Europe’s stark vaccine divide leaves East far behind

Patients waiting to receive a dose of COVID-19 vaccine at The Military Medical Academy in Sofia. (PHOTO / BLOOMBERG)

LONDON / HAVANA / MADRID / OTTAWA / BERLIN / BRASILIA / RABAT / ROME / PARIS / OSLO – The European Union this week hailed reaching a key milestone of 70 percent fully vaccinated. But in the bloc’s poorest country, the rate hasn’t even reached a quarter.

The figures in Bulgaria stand out as extreme, but also capture an east-west divide that’s gotten worse in recent months. Bulgaria has fully vaccinated just 20 percent of adults against COVID-19, while its neighbor Romania is at 32 percent. Germany, France, Netherlands, Spain and Ireland, by comparison, are all above 70 percent.

The east-west vaccine gap is one of many ways in which the pandemic has split Europe. There were also divisions across wealth and age, all of which, according to the European Council on Foreign Relations, will “haunt the continent for many years"

The wider gap is partly due to aggressive — sometimes controversial — campaigns in western European countries, especially France, that boosted rollouts. But it also reflects perceptions of corruption and a deeply embedded mistrust of authorities in some eastern nations, as well as concern about the safety of vaccines.

Some 23 percent of Bulgarians don’t want to get inoculated, compared with an EU average of 9 percent, according to a Eurobarometer survey published in June. Trust in the government is among the lowest in the bloc.

If the low takeup in Romania and Bulgaria leads to a fresh spike in cases, that will have economic repercussions, straining hospital resources, hampering businesses, and undermining their ability to attract much needed tourists to Black Sea resorts.

Bulgaria’s 14-day coronavirus case rate is about 190 per 100,000 people, just below the EU average. But the death rate is above 30 per 100,000, according to the ECDC, more than triple the EU number.

The east-west vaccine gap is one of many ways in which the pandemic has split Europe. There were also divisions across wealth and age, all of which, according to the European Council on Foreign Relations, will “haunt the continent for many years.”

“As Europe starts to deal with the long-term consequences of the pandemic, these divisions in experience will transform from a silent divide into a major schism,” it said in a report this week. “This could have profound implications for some of Europe’s biggest projects,” including freedom of movement and the bloc’s multi-billion euro recovery plan.

While vaccine uptake is better in Slovakia, Croatia and Slovenia — about 50 percent — all three are still below the EU average. Hungary is a regional outperformer, at 65 percent.

On Thursday, Bulgaria announced new restrictions for bars and restaurants to try to limit the spread of the virus. But despite rising hospitalizations and deaths, Prime Minister Stefan Yanev has ruled out introducing compulsory vaccines.

“It’s everyone’s right to decide how to manage their personal life and their personal health,” he said this week.

The caretaker government has opened walk-in vaccination points at shopping malls and public parks, but its authority is sorely limited. The country is mired in political uncertainty and heading for a third general election this year after multiple failures by parties to form a cabinet.

The lack of demand for shots has forced the country to sell or donate thousands of vaccines to elsewhere before they expire. Romania is also giving away shots.

“The high number of deaths from coronavirus is worrying,” Bulgarian Health Minister Stoycho Katsarov said Thursday. “That’s the other side of the coin of the vaccination issue. The last place in vaccination places us first in mortality. That’s the logical connection.”

South Africa

An arrangement whereby Johnson & Johnson (J&J) was shipping to Europe COVID-19 vaccine doses that were being packaged in South Africa has been suspended, African Union (AU)envoy Strive Masiyiwa said on Thursday.

The shots packaged by J&J's South African partner Aspen Pharmacare Holdings Ltd. and already sent to Europe would be returned, Masiyiwa said at a news conference organized by the AU's disease control body.

The development came following an announcement that Aspen was in talks with J&J to increase production of COVID-19 vaccines and evaluate a potential license for Africa’s biggest drugmaker, positioning itself for further developments in the inoculation sphere.

The discussions are underway as the AU and European Union look to bolster the supply of coronavirus vaccines to the continent, and could extend an existing agreement for Aspen to package and fill vials of the US company’s vaccine at a plant in South Africa. 

