The EU’s decision to only allow people to travel to the region if they are fully vaccinated with a European Medicines Agency (EMA) recognized COVID-19 vaccine is discriminatory and puts vaccine uptake at risk, writes Thabani Maphosa.
There are now 17 COVID-19 vaccines approved for widespread use, with more than 3 billion doses administered, and counting. While differences exist in the way that each of these vaccines work and to a small extent in their level of efficacy, what they all have in common is that they have been through rigorous clinical trials, assessed by either a stringent regulatory authority or the World Health Organization, or both, and found to be safe and extremely effective at protecting people from severe disease. So, when one of those regulatory authorities casts doubt on any of those vaccine products, by placing restrictions on people receiving them, it not only discriminates against those individuals it also undermines confidence in those vaccines.
The decision by the European Union to only allow people to travel to or within the region if they are fully vaccinated with a European Medicines Agency (EMA) recognized COVID-19 vaccine encourages the creation of a two-tier system that does precisely this. It sets a dangerous precedent that is already affecting uptake of vaccines and potentially puts billions of people at risk. Any measures that imply that some fully vaccinated people are less protected than others threatens to exacerbate the inequities in vaccine distribution that we have already seen in ways that will further widen this global vaccine divide. And at a time when the world is trying to resume trade, commerce and travel, such measures work completely counter to this, both in spirit and outcome.
We must all work towards the common goal of ending this pandemic and rebuilding life in a post-COVID world. That can only be achieved through equitable access to COVID-19 vaccines, the founding principle upon which COVAX was created. But besides protecting people’s health, this equitable access also has to mean protecting their lives and livelihoods, including their ability to travel and conduct trade. This is in the interest of all governments and individuals.
The WHO Emergency Use Listing makes this possible by providing a risk-based assessment through which unlicensed vaccines that have been shown to be safe and effective in clinical trials can be approved for global use during a public health emergency. It means that roughly half the people in the world, those living in countries that not only lack the resources to pay for COVID-19 vaccines but may also not have stringent national regulatory authorities in place, can still access vaccines through COVAX.
While it is the duty of every regional, national and local regulatory authority to assess the safety and effectiveness of vaccines in order to ensure their citizens are adequately protected, during a pandemic that also means ensuring that people elsewhere are vaccinated too. Because until people in all corners of the globe are protected the virus will keep circulating and this pandemic will continue. Avoiding that will entail regulators mutually respecting the assessments of other national and global regulators, including the WHO. Otherwise, it not only sends the signal, incorrectly, that hundreds of millions of people are getting second class vaccines, but if others follow suit, we could potentially end up with a patchwork of different regulations that massively complicate and delay the re-opening of international travel and economic activity.
While processes are underway to ensure that COVAX-supplied Covishield vaccines, produced by Serum Institute of India – the same vaccines the EU is willing to donate to lower-income countries – and Korean-made SK Bioscience’s vaccines, both of which are approved by WHO, are eventually included within a broader portfolio of AstraZeneca vaccines that are accepted by EMA, that is simply not enough. The EU must reverse its original policy and recognize all WHO approved vaccines, and those approved by stringent regulatory authorities, and we encourage other regulators to do the same. The high level of protection these approved provide each individual should be viewed as one and the same, just as no fully-vaccinated individual should be treated as more or less protected than another.
During this pandemic we have already seen an intolerable amount of injustice and inequity with the distribution of COVID-19 vaccines, with many wealthy nations now having vaccinated more than 50% of their population, while fewer than 1% of people in low-income countries have received their first jab. COVAX is now working to get 1.5 billion doses to people in 92 lower-income countries by the end of the year. This will be essential to ending the transmission of the virus, so we cannot afford to undermine confidence in these vaccines. To get this far we have had to overcome vaccine hoarding, as well as export bans on COVID-19 vaccines and vital components needed to make them. Imposing what is now effectively an import ban on people receiving COVAX vaccines only adds insult to injury.
No region, country or individuals should face more restrictions because they are unable to access specific vaccines. Nor do they need to.