key: cord-0270068-bai4ybvo authors: Basak, P.; ABIR, T.; Mamun, A. A.; Zainol, N. R.; Khanam, M.; Haque, M. R.; Milton, A. H.; Agho, K. E. title: Global Perspective of COVID-19 Vaccine Nationalism date: 2022-01-01 journal: nan DOI: 10.1101/2021.12.31.21268580 sha: 712238827f05b70e9c57b0ccdf380c1dc285aa01 doc_id: 270068 cord_uid: bai4ybvo Abstract: This study aimed to explore the global perspective of the association between GDP of various countries and progress of COVID-19 vaccinations; to explore how the global pattern holds in the continents, and investigate the spatial distribution pattern of COVID-19 vaccination progress for all countries. We have used consolidated data on COVID-19 vaccination and GDP from Our World in Data, an open-access data source. Data analysis and visualization were performed in R-Studio. There was a strong linear association between per capita income and the proportion of people vaccinated in countries with one million or more populations. GDP per capita accounts for a 50% variation in the vaccination rate across the nations. Our assessments revealed that the global pattern holds in every continent. Rich European and North-American countries are most protected against COVID-19. Less developed African countries barely initiated the vaccination program. There is a significant disparity among Asian countries. The security of wealthier nations (vac-cinated their citizens) cannot be guaranteed unless adequate vaccination covers the less-endowed countries. Therefore, the global community should take initiatives to speed up the COVID-19 vaccination program in all countries of the world, irrespective of their wealth. Keywords: COVID-19 vaccination; GDP; public health, high-income countries, developing coun-tries various countries and progress of COVID-19 vaccinations; to explore how the global pattern holds 23 in the continents, and investigate the spatial distribution pattern of COVID-19 vaccination progress 24 for all countries. We have used consolidated data on COVID-19 vaccination and GDP from Our 25 World in Data, an open-access data source. Data analysis and visualization were performed in R- 26 Studio. There was a strong linear association between per capita income and the proportion of peo-27 ple vaccinated in countries with one million or more populations. GDP per capita accounts for a 28 50% variation in the vaccination rate across the nations. Our assessments revealed that the global 29 pattern holds in every continent. Rich European and North-American countries are most protected 30 against COVID-19. Less developed African countries barely initiated the vaccination program. 31 There is a significant disparity among Asian countries. The security of wealthier nations (vaccinated 32 their citizens) cannot be guaranteed unless adequate vaccination covers the less-endowed countries. 33 Therefore, the global community should take initiatives to speed up the COVID-19 vaccination pro- 34 gram in all countries of the world, irrespective of their wealth. The worldwide effort to work up safe and effective Covid-19 vaccines has produced 40 remarkable results, thanks in part to early, crucial investments in clinical discovery 41 through initiatives like Operation Warp Speed (Kim, Hotez et al., 2021) . These accom- 42 plishments demonstrate the benefits of consistent, extended funding for basic research 43 and immunology: the scientific community was prepared to take action. Now, as the 44 world is faced with a scarcity of vaccines, there is a depressing reality: As of December is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint The copyright holder for this this version posted January 1, 2022. (Ritchie, Mathieu et al. 2020 ). Vaccine distribution is still very low in many of the 50 world's poorest countries. Experts predicted that 20% of the population in low-resource 51 areas would receive a vaccine in 2021 (Katz, Weintraub et al. 2021 ), but in reality, the ac-52 tual achievement was much lower. The critical nature of investment in research notwith-53 standing, prolonged neglect of public health and global delivery strategies has rendered 54 humankind unprepared to bring this pandemic to an end. Priority must be given to solv- 55 ing the complex bottlenecks in distributing and allocating newly approved vaccines (Katz, 56 Weintraub et al., 2021). As part of these efforts, vaccines must be produced in a safe, effi-57 cient, and timely manner. As a result of mistrust, misinformation, and historical legacies, 58 vaccine adoption is hindered (Weintraub, Subramanian et al., 2021) . Even wealthy coun-59 tries have encountered formidable obstacles when implementing mass vaccination pro-60 grams and made critical mistakes (Katz, Weintraub et al., 2021) . 61 Aside from that, the early competitive procurement of vaccines by the United States 62 and purchases by other high-income countries has led to the universal assumption that 63 each country will be exclusively responsible for its population. When powerful countries 64 secure vaccines and therapies at the expense of less-wealthy countries, it perpetuates a 65 long history of shortsightedness, inefficiency, and death (Katz, Weintraub et al., 2021) . 66 Industrialized countries are anxious to help with global vaccination, particularly for coun-67 tries that 76 require partnerships to warrant supply and delivery. Uncoordinated patches 68 of immunity could also exacerbate the spread of escape variants (Katz, Weintraub et al., is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint The copyright holder for this this version posted January 1, 2022. ; https://doi.org/10.1101/2021.12.31.21268580 doi: medRxiv preprint were also constructed with the same application. Esri's ArcGIS Pro (version 2.9, 116 esri.com/en-us/arcgis/products/arcgis-pro) was used to prepare the map. