Zoë Breininger | December 6th, 2024
The COVID-19 pandemic showcased the social, cultural, and economic factors that affect the dissemination of vaccines for communicable diseases. By 2022, the World Health Organization’s (WHO) goal of 70% vaccination coverage had not been met.
The implementation of a novel vaccine can be limited by many factors, including but not limited to acceptability, adoption, availability, cost, feasibility, penetration, sustainability, health equity, and favorability. In short, the adoption of a vaccine into circulation comes down to economic and social interests as well as access. One phenomenon that impacts social and economic interest through differential access is vaccine nationalism.
Vaccine nationalism refers to the tendency of countries, particularly wealthier ones, to push to get first access to vaccines, including necessary materials to manufacture them, at the expense of other countries’ supply. In the case of the COVID-19 pandemic, high-income countries (HICs), including the United States, China, and India, acquired large quantities of vaccine materials at the expense of low- to middle-income countries (LMICs). While this offered benefits to these HICs, allowing for domestic herd immunity to be reached faster, it prolonged LMICs’ efforts to obtain herd immunity, limiting their economic engagement and negatively impacting global economic activity.
Even though countries like the U.S. possessed a large supply of vaccines, many were wasted due to widespread vaccine hesitancy, as the rhetoric surrounding the COVID-19 pandemic politicized vaccination in a manner that had not been experienced previously. Coronaviruses, despite being the causal agent of the SARS and MERS epidemics, had not been taken seriously. Vaccination and pandemic precautions became a partisan issue. By associating politics with the anti-vaccination movement, a feeling of distrust and resistances towards vaccinations grew. This mentality trickled into vaccination rates for other illnesses, and we are just beginning to feel its impact. This effect was exacerbated by the lack of research on coronaviruses prior to the COVID-19 pandemic.
Despite sparse research on Coronaviridae viruses, Dr. Barney Graham’s research on viral proteins in respiratory syncytial virus (RSV) was pivotal in formulating the COVID-19 vaccine. Dr. Barney Graham, a Vanderbilt alumnus, began research on RSV in the early 2000s during his time at the university. His isolation of the F protein allowed him to create functional antibodies in a manner that could be replicated for coronaviruses. F proteins are responsible for the fusion of a virus to a cell, which is necessary for the virus to disseminate its genetic material. If this is successful, the virus can reproduce and infect other cells. Coronaviruses attach to cells using spike glycoproteins, similar to how F-proteins attach to cells to produce RSV.
Despite starting this research roughly two decades before the pandemic, the value of the research was not appreciated; thus, funding was sparse. However, this research played an intrinsic role in the development of the COVID-19 vaccine, and, despite the divisive rhetoric, shows that vaccine development for COVID-19 began long before the variant existed. Moreover, this also conveys the role of favorability in implementation science, as the public’s trust in the vaccine may have differed if more research had been conducted on coronavirus vaccines before the pandemic.
The COVID-19 pandemic demonstrated the impact of vaccine nationalism on overall herd immunity. The pandemic as a case study underscored the role of hegemony in vaccine distribution and exposes its micro and macro effects, emphasizing how partisanship may impact vaccination rates going forward. Additionally, the pandemic emphasized the need for sustained investment in vaccine research, even for infectious viruses that are not actively posing threats. Further demonstrating the need for a proactive approach to vaccine research and implementation, we must be hopeful that if something of this nature occurs again, a vaccine can be implemented swiftly with fewer implementation barriers.
References
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