Source:  NCSU COLLEGE OF AG & LIFE SCIENCES, 9/2/21


One of the questions that came up after the Biden administration’s Aug. 18 announcement on COVID-19 booster shots is whether it’s ethical for vaccinated people in the United States to get a booster when there are still so many people around the world waiting for their first dose of vaccine. And while we’re pondering ethics, is there a selfish argument for the U.S. to lead efforts to vaccinate people around the world? What about vaccine mandates? And when will we be able to vaccinate kids?

To address those questions, we spoke with Julie Swann and Matt Koci. Swann is a systems engineer with expertise in vaccine distribution whose work focuses on making health care and supply chains more efficient, effective and equitable. Swann is the department head and A. Doug Allison Distinguished Professor of the Fitts Department of Industrial and Systems Engineering at NC State. Koci is a virologist and immunologist whose work focuses on host-microbe interactions in birds; he is a professor in NC State’s Prestage Department of Poultry Science.

This post is part of a series of Q&As in which NC State experts address questions about the vaccines on issues ranging from safety to manufacturing to distribution. Among (many) other vaccine-related posts, we’ve already published a previous Q&A on vaccine boosters that addresses how they work and why they are being considered for some COVID-19 vaccines.

The Abstract: The Biden administration has said that people in the U.S. who received mRNA vaccines (Pfizer and Moderna) may want to consider vaccine boosters eight months after their second shot. Does that raise ethical concerns related to global vaccine access, since many people in other nations haven’t been able to get their first dose of vaccine?

Julie Swann: We need to continue to help get people vaccinated globally. A virus doesn’t know borders, the society we live in is very connected globally, and there are too many people dying. As of Aug. 28, vaccine trackers show that the vast majority of doses (over 80%) worldwide have been administered in countries that have high or upper-middle income. The U.S. has committed to providing initial doses but can do more to make sure that people worldwide have access to vaccine.

The doses in U.S. pharmacies, hospitals, clinics and doctor’s offices cannot be given directly to other countries. The expiration date would be too soon and the logistics too complicated. So we have doses that can be used for boosters, and also for children younger than 12 when they become eligible. We can vaccinate the American public while also helping others worldwide, especially given that vaccine manufacturing has now scaled up.

Matt Koci: Yes, we should be able to do both. The goal of the vaccines, beyond saving lives, is to help stop the virus from replicating uncontrollably around the world. Unfortunately, over the past 28 days the U.S. has accounted for around 27% of all the confirmed cases in the world. We need to help vaccinate the rest of the world, but we also owe it to the rest of the world to get our cases under control, so we don’t become the source of a new variant. Ideally that would be through getting nearly everyone vaccinated who is eligible. But if we can’t do that, and boosters can help tamp down breakthrough infections and limit case numbers, we should do that too.

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