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COMMENTARY: Epidemiology, not geopolitics, should guide COVID-19 vaccine donations

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With COVID-19 vaccine supplies shifting from scarcity to abundance in high-income settings, such as Canada, the EU, the USA, and the UK, the June 11–13, 2021, Group of Seven (G7) summit in Cornwall, UK, is the time when leaders from those countries should act on their promises to send surplus COVID-19 vaccine supplies to the many other countries where doses remain scarce.
 
Vaccine donations are not the only solution to the gap that has emerged between countries with and without sufficient doses of COVID-19 vaccines. Yet, the potential number of surplus vaccine doses purchased by G7 nations is likely to be in the hundreds of millions or more.

 

Vaccine manufacturers based in those countries have also offered to sell more than a billion doses at cost for use in low-income and middle-income countries (LMICs) in 2021, which G7 governments could buy and donate.

 
These supplies are sufficiently large to help with near-term vaccine demands while investments are made in technology transfer to LMICs and in scaling up global manufacturing capacity for vaccines and vaccine inputs to respond to SARS-CoV-2 and future pandemic threats.

 
Maximising the potential of vaccine donations in this pandemic depends on vaccine doses going where they can do the most good. But there is currently no consensus on where that would be. The USA has committed to sending three-quarters of its first tranche of donated vaccine doses to COVAX and EU officials have promised “many” of their surplus doses will go to COVAX.
 
Whether donated through COVAX or bilaterally, spare COVID-19 vaccine doses should be allocated to reduce the most premature deaths.

Although it is impossible to know for certain where future COVID-19 deaths will occur, it is possible to anticipate impending needs in this pandemic. The predominant models of global COVID-19 deaths have performed well in short-term forecasts of up to 12 weeks.

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The areas of greatest need, taking into account the available data on secured vaccines and likely SARS-CoV-2 variants, are in Latin America, central and eastern Europe, central Asia, and South Africa—settings that have received among the fewest COVID-19 vaccine donations to date. ...
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