“Aspen is hopeful that the current discussions between Johnson & Johnson and Aspen, including a possible license for Africa, could make a meaningful contribution to improving equitable COVID-19 vaccine access for the continent,” Chief Executive Officer Stephen Saad said in a statement.  

South Africa is heavily reliant on the single-dose shot as it looks to inoculate as many of its 40 million adult population as possible this year. Most nations elsewhere on the continent are at the back of the line when it comes to vaccine rollouts, raising the risk of the emergence of dangerous new variants. 

Aspen switched focus to producing so-called steriles such as anesthetics a few years ago to tap a higher-value market than its traditional generic medicines, paving the way for a push into vaccines. Gaining a license would allow Aspen to produce a fully-owned African COVID-19 shot manufactured locally, easing a dependence on other nations. 

WHO

The World Health Organization (WHO) recommends against using spare doses of COVID-19 vaccine to give booster shots to countries' fully-vaccinated populations, since the priority is to ensure the global population is vaccinated, the agency's head said.

Speaking in Berlin at the opening of a new epidemic intelligence hub, WHO Director-General Tedros Adhanom Ghebreyesus urged countries with spare vaccines available to donate any deliveries they received in the near term to COVAX or other initiatives aimed at sharing doses with poorer countries.

"For now, we do not want to see widespread use of boosters for healthy people who are fully vaccinated," he said. "We call on countries that have contracted high volumes of vaccines to swap near-term delivery schedules with COVAX and the African Vaccine Acquisition Trust, or AVAT."

ALSO READ: Study: Painless organ damage seen in COVID-19 'long hauler'

Americas

Three-quarters of the people in Latin America and the Caribbean have not been fully immunized against COVID-19 in contrast to the United States and Canada where a majority have been vaccinated, the Pan American Health Organization (PAHO), the WHO’s regional arm, said on Wednesday.

While vaccines lack in most countries, over half the population of the United States and more than 60 percent of the people of Canada, Chile and Uruguay have been fully vaccinated.

The Americas region needs an additional 540 million doses to ensure that every country can cover at least 60 percent of its population, PAHO Director Carissa Etienne said.

"The best way to protect against variants of concern, like the Delta variant, is to ensure more people are fully vaccinated everywhere," Etienne stressed.

COVID-19 infections are surging again in North America and hospitalization rates among young people and adults below the age of 50 are higher today than at any other point in the pandemic, PAHO reported.

COVID-19 outbreaks are accelerating in multiple Central American countries, especially Costa Rica and Belize, according to PAHO. In the Caribbean, Jamaica is seeing its highest-ever COVID-19 death toll as its hospitals reach full capacity.

In South America, infections are declining, except for Venezuela, where cases are plateauing, and Suriname, where transmission has increased for four consecutive weeks.

PAHO said it was monitoring the evolution in Latin America of the Mu variant, first detected in Colombia and labeled as a "variant of concern" by the WHO on Aug 30.

The new variant does not pose a particular threat or risk, since community transmission in the region continues to be relatively sporadic, according to Jairo Mendez Rico, PAHO advisor on emerging viral diseases.

In its weekly bulletin, the WHO said the Mu variant has been detected in 39 countries but was declining globally, with predominance in less than 0.1 percent of cases.

READ MORE: WHO puts coronavirus' new variant on watch

A health worker waits on a public bus to give residents over the age of 18 doses of the Sinopharm COVID-19 vaccine in El Alto, Bolivia, Sept 1, 2021. (JUAN KARITA / AP)

Global tally

Coronavirus cases worldwide have exceeded 218.4 million while the global death toll topped 4.5 million, according to data compiled by Johns Hopkins University.

Africa

Canada will donate more than 1.3 million doses of AstraZeneca's COVID-19 vaccine to three African countries through the COVAX vaccine-sharing facility, GAVI said on Thursday.

Nigeria, Kenya and Niger will receive first shipments of the COVID-19 vaccines on Thursday, the Global Alliance for Vaccines and Immunization (GAVI) said.

