When news of the omicron coronavirus variant made headlines last week, for many, it felt like a step backward. But the truth is that we should expect more and more variants — including some that, like omicron, contain concerning mutations — until the rest of the world gains better access to COVID-19 vaccines.
As public health experts have said since the beginning of the pandemic, a global crisis like this one requires a global response. But while those of us in the U.S. may be scheduling our boosters, just more than 10% of people in Africa have received at least one dose of a COVID-19 vaccine, NBC News reported.
In the U.S., about 60% of the population is fully vaccinated, the Centers for Disease Control and Prevention data indicate. By contrast, South Africa, where omicron was first discovered, has vaccinated about 22% of its population, according to estimates from Reuters. Nearby countries (such as Botswana and Zimbabwe) are in the same 20% to 30% vaccinated range.
But getting the world vaccinated against COVID-19 is necessary to reducing the risk for more variants in the future and, ultimately, ending the pandemic. That's why it's in the entire world's best interest to improve global access to vaccines, Emmanuel Peprah, director of implementation science for global health and assistant professor of global health at New York University, told TODAY. "There has to be an understanding that we will not get out of this issue solely based on the willpower of the United States," he said.
Vaccine hoarding helped create the perfect conditions for more variants
Any time an RNA virus like the coronavirus replicates, that gives it an opportunity to mutate, Dr. Timothy Brewer, professor of medicine in the division of infectious diseases at the David Geffen School of Medicine at UCLA and of epidemiology at the UCLA Fielding School of Public Health, told TODAY.
"Most of these mistakes have no impact on the virus at all," he explained. But sometimes those changes can make the virus more transmissible or more deadly, which is what happened previously with the alpha, beta and then the delta variant. "As the virus is being transmitted from person to person anywhere in the world, it's replicating," Brewer said. "And that creates the opportunity for mutations and deletions that can result in a new variant."
If we prevent the coronavirus from spreading and mutating by increasing access to COVID-19 vaccines, that will drastically reduce the risk for more variants worldwide. "By preventing people from getting infected, the vaccines are preventing opportunities for viruses to get into cells and replicate," Brewer explained. "And if viruses can't get into cells and replicate, they can't make new variants."
But as the numbers stand now, higher-income nations have vastly more of their populations vaccinated than lower-income countries. They also secured a huge amount of vaccine doses, which left other poorer nations in the lurch. It might be easy for Americans to put these disparities out of mind, but as omicron illustrates, variants that emerge elsewhere can — and often will — still affect us.
"Not only is our failure to share vaccines equitably taking a terrible toll on some of the world's poorest countries, but as these variants develop it means that the risks of infection can continue to increase in all places where people are not yet protected by vaccines," Dr. Rachel Vreeman, chair of the department of global health at the Icahn School of Medicine at Mount Sinai and director of the Arnhold Institute for Global Health, told TODAY.
Over time, variants could pose a risk to those who are fully vaccinated as well, as is the concern with omicron. "Essentially, this pandemic is not over until it's really over for everyone," Vreeman said.
Travel bans are not the right approach
When researchers in South Africa revealed that they had detected the omicron variant, governments responded with travel bans.
The U.S. announced it would restrict incoming travelers from South Africa and seven other countries, but that those restrictions will not apply to U.S. citizens returning to the country. Within days, officials in Canada detected the country's first omicron cases, and public health experts expect to find U.S. cases soon. It's an approach that, "public health-wise, does not make sense," Peprah said. "COVID doesn't care if you're a U.S. citizen or not."
And this type of travel ban isn't just unhelpful, Brewer said, it's actually counterproductive because it may discourage other countries from reporting new variants in the future.
"South Africa and Botswana were advanced in their science and did a great job of being transparent and reporting that this new variant was present in their countries. This is exactly what we hoped for from a public health standpoint," Vreeman said. "We don't want to punish people for doing that kind of excellent monitoring."
International collaboration is crucial to ending the pandemic
Instead of travel bans, public health experts say we need international collaboration to effectively battle the pandemic. The largest vaccine-sharing project of its kind is COVAX, and its run by the World Health Organization, the Coalition for Epidemic Preparedness Innovations and Gavi. The project was designed to buy COVID-19 vaccine doses and distribute them to lower-income countries, but it hit some major obstacles along the way. One major issue is the fact that richer nations are buying and stockpiling doses so quickly that lower-income countries often don't have a chance to secure them.
Under President Biden's administration, the U.S. has donated a significant amount of doses and money to international vaccine sharing efforts. But Biden has also said that the United States will continue to stockpile vaccine doses, "which is unfortunate," Peprah said.
Plus, vaccine equity "isn't just about the vials of the vaccine," Dr. Yvonne Maldonado, professor of pediatric infectious diseases, global health and epidemiology at Stanford University, told TODAY. The logistics of manufacturing, distributing and administering the vaccines on the ground have proven challenging in the U.S. and abroad, including in countries dealing with conflict and famine on top of the pandemic, Maldonado said.
Pushing through those challenges to get the world vaccinated is key, though, or we may be dealing with new variants for much longer. Maldonado points to the WHO's Essential Program on Immunization, which began in the 1970s, as an example of an international vaccine program that's been successful despite certain setbacks. "We know it can be done," she said.
If you're concerned about global vaccine equity, Maldonado urges you to get in touch with local leaders in your area to push them to advocate for this type of global support. But one thing people shouldn't do is skip their own COVID-19 vaccination in an effort to let someone else have their dose, Maldonado said. "Your one vaccine is a great gesture, but that gesture should probably be put into advocating for global equity to your local congressperson," she said.
Also remember that getting vaccinated isn't just about you. It can also have ramifications for your local community and, as the emergence of omicron suggests, those around the world.
"If we don't make the vaccines accessible — even in places that may seem very far away from us, the spread of this virus means that there's constantly a risk that new variants could start to spread worldwide," Vreeman said. "And when new variants emerge, no matter how many borders we close, no matter how much travel we try to limit, those variants can all too easily impact all of us around the globe."