The US secured 1 billion doses of Covid-19 vaccines. Medical ethicists say it should share with other countries

As the coronavirus situation worses in India, hospitals are full and lacking oxygen while only two percent of the population has been fully vaccinated. CNN's Sam Kiley speaks to a doctor in New Delhi who says the losses are incomprehensible.

Posted: May 2, 2021 6:58 AM
Updated: May 2, 2021 6:58 AM


With the coronavirus pandemic spiraling out of control in India and other developing regions, the United States this week committed to sharing 60 million doses of the AstraZeneca vaccine with other countries.

But that's a drop in the bucket.

The US has bought or contracted to buy more than 1 billion doses of coronavirus vaccines. That's enough to vaccinate the US population at least twice, with plenty left over.

Medical ethicists told CNN the US has a moral duty to share those doses with other countries. That's especially true, they said, now that the pandemic is relatively under control in the US while countries like India have been overwhelmed by the virus.

"I do believe that the US is obligated to share vaccines with other countries," said Keisha Ray, an assistant professor and bioethicist at UTHealth McGovern Medical School in Houston, "especially those countries we might consider poorer countries or what we call underdeveloped countries."

Arthur Caplan, director of the Division of Medical Ethics at NYU's Grossman School of Medicine, agreed. He said the US was "ethically obligated" to share vaccines, pointing to the "horrific death toll and hospitalization tsunami that's taking place in many countries."

"Morally," he said, "we have to help."

It's a question of when -- not if

From an ethical perspective, everyone should have access to protection from Covid-19, Kathy Kinlaw, associate director for Emory University's Center for Ethics, told CNN.

She said many countries lack vaccine access because of the "diminished purchasing power for healthcare in general, but also for Covid-19 treatments and vaccines."

"I think the United States is definitely in a position where we should be sharing, absolutely," she said. "It's a matter of timing -- I think that's one real issue here."

The US is not simply obligated to share vaccines by virtue of its resources, Ray said. Wealthier countries like the US have historically benefited by hindering other countries, she said, whether through government relations or colonialism.

"We've gone to other poorer countries, taken their resources, and we've built our wealth on the backs of their resources," she said. "And we've left them in a position that now they can't care for themselves."

"Now we are in a position to give back, we are in a position to go there and help these countries," she said, like "paying our debt."

All three agreed it was right for the US to control its virus outbreaks before sharing vaccines. The pandemic is still an issue in the US, Ray said, but conditions have improved greatly.

"When you look at the US and global distribution of vaccines, you have to first ask, is the US in a position to help other people? That means it won't be of detriment to its own people, in this case Americans," she said. "So do we have the resources to share with other countries who are really struggling with the Covid pandemic? And simply put, right now, the answer is yes."

Caplan likened it to the rule for airplane oxygen masks that flight attendants describe prior to takeoff: "Put your own mask on before you assist others."

"You need to stabilize your own nation before you assist others," he said. "And I think we're there. I think we're getting there now."

US supply is outpacing demand

One factor in deciding to release extra vaccines is the issue of supply and demand -- specifically, that the former will soon outstrip the latter in the US, Kinlaw said. And that could mean it's time to start shipping spare doses overseas, she said.

A recent report by the Kaiser Family Foundation said the country as a whole will "likely reach a tipping point on vaccine enthusiasm in the next 2 to 4 weeks."

"Once this happens," the report said, "efforts to encourage vaccination will become much harder, presenting a challenge to reaching the levels of herd immunity that are expected to be needed."

Health experts have already warned of waning demand.

One official in Ohio's Mercer County told CNN this month that officials are struggling to fill vaccine appointments. And earlier this week, Georgia officials announced they would close the state's eight remaining mass vaccination sites on May 21.

The US needs to continue to address vaccine hesitancy at home and be responsive to peoples' concerns, Kinlaw said. "But certainly there could be a point where there are people who will not take the vaccine and we have extra vaccine in this country, in which case it should be used and shared."

Data from the US Centers for Disease Control and Prevention shows that 30% of the US population is fully vaccinated. Experts like Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, have estimated the US needs between 70% and 85% of the country to be immune -- either through vaccination or prior infection -- to reach herd immunity.

But even without reaching that crucial threshold, the US has enough vaccines to share with other countries, experts said.

The US could have an estimated 300 million excess doses by the end of July, according to a recent Duke University report.

"The world's wealthiest nations have locked up much of the near-term supply," wrote Dr. Krishna Udayakumar and Dr. Mark McClellan, health experts at Duke. "At the current rate vaccines are being administered, 92 of the world's poorest countries won't vaccinate 60% of their populations until 2023 or later."

Ray told CNN the main issue in the US is not one of supply. It's vaccine access for poor communities, rural communities and communities of color -- particularly those that are Black and Latino -- and lingering hesitancy, largely among White and conservative populations.

