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Global Vaccination: Continuing Challenges

Written by Sarthak Sharma, Master of International Policy Candidate


As the United States and other advanced nations vaccinate large percentages of their populations with highly effective vaccines, the focus is shifting to inoculating the more vulnerable and less developed parts of the world against COVID-19. With slow vaccination rates in developing and underdeveloped regions, particularly in Africa, infection surges continue to burden healthcare systems and present obstacles for the resumption of economic activities. Threats posed by new variants could also further dampen efforts in the global fight against the ongoing pandemic. With new and emerging perils from COVID-19, it becomes imperative that efforts towards global vaccination are ramped up.

The Threat of Covid-19 Variants

Serious SARS-CoV-2 mutations have been documented globally with some variations being more resistant to treatments or vaccines. The Alpha variant, for example, first identified in the United Kingdom, is estimated to be around 40%-90% more transmissible than pre-existing strains and contributed to a rise in infections in the country. The Delta variant, a double mutant first identified in India, has even higher transmissibility than the Alpha variant and is slightly less responsive to antibodies generated by highly effective vaccines including Pfizer. In India, this variant, coupled with government mismanagement, led to a massive COVID-19 surge and a near-collapse of the country’s healthcare system. Beta and Gamma, first found in South Africa and Brazil respectively, are the other variants of concern as specified by the World Health Organization (WHO). As these variants spread globally, there are concerns regarding the havoc they may wreak in unvaccinated populations with indications of COVID-19 resurgence in parts of Southeast Asia and Africa. Moreover, as infections spread, there are increased chances for the virus to mutate to more contagious and virulent strains putting pressure on healthcare systems, making vaccines less effective against particular variants, and delaying the opening up of the global economy. There is already an altered version of the Delta variant, known as the Delta Plus, that is spreading in numerous countries. The ultimate solution seems to be high vaccination rates that will blunt the spread and reduce the chances for the virus to mutate further.

Vaccine Diplomacy: A Brewing Competition

After India, the world’s largest producer of vaccines, halted its exports to counter its devastating surge, China stepped up and became a major supplier of COVID-19 vaccines to much of the developing world. Although the Chinese vaccines have a lower efficacy rate, the country has been fairly successful in its vaccine outreach with millions of doses delivered to developing regions. In June 2021, President Biden pledged half a billion doses of highly effective vaccines that will be donated with “no strings attached”. Biden has criticized China and Russia for seeking favors with their vaccination programs. Whatever the result of this competition may be, increased vaccine exports by the U.S. and other countries may translate into sufficient supplies to vaccinate the global population in a shorter period of time. However, vaccine nationalism and hoarding by some states could lead to uneven access to life-saving inoculations that may prolong the pandemic.

Learning Our Lesson

Not only has the pandemic exposed problems in healthcare systems, but it has also presented governance challenges in developing coherent, collaborative, and effective strategies against a global crisis. Unfortunately, the devastation caused by the pandemic cannot be undone, but it does provide an opportunity to address some of the challenges that could lead to better prevention and response in future outbreaks.

  • One of the first steps that must be taken is strengthening and reasserting the role of international institutions. During the pandemic, the WHO played a vital operational role, coordinated rapid-pace scientific work, and began the COVAX scheme for vaccine distribution to poorer nations. Countries must continue to support these institutions during times of crisis for them to function properly. Nonetheless, evaluations and restructuring of the WHO are necessary for it to be a well-functioning global health institution able to quickly and correctly understand the scope of a health crisis and guide nations in times of health emergencies, specifically during the initial response. This may provide additional time for governments to develop relevant policies and boost healthcare infrastructure.

  • Governments must identify ways to tackle misinformation and disinformation that hurt pandemic response. Extensive analysis is required to understand the role of IT companies, health institutions, and political entities in the dissemination of information. Addressing these concerns could make people take increased precautions and reduce vaccine hesitancy.

  • Governments and the pharmaceutical industry must ensure continued efforts in developing and administering booster shots that defend against emerging variants. Variants are skirting protection provided by less effective vaccines, most notably Chinese made Sinovac and Sinopharm, and the current strategy of two shots may be inadequate against more virulent COVID-19 strains.

  • There is a stark variance between rich and poor countries in terms of the number of doses administered. This highlights the need for investing in vaccine research and manufacturing capabilities in different regions, particularly in Africa, for better access to life-saving inoculations.

  • Finally, more transparency and cooperation are needed to identify the origins of COVID-19 or any other disease or variant. Not only will it ensure accountability on part of the actors involved, but also assist in creating strategies to tackle future outbreaks and develop a quick response plan.


The pandemic has revealed shortfalls in how we tackle a global epidemiological crisis, and vaccines have proven to be crucial in curbing the spread of infections. As countries increase vaccine production and inoculations, it must now be a priority to ensure equitable and quick access to doses to vulnerable populations. Lockdowns, although effective, will not completely end the COVID-19 spread and will entail economic costs. Not prioritizing global vaccination could prolong the ongoing pandemic and threaten more lives and livelihoods.



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