Omicron shows need for global vaccine coverage, as Canada doses slowly reach African clinics

TORONTO -

Vaccine inequity is a more pressing concern than ever, but despite wealthy countries making a show of donating doses, the rollout of those doses to poorer regions of the globe has been a slow drip rather than the flood needed for wide protection.

Vaccine doses donated to COVAX by Canada have started arriving at their intended destinations, all while the spread of Omicron highlights one of the dangers of failing to ensure global vaccine coverage.

At the CFK Africa Tabitha Medical Clinic in Kibera, Kenya, health workers are finally getting the first box of Canadian-donated AstraZenca vaccines, now called Vaxzevria.

Eddah Ogogo, CFK Africa's primary health-care program co-ordinator, said they were “excited” to receive the vaccine doses.

“This is very crucial in fighting the pandemic,” she said.

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This clinic is in the middle of a poor and densely packed community outside of Nairobi with an estimated population of more than 250,000 people.

The clinic was founded by a local nurse Tabitha Atieno Festo, and is now funded by an international charity, CFK Africa, as well a partnership with the U.S. Centers for Disease Control and Prevention. It relies on shipments like this one from Canada.

Kenya is one of three countries in Africa that started receiving the first Canadian-donated shipments of AstraZeneca this fall through COVAX, the World Health Organization’s (WHO) vaccine donation program seeking to provide vaccines to lower-income countries where vaccine access is still a huge problem. Nigeria and Niger also started receiving doses in September.

While Canada has announced that it will donate, through financial support or direct doses, the equivalent of at least 200 million doses to COVAX by the end of 2022, so far it has shipped out around 9.1 million doses according to the government’s website — a small fraction of the amount Canada procured for itself.

In Kenya, less than 11 per cent of people have received even one dose so far.

According to a Reuters tracker, the country has reported around 255,000 COVID-19 infections, and 5,300 virus-related deaths.

Amos Achola, who lives in Kibera, says he has lost five family members, and even more neighbours to COVID-19 so far. 

“COVID-19 has really affected my family negatively because I used to work,” he said. "When COVID-19 hit, I stayed here and to date I am jobless right now.”

After some hesitation, he said he stopped listening to rumours that the vaccine was dangerous, and has come to the clinic to get inoculated. 

He said he believes it is important to get vaccinated because he believes in protecting himself.

World health officials have been warning for months that delaying vaccinating the globe could allow new variants to develop in countries with a lower level of vaccination.

As of now, there haven’t been any cases of the Omicron variant at the Tabitha Medical Clinic, but allowing COVID-19 to spread unchecked in poorer regions of the world is a recipe for disaster, officials say.

In some parts of Kenya, five to seven people often share a 10-by-10-foot home, the majority of families lack regular access to clean water and soap, and masks can be prohibitively expensive for people living on less than US$2 per day.

“We have very many tiny urban dwellings,” Ogogo said, describing the community around the clinic.

“Isolation is also very difficult. [Sick patients] will have to share with small dwelling units and this may increase the spread of the virus should one member of the household get infected.”

But while this clinic is able to vaccinate today using doses from Canada, with other doses of Pfizer and Moderna arriving - vaccine sharing remains shamefully low, according to world health officials, with wealthy countries achieving high levels of vaccination while some poorer areas of the world haven’t even received first doses.

“Vaccination is our best defence,” Dr. Matshidiso Moeti, WHO Regional Director for Africa, said in a press conference last week. “But while many high-income countries report more than 60 per cent vaccine coverage, just over seven per cent of Africa’s population is fully vaccinated — in spite of a rise in shipments of doses to the continent.” 

COVAX was supposed to receive 3.67 billion COVID-19 vaccine doses, but so far they have 589 million.

A database run by the International Monetary Fund and WHO which tracks how many vaccines countries have secured compared to their population shows that Canada has secured 414 per cent of its population — meaning that we have purchased enough vaccines to fully vaccinate our entire population four times over.

According to the same database, Kenya has only secured enough vaccines for 56 per cent of the population. The database does not look at how many people have received vaccines in a region, merely the secured supply or expected supply.

Another data set from WHO and IMF found that 73 countries are not on track to reach the goal of 40 per cent vaccination coverage by the end of 2021. None of those countries were designated as high-income.

Catherine Hankins, part of Canada’s COVID-19 Immunity Task Force, said that there are issues with “the lack of notice and the short shelf life of donations.

“What do I mean by that is the countries […] need to be getting vaccines that have at least a 10 week shelf life in order for them to be able to use them, and they need four weeks notice that they're coming,” she explained.

“The important points really are that you can feel like you're doing well because you're donating vaccines, but if you're donating vaccines with shorter shelf life, and you're not giving countries enough notice that it's coming, they’re not able to use it well and so we really need to think about this together. How do we make this work logistically?”

She said if Canada is committed to helping get the unvaccinated vaccinated across the globe, we need to step up.

“We're seeing right now what happens when we don't pay attention to what's going on in other countries.”

Hankins said vaccine production capacity in Africa will eventually need to be ramped up. To that end, the World Health Organization, COVAX and the Medicines Patent Pool have teamed up with Africa CDC and partners to create an mRNA technology transfer hub in South Africa. Unfortunately, its efforts will take time, and people on the continent need vaccines now.

Local health workers at CFK Africa's Tabitha clinic in Kenya simply want a steady supply. So far, they have managed to give first doses to 1,026 recipients. Those who work at the clinic say that despite widespread vaccine hesitancy, more people are starting to come forward seeking the shot.

Ogogo said they need doses “without fear of delay, that fear of coming to the facility and missing out on something.”

It’s a desperate plea as the world learns the hard lessons of shared protection.