Abstract
Pursuing vaccinations against COVID-19 brings hope to limit the spread of SARS-CoV-2 and remains the most rational decision under pandemic conditions. However, it does not come without challenges, including temporary shortages in vaccine doses, significant vaccine inequity, and questions regarding the durability of vaccine-induced immunity that remain unanswered. Moreover, SARS-CoV-2 has undergone evolution with the emergence of its novel variants, characterized by enhanced transmissibility and ability to at least partially evade neutralizing antibodies. At the same time, serum antibody levels start to wane within a few months after vaccination, ultimately increasing the risk of breakthrough infections. This article discusses whether the administration of booster doses of COVID-19 vaccines is urgently needed to control the pandemic. We conclude that, at present, optimizing the immunity level of wealthy populations cannot come at the expense of low-income regions that suffer from vaccine unavailability. Although the efficiency of vaccination in protecting from infection may decrease over time, current data show that efficacy against severe disease, hospitalization, and death remains at a high level. If vaccine coverage continues at extremely low levels in various regions, including African countries, SARS-CoV-2 may sooner or later evolve into variants better adapted to evade natural and vaccine-induced immunity, ultimately bringing a global threat that, of course, includes wealthy populations. We offer key recommendations to increase vaccination rates in low-income countries. The pandemic is, by definition, a major epidemiological event and requires looking beyond one’s immediate self-interest; otherwise, efforts to contain it will be futile.
Highlights
The COVID-19 vaccines were developed and authorized at an unprecedented pace.The first COVID-19 cases were reported in China in late 2019, whereas their etiological factor was identified in mid-January 2020 when its first whole-genome sequence was made publicly available by Chinese scientists
As shown in countries dominated by the B.1.617.2 variant, there is a significant negative correlation between fully vaccinated rate and mutation frequency (Mf ), with the highest values of Mf observed for populations with vaccination rates below 10% [68]
Global health agencies and funding partners should organize global crowdfunding to support vaccine deliveries to low-income countries. As part of their corporate social responsibility and contribution to the global fight against the pandemic, large pharmaceutical companies involved in the production of COVID-19 vaccines should consider a two-tier pricing system with a cross-subsidy
Summary
The COVID-19 vaccines were developed and authorized at an unprecedented pace. The first COVID-19 cases were reported in China in late 2019, whereas their etiological factor was identified in mid-January 2020 when its first whole-genome sequence was made publicly available by Chinese scientists. The European Medicine Agency stated that “there is no urgent need for the administration of booster doses of vaccines to fully vaccinated individuals” [25] in September 2021, a month later, it concluded that in the case of BNT162b2, “booster doses may be considered at least 6 months after the second dose for people aged 18 years and older” [26]; the agency expressed the same opinion on mRNA-1273 on 25 October 2021 [27] These recommendations may have been met with relief by some national authorities in light of the autumn 2021 surge of infections in European countries, with the majority of cases caused by B.1.617.2. Unvaccinated individuals remain the main drivers of viral spread in the population
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