With Canada becoming the third country after Britain and Bahrain to grant emergency approval for use of the Pfizer COVID-19 vaccine, there is still no rollout date on when countries in Latin America and the Caribbean can expect to get access to the first doses of a vaccine against the deadly virus.
"While a number of vaccine candidates are under consideration, no vaccine has been approved for distribution across our region yet," Dr. Carissa Etienne, the director of the Pan American Health Organization, the regional branch of the World Health Organization, said Wednesday during a remote briefing from Washington.
Still, in anticipation of a vaccine rollout, PAHO this week is convening health ministers from across the region in an extraordinary session. It is calling on member nations to prepare for the purchasing and distribution of a COVID-19 vaccine, and to prioritize who will be first in line.
"At first we will not have enough doses to protect everyone. So the objective is to save lives using the first deployment to reach those most vulnerable to develop severe forms of COVID-19," Etienne warned.
"Each country must identify priority groups and adapt the communications campaigns and materials to meet their needs, including by working alongside community leaders to empower communities, to seek vaccination," she added. "Health care workers will likely be among the first to benefit from a vaccine, and will also play a key role in raising awareness about the importance of immunization."
Vaccination campaigns have always been challenging in Latin America and the Caribbean, where countries have long struggled to vaccinate their population against diseases that are eradicated elsewhere in the world.
In Puerto Rico, where officials are still waiting on the U.S. Food and Drug Administration to authorize emergency use for vaccines from Pfizer and Moderna, residents were told to be patient during a recent digital event hosted by public health and science organizations.
"We will have enough vaccines to vaccinate all the population that needs to be vaccinated," Puerto Rico Department of Health Deputy Secretary Dr. Iris Cardona said Tuesday. "What happens is that in the first weeks, not all the doses needed will arrive in one shipment."
Cardona said the island's Department of Health, through its vaccine division, is in charge of organizing the distribution and administration process. It has followed guidelines and recommendations from the Centers for Disease Control and Prevention and the Trump administration's Operation Warp Speed to establish its vaccination plan, which has taken months to formulate.
Health care workers, starting with those who work in hospitals, will be the first to receive the vaccine on the island, as well as people who live in assisted living facilities and other shared confined spaces, and essential workers. The first round of vaccinations is expected to take approximately three months, said Cardona. In the following phases, which could overlap with the first, the health department hopes to make the vaccine widely available in pharmacies, doctors' offices and vaccination centers, among others. It will begin the inoculation of the general population with patients who have chronic conditions, Cardona said in a radio interview with Puerto Rican station WKAQ.
Last month, PAHO said its initial goal will be to vaccinate 20% of the population in Latin America and the Caribbean against the novel coronavirus. The cost: more than $2 billion for at least 2 billion doses of a vaccine by the end of 2021.
Low-income countries in the region will be helped by the COVAX Facility, a WHO alliance that was created to ensure equitable access to COVID-19 vaccines, while 28 self-financing countries that have signed agreements with the COVAX Facility will have the option to purchase vaccines through PAHO's Revolving Fund. This is expected to speed up access to a vaccine.
"We don't know how many doses will be produced in 2021 or 2022 yet," PAHO Assistant Director Jarbas Barbosa said Wednesday.
Barbosa also said scientists do not yet know the level of coverage needed to interrupt the transmission of the virus, which has killed more than 753,000 people in the Americas and continues to log record number of new infections.
"Based on other diseases and other vaccines, the WHO has an estimation. We need to reach at least 70% of the population in order to interrupt the transmission," Barbosa said. "But this is still a hypothesis. We need to have more research and more information to confirm this.
"The first step, and it's a huge step, is to vaccinate this 20% of each population to protect the most vulnerable groups and to save lives, and this is a very important challenge worldwide," Barbosa said. "For this reason, we are supporting these countries in Latin America and the Caribbean to have their immunization plans and to be ready for a vaccine rollout."
Over the past eight months, countries worldwide have invested $10 billion in the effort to develop vaccines, diagnostics and therapeutics. But there is still a finance gap of $28 billion, including $4.3 billion urgently needed for the next two months, United Nations Secretary-General Antonio Guterres told the U.N. General Assembly during a Dec. 3 special session on the pandemic.
"This funding is critical for mass manufacturing, procurement and delivery of new COVID-19 vaccines and tools around the world," he noted.
In all, 189 countries are participating in the COVAX initiative, with countries in the Americas region representing about a fifth of the members.
Etienne said despite the economic hardships that Latin America and Caribbean countries have endured during the global pandemic, they have done their part "in securing more than $1 billion in down payments and financial guarantees to engage with COVAX."
Over the past few weeks, the Americas region has been experiencing some of the highest level of COVID-19 infections since the outbreak was first detected in Brazil.
So far, there have been more than 28.5 million cases of COVID-19 in the region, with Honduras and Guatemala experiencing an increase in cases in areas recently ravaged by hurricanes. After keeping the virus at bay for months, many countries in the Caribbean are also witnessing slight but steady jumps in infections. This is true in the Dutch territories of Curacao, Aruba and St. Maarten, and the British territories of Bermuda, the Cayman Islands and the Turks and Caicos.
"The situation in some countries in South America is also concerning," Etienne said. The curve, once flattened in Uruguay, is now rising again. Brazil, which reported 20,000 cases a day a month ago, is now reporting more than 50,000 cases, the highest in South America.
"Brazil's health system is under strain and hospitals are at capacity in some areas," she said. "We're also seeing rises in cases and deaths in areas of Colombia bordering Venezuela and Ecuador. Further south, Paraguay is experiencing a surge in infections and health authorities are monitoring the situation closely to ensure enough bed capacity to manage critical patients."
Etienne said they are hopeful that the COVID-19 vaccines that will soon come to market will help to contain the pandemic, "but this will take time and advanced planning." She and others also warned that it is only one tool in the box. Individuals must continue to social distance, wash their hands and wear masks.
