After missing the target to vaccinate 70% of people in every country against COVID by July 2022, WHO’s new vaccine strategy prioritises 100% coverage for health workers and older people – but admits that every country will have to decide for itself. 

The World Health Organization has published an update to the Global COVID-19 Vaccination Strategy that preserves its 70% global vaccination target and 100% vaccination targets for health care workers and older populations, but acknowledges that countries will still need to determine their ‘context-specific targets’ for their own COVID-19 national vaccination programmes. 

The language walks back previous WHO statements about achieving vaccine coverage of 70% of the population of each country by mid-2022, a target that was clearly missed. Now, that 70% goal is described as “aspirational” without any new date set for when it might be achieved.  While WHO called for 100% of health workers and older people to be covered, it also acknowledged that each country will have to set its own targets in line with local conditions and priorities:   

“This acknowledges that countries will determine the breadth of their COVID-19 national vaccination programmes considering factors such as: local COVID-19 epidemiology, demographics,
opportunities to leverage COVID-19 to strengthen primary health care systems, other health priorities, socio-economic risks from future waves of disease, population demand for breadth of vaccination, and sustainability of vaccination efforts,” the strategy states.

The update, published Friday, stresses that many of the people who are most at risk remain unprotected despite the biggest and fastest global vaccination rollout in history — with over 12 billion doses of COVID-19 vaccines administered globally across nearly every country in the world, resulting 60% global coverage.

Only 37% of older people in low-income countries got jabs

Only 28% of older people and 37% of health care workers in low-income countries have received a primary course of vaccines, and most have not received booster doses, according to a WHO statement. For the general population, only 16% of eligible adults in low-income countries and 21% in Africa have received a full two-course initial dose according to Oxford University’s “Our World in Data” vaccine tracker.  Twenty-seven of WHO’s member nations, including 11 low-income countries, have not yet started a booster or additional dose program. Controversy still swirls over who is fundamentally responsible for the continuing low rates of COVID vaccination in Africa, in particular, with fingers pointed at the pharma industry, WHO, and widespread vaccine hesitancy, alternately. 

WHO emphasized the need to vaccinate those most at risk for COVID-19. 

“Even where 70% vaccination coverage is achieved, if significant numbers of health workers, older people and other at-risk groups remain unvaccinated, deaths will continue, health systems will remain under pressure and the global recovery will be at risk,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus, in announcing the strategy. 

“Vaccinating all those most at risk is the single best way to save lives, protect health systems and keep societies and economies open,” he said.

The strategy uses both primary and booster doses to reduce deaths and severe disease. The aim is to protect health systems, societies, and economies, as well as to facilitate the research, development, and equitable distribution of new vaccine products. 

Using local data and engaging communities

To ensure vaccines reach the highest priority groups, the strategy emphasizes the need to measure progress in vaccinating these groups and developing targeted approaches to reach them.

These approaches include using local data and engaging communities to sustain demand for vaccines and reach more displaced people through humanitarian response.

Call for more equitable distribution of new vaccines

The strategy also calls for the equitable distribution of new COVID-19 vaccines with “improved attributes” that increase “depth and breadth” of protection and ease delivery.

But it also stresses that supply agreements should aim at “targeting availability of vaccine products with improved attributes, for all countries.”

Omicron BA.5 and other subvariants have reduced the efficacy of vaccines, prompting the need for new vaccines that can protect against these variants of concern.

While current vaccines were designed to and have largely succeeded in preventing serious illness and death, they have not substantially reduced transmission rates. Global weekly COVID-19 cases almost doubled in the past six weeks, according to WHO’s press briefing on Wednesday. The surge has been driven by the Omicron BA.5 subvariant. 

“It is fundamental to continue investing in research and development to make more effective, easier to administer vaccines, such as nasal spray products,” WHO says, while also noting that ensuring the sustainability of the COVID-19 vaccination effort is an operational priority that will “require urgent attention and reorientation before the end of 2022.”

Image Credits: Samy Rakotoniaina/MSH, WHO.