And the ideal should not be the enemy of the possible...but unfortunately (in both international public health and politics), for now it is.

I never said the people of those countries "don't deserve" help. What I said was getting the doses to them, evading the corrupt dictators & warlords who control them, and into the arms of the involuntarily unvaccinated pose a logistical nightmare that may well be as of yet an insurmountable obstacle. And while we argue about and study & implement those measures, doses will continue to spoil and benefit nobody.

Some may call me cynical--I prefer "pragmatic." It's pointless to flail around with no concrete plan as to how (nor the physical resources) to achieve results. Until we get the entire globe to herd immunity (preferably via vaccination), we will never defeat the pandemic. It's a noble goal, but may not be achievable. It sucks. It's cruel. But it's also reality.

Getting vaccines into people in developing countries seems to have worked for polio and measles. Why not COVID? Rich countries are limiting exports.

https://www.nature.com/articles/d41586-021-01762-w

Overnight, the IL QANut woman who hung banners over highway overpasses while yelling died of COVID. While in the ICU she demanded ivermectin--and her followers picketed and made death threats against the hospital that refused to give it to her. Their leader, a notorious local anti-mask anti-vax attorney, is accusing the hospital of "medical murder" for not giving it to her. He's threatening to sue but--like the potential "bounty hunters" under the new Texas abortion law--he and that mob lack standing because they have no cause of action.

Meanwhile, which heart attack patient or trauma victim could have put that ICU bed to better use? In Idaho, hospitals are preparing to have to triage--with willful unvaccinated status a possible disqualifier for COVID patients. And in another state, one county's hospital system has stopped delivering babies--not for a lack of beds but because their anti-mandate nurses are walking off the job rather than get vaccinated or even tested.

There were anti-mandate protests called for in each province at a hospital today. My hospital was the protest site in QC. News report said there were 10 people. Losers. 🤣

Doctors Without Borders/MSF is involved in covid care but there is already an intenational agency for the vaccine distribution to underserved countries. It's called COVAX. Canada donated a bunch of vaccines (but we still have spares - I think Canada contracted 10 doses/person)

https://www.who.int/news/item/08-09-2021-joint-cov...

The lack of vaccines is the main problem. No vaccines will be distributed to areas without the infrastructure to distribute them. Some countries are isolated enough with few cases that they can wait. Others have more demand than supply. Target those.

Ok. So no to Afghanistan. That sucks. How about this place?

https://apnews.com/article/africa-kenya-atlanta-co...

To expand:

We tell anti-vaxxers to listen to experts and cite our sources.

I've cited the pandemic expert on vaccine diplomacy to beat the pandemic.

exbrnxgrl - I applaud your Peace Corp service in Afghanistan, but it doesn't make you an expert in vaccinating all developing countries.

I agree however I have done some fairly extensive traveling through quite a few third world countries on almost every continent. Sadly, the essential structure of many are the same, i.e. authoritarian rule, graft and corruption at almost all levels of both the public and private sector. small upper class, minimal middle class, most in poverty and all of the attendant inequities that go along with such wealth imbalances.

Though I wish that reality was different, and I am always hopeful it might be, there is an uglier side to humanity that I have been both horrified and privileged to know first hand.This is not negative, simply pragmatic.

In one third world country, yesterday, 1 million doses were administred. Not every third world country is Afghanistan without a stable state. And not every third world country is asking for donations or handouts. Rich countries are paying more to secure more vaccines and hoard them. Remember at the beginning US was not even giving Vaccines to Canada and Canada had planned and purchased all those vaccines well in advance. The result? While I was in chemo and vulnerable my healthy young US coworker got the vaccine and went to Hawaii.

And there were some longer term impacts due to policies, as there was another shortage of Pfizer in Canada in June at the time that I was approved for my second shot. As a result, I had Pfizer and then Moderna. While they say the coverage will be equivalent, there are many places that will not recognize my mixed dose status including much of the US. I had hoped that if things settled down I would be able to celebrate my 60th birthday in New York but that remains uncertain unless I get a third dose.

"I'm not sure of the issue with the vaccines coming from manufacturing plants in Europe - with any multinational company, products can come from any of their facilities on a supply/demand basis. Considering the U.S. has a vastly larger population than Canada, why wouldn't it make sense for local products to be used in the U.S. first, as long as the European facilities could keep up the supplies needed to other countries?"

No, it wouldn't make sense, not if the American plants were designated within Pfizer and Moderna as being the supply sources for Canada. The American plants were built with capacity to supply the U.S., Canada, and maybe Mexico and some Latin American countries. The mandate by Trump/Biden put extra pressure on the EU sites, which were not supposed to be supplying Canada (and possibly these other countries) and couldn't keep up. Early on - February, March, April, even into May - Canada and many EU countries were significantly behind the U.S. in % vaccinated because of lack of supply. At a time when only those 65+ could get vaccines in Canada and many places in Europe, the U.S. had enough supply to open up vaccinations to all ages (of course, since they had all the vaccine production that should have gone to Canada and other countries normally supplied by the U.S. plants), and they were flooding drugstores with supply. I would watch the U.S. evening news every night with steam coming out of my ears.

wrenn, yes, the reason that Canada's vaccination rate eventually (in May/June) jumped past other countries was the decision to give out as many first doses as possible before starting in on second doses. To be honest, I think that worked in our favour. From my reading, it's my understanding that a 3-4 month window between vaccine doses is generally believed to be optimal. With the Pfizer and Moderna vaccines, the recommended interval between doses was much shorter, but this was driven solely by the fact that they were rushing to market; in the clinical trials, to save time, they only tested the shorter interval. AstraZeneca did test both 4 week and 12 week 2nd dose intervals in their clinical trial, and 12 weeks was far superior. I seem to recall reading recently that a trial result came out on Pfizer at 12 weeks, and the results were improved versus having the 2 doses at the shorter (and officially recommended) interval. So despite not having specific information about Pfizer and Moderna vaccines, Canadian officials made their decision to delay second doses based on a lot of vaccine history. With AstraZeneca, they made the decision on 12 weeks for second doses based on the AZ clinical trial results.

I don't know this for fact, but I suspect that part of the reason why the efficacy of the vaccines is fading so fast in Israel and U.S., both countries where they got 2nd doses into people quickly, is because those second doses were given at 3-4 weeks, versus a more optimal extended timeframe.

Despite the major mess-up that was the vaccine roll-out in Canada, in the end I think I got lucky. At a time when only those 80+ could get a Pfizer or Moderna vaccine in Ontario, AstraZeneca (which did not have enough seniors in their clinical trial) was made available to those aged 60-65. That allowed me to jump the line and get my first dose sooner. 12 weeks later, by the time I was eligible for my second dose, I had the choice of AZ, Pfizer or Moderna. Based on several clinical trials that found that AZ followed by Pfizer was more efficacious than 2 doses of AZ or 2 doses of Pfizer, I opted for Pfizer as my second dose. Mixed doses appear to be better than 2 doses of the same. Check. 12 weeks between doses appears to be better than 3-4 weeks. Check. A double win for me, but only after a lot of frustration, thanks to the supply issues and very slow roll-out.

Edited to add: SerenitySTAT, I had not seen that study. Very interesting. It appears that they are saying that the interval should be "at least" 9 weeks, with delays of anywhere from 9 weeks to 15 weeks being optimum. This is consistent with my earlier reading about intervals on other types of vaccines.