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint The copyright holder for this this version posted January 1, 2022. ; https://doi.org/10.1101/2021.12.31.21268580 doi: medRxiv preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint The copyright holder for this this version posted January 1, 2022. ; https://doi.org/10.1101/2021.12.31.21268580 doi: medRxiv preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint The copyright holder for this this version posted January 1, 2022. ; https://doi.org/10.1101/2021.12.31.21268580 doi: medRxiv preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint The copyright holder for this this version posted January 1, 2022. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint The copyright holder for this this version posted January 1, 2022. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint The copyright holder for this this version posted January 1, 2022. In this current study, we aimed to establish the association between the GDP of na-194 tions with COVID-19 vaccination rates. We found that, in general, the wealthier a country is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint The copyright holder for this this version posted January 1, 2022. can countries, which greatly affect their ability to acquire the vaccines they require. 234 The population of the African continent is estimated at more than 1.2 billion people. 235 With the recent spread of the virus on the continent, more than 1,528,000 people have been 236 infected and more than 36,828 dead (ECDC 2020). This is against the global figure of more is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint The copyright holder for this this version posted January 1, 2022. ; https://doi.org/10.1101/2021.12.31.21268580 doi: medRxiv preprint nario is a bit different, which was the fear of the WHO and public health advocates. Inter-293 nationally, high-income countries have adopted a competitive "fend for yourself" atti-294 tude, competing against others for access to supplies and commercial advantage in the 295 COVID-19 vaccines. 296 Most of the leading vaccines supply was pre-ordered by wealthy nations, even before 297 the safety and efficacy data was made accessible. Therefore, the nationalistic competition 298 for vaccines is a key factor contributing to the challenges faced in the equitable global 299 distribution of the COVID-19 vaccines. These practices are contrary to the global interest 300 and are likely to harm countries and citizens of the Global South. Even in Ghana's situa-301 tion, where the country (which became the first country to receive a shipment of the vac-302 cine from the COVAX initiative, but, currently, the supply is just enough for one percent 303 of the country's population) recently received 600,000 doses of the AstraZeneca/Oxford 304 vaccine, it is seen that this is still too low of a supply to be able to achieve herd immunity. 305 The global pattern observed is that the low-income countries with the least economic and is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint The copyright holder for this this version posted January 1, 2022. ; https://doi.org/10.1101/2021.12.31.21268580 doi: medRxiv preprint Foremost, to adopt an attitude, an approach, and actions that reflect global fairness, 308 solidarity, and equity for the expedient vaccine distribution and immunisation campaigns 309 across the globe in order that there is not a discrepancy between words and actions. The 310 WHO director-general, Dr Tedros Adhanom Ghebreyesus, stated it clearly in his opening 311 speech of a WHO executive board meeting: "Not only does this me-first approach leave 312 the world's poorest and most vulnerable people at risk, it is also self-defeating. Ultimately, 313 these actions will only prolong the pandemic, prolong our pain, the restrictions needed to 314 contain it, and human and economic suffering" (WHO 2021). This recommendation also 315 resonates with the idea that no one is safe until everyone is safe. There is the risk of exac-316 erbating more inequities in COVID-19 infection and mortality rates with some of the cur-317 rent practices. 318 Furthermore, there is the need for local, national, regional, and international coordi-319 nation of the vaccination rollout. There is already an established mechanism to actualise 320 this. It is known as the Access to COVID-19 Tools (ACT) Accelerator, a partnership 321 launched by WHO and its partners to support this coordinated and global effort (WHO 322 2021). is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint The copyright holder for this this version posted January 1, 2022. ; https://doi.org/10.1101/2021.12.31.21268580 doi: medRxiv preprint COVID-19 highlights the need for inclusive responses to public health 356 emergencies in Africa The world's richest countries are hoarding vaccines. This is morally indefensible The unequal scramble for coronavirus vaccines--by the numbers COVID-19 Update Worldwide. European Centre for Diseases Prevention and 362 Most of Africa Will Not Have Access to COVID-19 Vaccines for up to a 364 Year After Approval. Quartz Africa Effect of donor funding for 367 immunization from Gavi and other development assistance channels on vaccine coverage: evidence 368 from 120 low and middle income recipient countries Vaccine prices: a painful shot for Africa Vaccine Equity-Finding a Path Forward Operation Warp Speed: implications for global vaccine security How COVID vaccines are being divvied up around the world COVID-19 vaccines: how to ensure 378 Africa has access Rural communities in Africa should not be forgotten in responses to COVID-19 Current trends of immunization 383 in Nigeria: prospect and challenges How will the world's poorest people get a coronavirus vaccine Coronavirus (COVID-19) Vaccinations In race to secure Covid-19 vaccines, World's poorest countries lag behind Why Leaders Must Invest In Delivery Strategies Now: Analysis describe lessons 393 . CC-BY-NC It is made available under a perpetuity.is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprintThe copyright holder for this this version posted January 1, 2022. ; https://doi.org/10.1101/2021.12.31.21268580 doi: medRxiv preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprintThe copyright holder for this this version posted January 1, 2022. ; https://doi.org/10.1101/2021.12.31.21268580 doi: medRxiv preprint