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An update on the global COVID-19 vaccination effort


The World Health Organization's goal of getting 70% of the world's population vaccinated by June is not going to happen. And it may never. It's making officials reconsider what the real goal of global COVID vaccination should be.

To talk about this and the many twists and turns in the global vaccination effort, we're joined by NPR global health correspondents Nurith Aizenman and Jason Beaubien. Hello.



SCHMITZ: Nurith, let's start with you. You are, in fact, in Brazil right now reporting on this vaccine issue.

AIZENMAN: Yes. I'm in Rio de Janeiro. I'm looking out through my window over this city's famous Ipanema beach, where I'm not seeing any masking. There's definitely a relaxed feeling here about the coronavirus right now, and that's largely due to a vaccination rate that is very high and certainly higher than the U.S. But the path to get there has been twisty, indeed.

SCHMITZ: Oh, yeah. Even before vaccines and treatments, Brazil's president, Jair Bolsonaro, was basically comparing COVID to a bad cold.

AIZENMAN: Exactly. And he was also totally initially disinterested in vaccines. But then by January of 2021, when Brazil's Sao Paulo state started doing vaccinations, there was such a clamor across the country for vaccines to be made available everywhere that Bolsonaro's government basically had to change tack. Brazil got the technology to make the AstraZeneca vaccine. Then it started buying tens of millions of Pfizer doses.

And today, 76% of Brazilians are fully vaccinated. Among Brazilians age 5 or older, it's 85% that are fully vaccinated. And by the way, in the U.S., 65% of the population is fully vaccinated.

SCHMITZ: Wow. That's a big difference. How did Brazil's government turn things around? Was there a major public relations campaigns, stuff like giveaways like we had in this country?

AIZENMAN: Well, President Bolsonaro did not start promoting the vaccines. If anything, he continued making comments suggesting incorrectly that vaccines aren't all that protective. But Brazil has this very long and proud tradition of public vaccination.

I spoke about this national culture of vaccination with Sotiris Missailidis of the Bio-Manguinhos Institute at Fiocruz Foundation. It's a government-funded facility that essentially makes many of the vaccines that are used in Brazil. And Missailidis noted that Brazil has this network of public clinics that offer people vaccines for free. Brazilians are used to this, and so he says when it came to COVID...

SOTIRIS MISSAILIDIS: The national response, the general response is to go in the line and vaccinate. And for the population, it's almost their right. They have the right to vaccination.

AIZENMAN: Even without a major public relations campaign, people just came forward to get their COVID jabs in a steady stream month after month.

SCHMITZ: As he said, it's a right. Let's turn to Jason. Jason, you've been in the Middle East, in Iraq, where vaccination rates are pretty low. Is this a matter of not having enough doses? Or what's going on here?

BEAUBIEN: Yeah. I was in Iraq for much of February, and at that point, only 17% of Iraq's population was fully vaccinated. Now it's only up to 18%, so there hasn't even been a lot of movement in the last couple of months. And what's interesting here is that this is a country that has plenty of vaccines. Iraqis can get Pfizer, AstraZeneca, Sinopharm. Doses are offered for free in clinics. Also, we've got campaigns of people out in markets and shopping malls offering it.

But health workers were telling me that people simply weren't interested. You know, there are very high levels of distrust both about the West and, by Iraqis, about their own government. So some people simply didn't want to get vaccinated because the government was telling them that they should. And also, for many people, they just didn't see it as a priority. You know, they've got other problems in their life, and this was not something that was important to them.

SCHMITZ: And Iraq is not an isolated case. You're seeing this elsewhere, too, right?

BEAUBIEN: Yeah, absolutely. I mean, a lot of places that have struggled with other, you know, health and social programs in the past are also struggling with COVID vaccinations. Haiti, for instance, has one of the lowest vaccination rates in the world. I should point out that they did struggle to get doses early on. But, you know, they've also been facing earthquakes and political instability and unbelievable levels of gang violence. And, you know, in that context, a vaccine against what's seen as a disease that doesn't seem to be killing a lot of people around them or making people very sick - you know, it isn't a major priority.

The average Haitian is 24 years old, so this is a very young country. And people are less vulnerable to severe cases of COVID, even if they do catch it. And this is something you are also seeing play out in many African countries.

SCHMITZ: Wow. You know, I'm looking at a map showing vaccination rates globally, and Africa really does stand out for having very low rates of vaccination. Nurith, you've also been speaking to health officials there, right?

AIZENMAN: Yes, particularly health advocates in South Africa, where there's a robust discussion now about whether, given that so many people who couldn't get the vaccine early on now have some protection due to infection with the coronavirus, the discussion is whether this repeatedly stated goal of vaccinating as many people as possible is kind of misplaced. There's the sense that it's distracting from a much bigger priority, which is to get a really high share of the elderly and other very vulnerable people vaccinated and boosted. These are the people who, even after exposure to the virus, are still at the most risk from future infections.

BEAUBIEN: Yeah. This is definitely something that we're hearing more of globally. You know, many officials are giving up on the idea that everybody should get vaccinated or will even choose to. It seems like we're entering a new phase, and we're adopting this more pragmatic approach and focusing efforts more intensely, as Nurith says, on the most vulnerable.

SCHMITZ: That was Jason Beaubien and Nurith Aizenman from NPR's global health reporting team. Thanks to you both.

AIZENMAN: You're welcome.

BEAUBIEN: You're welcome. Transcript provided by NPR, Copyright NPR.

Jason Beaubien is NPR's Global Health and Development Correspondent on the Science Desk.