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Inequality and delays: Great reasons of concern in COVID-19 vaccination

Almost three months later, the events that have transpired and the decisions taken, maintain the illusions as well as the referred concerns. But the latter have increased a bit given the sluggishness in the vaccination process and the constant social inequality with everything related to the pandemic.

In February, the Government began the National Vaccination Plan and the established prioritization began to work. The official news focused on the benefits of the governmental procedure, while the more critical news outlets visibilized some of the issues during the execution of the plan 2.

Towards mid-February, through several communication channels, we found out of the arrival of the first 50,000 dosages of the Pfizer vaccine, which were distributed across the nation. Of the total first dosages, 12,500 were distributed in Bogotá.3

During February and March, another 2,800,000 vaccines arrived including Sinovac and vaccines from the COVAX mechanism (Pfizer and AstraZeneca). So, for the end of March, the total number of doses was 3,362,000, and for that time, close to half of them had already been applied 4.

Without a doubt, 3 million vaccines are an important amount and have required great logistics to comply with the national effort to vaccinate 35.2 million inhabitants. But in light of the requirements –estimated in close to 61 million doses– these figures are not so promising. Then for Easter, the vaccination pace slowed down a bit.

This is why the vaccination process raises concerns. When you think it took more than a month and a half to dispose of 3.36 million vaccines (although in that time not all dosages were applied), it is not difficult to conclude that at that rhythm, the total vaccination of all Colombians could take a little more than two years. Then the vaccination process turns too slow.

Obviously, the experience obtained in the process and the agility in purchases could make it faster, but the scenario does not seem very favorable. Even more with the obstacles produced by the obsessive protection of patents, hindering other laboratories from producing more vaccines.

But this difficulty is not new as we already lived through this situation with the HIV-AIDS epidemic. A few years back this was made apparent with the sale of antiviral drugs for treating AIDS, harming many patients, especially from African countries. The issue raised so many concerns that inclusively it was a matter of debate during the Fourth Ministerial Conference of the World Trade Organization (WTO) carried out in 2001 which led to the Declaration of Doha 5.

Despite the new regulations, the matter made evident the fact that when drug patent rights are privileged (and in this case, the vaccines) due to the care (and preventive) needs of people, this does not only threaten the lives of people but also public health of entire countries. It is also important to not forget that in 2020, the Colombian government voted against the proposal to temporarily suspend the property rights over the patents of the COVID-19 vaccines, discussed at the WTO 6.

On the other hand, the social inequality in the face of the pandemic is also worrisome and produces great concerns in the world. Several studies have shown the discrimination endured by several communities during the pandemic. Particularly, women, the impoverished, and black, and Indigenous communities. It is worth recalling that Latin America is a particularly vulnerable region 7.

This inequality is already being documented in the Colombian case. In a recent article published in the Journal of Epidemiology and Community Health, five Colombian researchers produce evidence of the socioeconomic inequality linked to COVID mortality in Colombia 8. There, the authors show that COVID incidence was greater in elders above 60 years of age, men, indigenous community members, and people in the subsidized health regime.

This was also mentioned in the latest report of the National Health Observatory which analyzes the consequences of the pandemic in Colombia. There, the authors show the direct and indirect effects of the pandemic on special populations. In particular, they refer to the precarious conditions of Venezuelan migrants, the difficulties endured by Indigenous populations, the distressing conditions of the incarcerated, and the drama of communities afflicted by the armed conflict in the country 9.

And now, according to some provinces and territorial instances, preliminary reports on the vaccination process show that the process is concerning differential behavior. The efficiency in applying available dosages has been heterogeneous as in Provinces like Bolívar, Huila, and Cundinamarca have been good, while in others like Cauca, Sucre, and La Guajira have shown a deficient behavior, although this valuation is changing through time 10.

This situation added to the differential behavior in face of diseased patients and the documented socioeconomic inequalities in regards to COVID mortality, makes the scene look threatening.

In this context, one would hope for great action in wealth redistribution policies. But, instead and amid the drama of the pandemic, the government only thinks of establishing a new and dated tax reform that protects the wealthier instead of the middle and lower classes. This seems senseless but curiously, reflects a solidary social transformation. Due to this mistaken notion of solidarity shown by the Government, the immediate future seems rather obscure, I hope my vision is only the product of a momentary pessimistic outburst.












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