The rapid global spread of COVID-19 has demonstrated that no matter how successful America is at fighting this pandemic here at home, we will never stop this threat unless we’re also fighting it around the world. In this series of issue briefs, the USGLC takes an in-depth look at the global response and COVID-19’s impacts on vulnerable populations, global development and diplomacy, and the future of U.S. global leadership. Read more from our series here.

As COVID-19 vaccines continue being rolled out around the world, the conversation on global immunization has shifted from approval and manufacturing to rollout and ensuring countries have the resources to get shots into arms. With vaccine misinformation rampant and vaccine hesitancy still at play globally, current variants have reaffirmed the risks associated with low global vaccination rates: no one is safe, until everyone is safe. COVID-19 has also disrupted routine immunizations around the world, reversing progress made on preventable diseases like measles and tuberculosis.

  • COVID-19 vaccination rates continue to lag significantly in low-income countries, where only 15% of the population has received one dose. This is remarkably lower than the vaccination rate in high-income countries, where more than 80% of the population has received at least one dose.
  • North America and Europe administered significantly more COVID-19 vaccines than other continents: 78% of the population in North America and 68% of the population in Europe have received as least one dose. On the other hand, only 20% of the population in Africa is partially vaccinated.
  • Large parts of the world are likely to fall short of the World Health Organization’s (WHO) vaccination target of having 70% vaccine coverage in all countries by mid-2022, with projections estimating that 122 countries are currently on a trajectory to miss this goal.

In March 2022, the United States passed the significant milestone of delivering 500 million COVID-19 vaccine doses to more than 110 countries. This is a pivotal benchmark in the Administration’s pledge to donate more than 1.2 billion shots worldwide. However, work is far from over as continued vaccine inequity threatens economic recovery.

Economic Impact. A more equitable global vaccine solution would have significant economic benefits for both the United States and lower-middle income countries. The IMF estimates that global economic loses may cost upwards of $5.3 trillion by 2026 if the international community fails to deliver enough vaccines to developing countries.

  • By the end of 2021, only 2.3% of those in low-income countries had been fully vaccinated. The U.N. Development Program (UNDP) suggested that had this vaccination rate been equal to that in high-income countries (54%), low-income countries’ GDP would have increased by more than $16 billion, or 5.2%.
  • The Omicron variant has made it clear that vaccine inequity slows global economic recovery. In early-2022, the World Bank reported that global growth is expected to decline significantly from 5.5% in 2021 to 4.1% in 2022, due to emerging variants and rising inflation.
  • Between 2022 and 2023, the United States is estimated to lose $41.3 billion in cumulative GDP due to insufficient vaccination rates in low-and middle-income countries. Though funding shortfalls and vaccine hoarding has contributed to low global vaccination rates, there are other factors to consider.

Vaccine Misinformation & Hesitancy. Countering misinformation and promoting vaccine safety plays a critical role in advancing global immunization. While vaccine hesitancy is not the only driver of low vaccination rates globally, its impact is significant.

  • In 2021, the Africa CDC published a survey noting that respondents perceived the COVID-19 vaccine to be less safe and effective than other vaccines. In Senegal, most notably, although 29% of respondents disagreed that vaccines in general are safe, 41% were not confident that the COVID-19 vaccine is safe.
  • While social media is a crucial platform to encourage vaccinations, it has also become a tool to discredit vaccines and public health agencies, slowing global vaccination rates. These are not geographically isolated trends.
    • Among those who reported seeing COVID-19 disinformation messaging, 59% viewed these messages on social media platforms.
    • In Bolivia, a country situated in one of the highest vaccinated regions in the world, misinformation circulating on social media has been rampant, leading some politicians to promote the use of a toxic bleach agent to cure COVID-19.

Building Capacity: Shots into Arms
As global vaccine donations and delivery ramps up, countries are now focusing on how to maximize capacity to meet the growing demand of vaccines and get shots from tarmacs into arms.

  • In 2022, the World Health Organization identified a $16 billion funding gap that has slowed delivery of critical COVID-19 testing and treatment tools to low-and middle-income countries. Without sufficient investments in the global COVID-19 response, global partners will be unable to provide life-saving supplies and resources to countries already struggling to implement vaccine plans.
  • John Nkengasong, WHO’s Special Envoy to Africa, said, “the greatest barrier you have now is: how do you provide enough logistics to vaccinate at scale?
  • In December 2021, USAID answered this question with the announcement of Global VAX, a new initiative to accelerate vaccine delivery, planning, and access in sub-Saharan Africa. Since Global Vax was launched, vaccination rates in low-income countries have risen from 6% to 13%.

Impact of COVID-19 on Routine Immunizations

The COVID-19 pandemic has also created new barriers to routine immunizations, putting millions of people around the world at risk of contracting preventable diseases such as measles, malaria, and tuberculosis. Necessary yet consequential diversions of resources to support the COVID-19 response have impaired routine immunization services and have forced the suspension of vaccination drives, increasing the likelihood of other disease outbreaks. Kate O’Brien, director of the WHO’s department of immunization sent a clear warning: “Routine immunization must be protected and strengthened; otherwise, we risk trading one deadly disease for another.”

  • Key improvements in the fights against HIV, TB, and malaria have reversed for the first time and the three diseases continue to killmore people in most low- and lower-middle-income countries than COVID-19. 
    • A polio outbreak that began in the Democratic Republic of Congo (DRC) in 2018 is now an even bigger threat, and Ebola outbreaks continue to strainthe country.
    • The WHO reported that for the first time in over a decade, TB deaths increased due reduced access to care. Disruptions to TB services are particularly severe, with an estimated1 million people currently suffering from TB without official diagnosis.
  • By April 2022, 19 measles vaccination campaigns globally were still postponed, putting 73 million children at risk.
  • Vaccine-preventable disease outbreaks are on the rise in Africa. Almost 17,500 cases of measles were recorded in the region between January and March 2022, a 400% increase compared to the same time in 2021.
  • In Afghanistan, a large measles vaccination campaign is underway as the disease has resurged, killed 142 children and infected 18,000 more since the start of 2022. The risk of measles outbreaks remains high as millions of children missed their first vaccine dose during the pandemic.

Last updated May 2022