"That is an education, a public outreach and an access issue," she said. "We have other hurdles that are not supply hurdles. So we do have the supply to help other countries."

Global herd immunity will benefit everyone

It's not just the right thing to do.

The US and the world stand to benefit, especially if it wants to prevent further spread of the coronavirus and the emergence of new variants, the ethicists said.

"If you don't get these hotspots under control outside the US, they're going to come back, likely with new, dangerous strains that may undermine our vaccines," Caplan said. "It's both prudent to do it and ethical to do it."

Kinlaw also emphasized the importance of herd immunity not only in the US, but globally.

"Epidemiologically, we should be working to suppress the virus and to decrease transmission and decrease the continue evolution of the virus and the variants," she said. "That is going to be beneficial to every single person."

But vaccinations everywhere could also present economic benefits, Kinlaw said, allowing people to travel more freely and conduct business around the world.

"Beyond just doing what is just, we can look at it practically," said Ray, "and we can't have a country as large as India and as important to the global economy as India not producing the goods that we have come to rely on them for."

There are plenty of questions that will also have to be addressed when the US shares vaccines, Caplan said, like, "Who goes first? What do you do within the country? Is it too late and better to send medicine rather than vaccine?"

He pointed to the need to ensure a country that receives doses from the US is distributing them fairly and to vulnerable individuals.

"One of the ethical challenges is, are we going to insist on fair distribution within those countries? Or are we just going to give them vaccine and let them give it to the military and elite?" he said.

"It sounds nice to say we're going to aid others, but its simplistic, because some governments are corrupt," he said. "Some governments have no distribution plan other than to give it first to their own leaders, rather than to those in need."

Mississippi Coronavirus Cases

Data is updated nightly.

Cases: 314710

Reported Deaths: 7254
CountyCasesDeaths
DeSoto21646260
Hinds20369416
Harrison17949309
Rankin13643278
Jackson13450246
Madison10113217
Lee9986174
Jones8384163
Forrest7689152
Lauderdale7198240
Lowndes6403148
Lamar623686
Lafayette6203119
Washington5341134
Bolivar4802132
Oktibbeha462998
Panola4596107
Pearl River4519146
Marshall4450103
Warren4393121
Pontotoc420872
Monroe4115133
Union411176
Neshoba4031176
Lincoln3969110
Hancock379586
Leflore3498125
Sunflower336290
Tate334784
Pike3327105
Scott316274
Alcorn313368
Yazoo311770
Itawamba300577
Copiah297465
Coahoma295579
Simpson295388
Tippah288768
Adams286982
Prentiss280060
Marion269380
Leake268473
Wayne262841
Grenada261587
Covington259881
George248148
Newton246862
Winston227581
Tishomingo227067
Jasper221148
Attala214473
Chickasaw208057
Holmes189174
Clay185554
Stone182833
Tallahatchie178941
Clarke178080
Calhoun170932
Yalobusha164638
Smith162534
Walthall134245
Greene130633
Lawrence128724
Montgomery127142
Noxubee126734
Perry126338
Amite123142
Carroll121829
Webster114532
Jefferson Davis107133
Tunica105726
Claiborne102430
Benton100025
Humphreys96733
Kemper95828
Franklin83923
Quitman81116
Choctaw76418
Wilkinson67531
Jefferson65728
Sharkey50217
Issaquena1686
Unassigned00

Alabama Coronavirus Cases

Cases: 537813

Reported Deaths: 11024
CountyCasesDeaths
Jefferson791691529
Mobile41177808
Madison35002507
Tuscaloosa25871454
Shelby25076249
Montgomery24549591
Baldwin21290309
Lee15946171
Calhoun14556319
Morgan14364280
Etowah13890353
Marshall12262223
Houston10602282
Elmore10115206
Limestone10031151
St. Clair9890245
Cullman9730194
Lauderdale9449243
DeKalb8853188
Talladega8325176
Walker7259277
Autauga6971108
Jackson6830112
Blount6750139
Colbert6317134
Coffee5546119
Dale4869113
Russell444338
Chilton4343113
Franklin426282
Covington4138118
Tallapoosa4040152
Escambia394577
Chambers3581123
Dallas3564153
Clarke351361
Marion3137101
Pike311977
Lawrence302298
Winston275673
Bibb263064
Geneva252577
Marengo249664
Pickens234862
Barbour231956
Hale223677
Butler217869
Fayette212462
Henry189644
Cherokee184345
Randolph182042
Monroe178140
Washington167639
Macon160750
Clay156957
Crenshaw153357
Cleburne149241
Lamar143035
Lowndes139653
Wilcox127430
Bullock123041
Conecuh110629
Coosa108928
Perry107826
Sumter104932
Greene92634
Choctaw61024
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