WHO Appeals to Postpone COVID-19 Vaccine Boosters Until 2022; Tedros Lashes out at Pharma Association
COVID booster vaccines have gained traction in several countries – US, Israel, Germany, UK, and others, but low- and middle-income countries lag significantly behind in shots.

The World Health Organization (WHO) has called for its global moratorium on COVID-19 boosters to be extended until the end of the year to enable vaccines to be directed to countries that have not yet been able to reach their vulnerable citizens.

“A month ago, I called for a global moratorium on booster doses at least until the end of September to prioritise vaccinating the most at-risk people around the world who are yet to receive their first dose,” WHO Director-General Tedros Adhanom Ghebreyesus told the body’s media briefing on Wednesday.

“There has been little change in the global situation since then, so today I am calling for an extension of the moratorium until at least the end of the year, to enable every country to vaccinate at least 40 percent of its population.”

The WHO’s global target is for every country to vaccinate at least 10% of its population by the end of this month, at least 40% by the end of this year and 70% of the world’s population by the middle of next year – but the September target so far is likely to be missed due to the failure of rich countries to donate sufficient doses to low- and middle-income countries.  And current commitments to COVAX, the WHO co-sponsored global vaccine facility, are running several hundred million doses short of the 40% end-year goal. 

Dr Kate O’Brien

Dr Kate O’Brien, WHO’s director of immunisations, also stressed that there was neither scientific consensus nor enough evidence to support giving COVID-19 boosters.

“We’re not asking [countries] to withhold something for which there is a strong set of evidence,” said O’Brien. “The vaccines are holding up very, very well against the severe end of the disease spectrum. The actual focus of the vaccine programme is to prevent severe disease, hospitalizations and deaths, and we see in the evidence that, in fact, the vaccines are performing extremely well over time, and against the variants,” she said. 

According to a technical report issued by the European Centre for Disease Prevention and Control (ECDC) last week, “based on current evidence, there is no urgent need for the administration of booster doses of vaccines to fully vaccinated individuals in the general population” but that ”additional doses should already be considered for people with severely weakened immune systems as part of their primary vaccination”.

“We will continue to watch the evidence very carefully, but our expert advisory committees continue to see that there is not a compelling case to move forward with a generalised recommendation for booster doses,” added O’Brien.

No more promises, just vaccine delivery

Tedros hit out at high-income countries that have promised to donate more than one billion doses as “less than 15 % of those doses have materialised”. 

“Manufacturers have promised to prioritize COVAX and low-income countries. We don’t want any more promises. We just want the vaccines,” Tedros added.

Although 5.5 billion vaccine doses have been administered globally, 80% have been administered in high- and upper-middle-income countries, according to the WHO.

Reiterating his weekend appeal to G20 health ministers, Tedros said that “the world’s largest producers, consumers and donors of vaccines, the world’s 20 leading economies, hold the key to vaccine equity and ending the pandemic”.

They could do so by swapping their near-term vaccine deliveries with COVAX, fulfilling their dose-sharing pledges by the end of this month and “facilitating the sharing of technology, know-how and intellectual property to support regional vaccine manufacturing”, he added.

WHO’s Bruce Aylward

Dr Bruce Aylward, the WHO representative on COVAX, said that despite promises made by the G7 and others, the global vaccine platform had to reduce its supply forecast this week as there had been a 25% reduction in the number of doses that will go through COVAX – unless there is urgent action by the world’s G20 countries and vaccine manufacturers. 

“People have come out and said, ‘Well, it’s only 100 million doses if we do boosters’, but we’ve just had to downgrade supply by a few 100 million doses. It makes a real difference in the face of scarcity,” added Aylward.

“To get all the world to 40% [vaccination] coverage in every single country requires two billion doses of vaccine,” he added.  

According to its latest Supply Forecast, COVAX expects to have access to 1.425 billion doses of vaccine in 2021 “in the most likely scenario and in the absence of urgent action by producers and high-coverage countries to prioritize COVAX”.

