ravages of COVID-19, a surge commencing in May saw variants move through a mostly unvaccinated population. He had received an email from a disconcerted Nayiga. ‘I got my first shot and am yet to receive the second.’
It disturbed the director-general that rich countries were galloping in their rush to acquire booster doses even as ‘hundreds of millions of people’ were still waiting for their first jab. While he understood that ‘all governments’ would seek to protect their people from the Delta variant, ‘we cannot accept countries that have already used most of the global supply of vaccines using even more of it, while the world’s most vulnerable people remain unprotected.’ In his view, a moratorium on boosters should be put in place until the end of September ‘to enable at least 10 per cent of the population of every country to be vaccinated.’
Three reasons for resorting to such shots are advanced by Dr. Katherine O’Brien. The person may not have responded adequately to the first two doses. The second is that immunity wanes over time, meaning that a dose might well arrest that deterioration. Third, the performance of the vaccines might prove inadequate against new variants of the virus. The fact that the vaccines were ‘holding up really well to protect you against severe disease, against hospitalization and against death’ suggested that a third shot was unnecessary.
On 1 September, the European Centre for Diseases Prevention and Control observed that fully vaccinated individuals did not need a top-up shot, nor would it be advisable. ‘Special consideration should be given to the current global shortage of global COVID-19 vaccines, which could be