COVAX supply forecast, 8 September 2021

COVAX added that its work was being hampered by “export bans, the prioritisation of bilateral deals by manufacturers and countries, ongoing challenges in scaling up production by some key producers, and delays in filing for regulatory approval”.

Tedros ‘appalled’ by IFPMA comments

Tedros also lashed out directly at the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), for comments made in an media briefing on Tuesday.

He complained that the IFPMA was calling for dose-sharing with poorer nations – but only after rich countries had vaccinated virtually everyone who wanted a jab.

“Yesterday, the IFPMA said that G7 countries now have enough vaccines for all their adults and teenagers, and to offer booster doses to at-risk groups, and that manufacturing scale-up should now shift to delivering global vaccine equity, including dose sharing,” said Tedros.

“When I read this, I was appalled,” said Tedros. “In reality, manufacturers and high-income countries have long had the capacity to, not only vaccinate their own priority groups, but to simultaneously support the vaccination of those same groups in all countries.

“We have been calling for vaccine equity from the beginning, not after the richest countries have been lower-middle-income- and lower-middle income countries are not the second or third priority. Their health workers, older people, and other at-risk groups have the same right to be protected. I will not stay silent when the companies and countries that control the global supply of vaccines think the world’s poor should be satisfied with leftovers,” Tedros said.

In the IFPMA statement, the pharmaceutical body stated that: “The biopharmaceutical industry continues to call for dose sharing and renew its commitment to work with governments to support their efforts.

“From now on, G7 countries have sufficient stocks of doses to vaccinate adults, teenagers and roll out boosters programmes to protect the most at-risk groups as well as substantially increase the number of doses available to low- and lower-middle-income countries. Political leadership is critical to enable dose deliveries as quickly as possible.

“Reducing the toll of the pandemic on lives and livelihoods requires equitable access to vaccines and country readiness for vaccination.”

WHO Director General Dr Tedros Adhanom Ghebreyesus.

Aylward, meanwhile, took a less combative position, recognising that vaccine inequity was no longer an issue of supply constraints.

“We had the IFPMA came out yesterday and said ‘Look, global production is 1.5 billion doses a month now’. The absorptive capacity of the world is less than a billion right now… So, the volumes are there. This is a fixable problem, but it’s only going to get fixed if the political will and the will of the manufacturers come together to solve it,” he said.

Israel, currently facing one of the highest infection rates in the world due to a Delta variant surge, has already implemented boosters shots for any residents who got their jabs more than five months ago.  And the White House has also announced it would begin offering boosters in September for everyone immunised eight months ago or longer – although regulatory authorities are still debating authorization of the plan. Several other countries including France, Germany, Thailand and the United Arab Emirates are offering boosters.

But Aylward noted that many other countries had already consulted the WHO on whether booster policies can be delayed. 

“Some countries may be going ahead with [booster] decisions, others may not. But our role is to make sure that we put forward the strongest possible arguments for the way out of this pandemic, and the way out is an extended moratorium because, since the last time we called for it, the equity gaps have got greater, the amount of vaccine available in low-income countries has gone down,” he added.

Recognise all WHO-listed vaccines

Tedros also condemned the refusal of some countries to allow travellers who have been fully vaccinated with a vaccine that has WHO Emergency Use Listing (EUL) entry on the basis that their vaccines have not been approved by their national regulators.

“WHO Emergency Use Listing follows a rigorous process based on internationally recognized standards. All vaccines that have received WHO Emergency Use Listing are safe and effective in preventing severe disease and death, including against the Delta variant,” said Tedros, urging all countries to recognize all vaccines with WHO EUL.

This follows reports that some European countries are still not allowing travellers vaccinated with Covishield, the AstraZeneca vaccine produced by the Serum Institute of India, to enter their countries – even though the European Union has approved the AstraZeneca vaccine made elsewhere.


Image Credits: Marco Verch/Flickr.

Combat the infodemic in health information and support health policy reporting from the global South. Our growing network of journalists in Africa, Asia, Geneva and New York connect the dots between regional realities and the big global debates, with evidence-based, open access news and analysis. To make a personal or organisational contribution click here on PayPal.