The number of confirmed COVID-19 cases in Africa reached 7,786,104 as of Wednesday afternoon, the Africa Centers for Disease Control and Prevention (Africa CDC) said.

The death toll stood at 196,243 while some 6,941,815 patients across the continent have recovered from the disease, the Africa CDC said.

Norway

Norway will begin to offer COVID-19 vaccines to children aged 12 to 15, Prime Minister Erna Solberg said on Thursday.

Only the vaccine developed by Pfizer and BioNTech is so far recommended for this age group, the Institute of Public Health said.

For the time being, only a first dose will be offered, while a decision on whether to offer a second dose will be made at a later time, Solberg said.

The country is currently seeing a rapid rise in infections, particularly among the young, and will postpone a further relaxation of social restrictions for the time being.

"The government will not proceed with a reopening at this time," Solberg said.

Some 72 percent of all Norwegians have now received a first dose of a COVID-19 vaccine and 57 percent of the population is fully vaccinated, according to the Institute of Public Health.

Ethiopia

Ethiopia registered 1,217 new COVID-19 cases in the past 24 hours, taking the tally to 309,351 as of Wednesday evening, the country's Ministry of Health said.

The ministry also reported 17 more COVID-19-related deaths and 1,220 new recoveries during the same period, bringing the death toll to 4,692 and total recoveries to 278,062.

According to the ministry, there were 26,595 active COVID-19 cases, of whom 620 were in severe health conditions.

The East African country has so far administered a total of 2,455,791 COVID-19 vaccine doses, according to the ministry.

Angola

Angola aims to administer an average of 90,000 vaccine doses against COVID-19 daily, the country's minister of state and head of the Presidency's security affairs, Francisco Pereira Furtado has said.

Also on Wednesday, Angola reported 237 new cases and 10 deaths, taking the tally to 47,781 cases and the toll to 1,227.

Belgium

Belgium's King Philippe and Queen Mathilde cancelled their attendance at all public events from Thursday after a family member tested positive for COVID-19.

The palace said in a statement that the king and queen had decided to limit their contacts in the coming days. A spokesperson declined to identify which family member had produced the positive test.

Public broadcaster VRT said it was one of the monarchs' two younger children, 15-year-old Emmanuel and 13-year-old Eleonore, and that the king and queen had both tested negative.

The palace said the king and queen's activities planned up to and including Monday had been cancelled or postponed. They included an audience for everyday "heroes" on Thursday and attendance at an international athletics meeting on Friday.

Bulgaria

Restaurants and bars in Bulgaria will have to close at 10 pm from Sept 7, while indoor sports competitions will be held without spectators, the health minister said on Thursday, as the Balkan country braces for a surge of new coronavirus infections.

Bulgaria, the least vaccinated country against the coronavirus in the European Union, has seen a spike in infections in recent weeks, mostly of the highly infectious Delta variant.

On Thursday alone the country of 7 million people registered some 1,745 new cases, bringing its tally of active infections to some 32,192.

Some 18,950 people have died since the beginning of the pandemic, with 54 more deaths reported on Thursday in the country.

"There is no place for panic. The situation is serious, but not out of control. The low percentage of vaccinations forces us to impose these measures," interim Health Minister Stoicho Katsarov told reporters.

Under the new restrictions, which will be in force until the end of October, music festivals will be banned, while cinemas and theaters will have to operate at 50 percent capacity.

Students will be allowed to attend classes when the school year begins on Sept 15, Katsarov said, but he warned that if the infections continue to rise, they may have to switch to online studies.

France

Twelve million French children headed back to school on Thursday, wearing facemasks, using sanitizer at the entrance and standing distanced from each other in the yard under strict government rules aimed at curbing the spread of COVID-19.

"This is very different from usual 'back-to-school' days," said Matthieu Seguin, deputy director of the Rodin high school in central Paris, also pointing out air purifiers in classrooms and spare masks for any pupils that had forgotten theirs.

With inoculations now also available for children from age 12, and pupils encouraged to get their shots, Seguin said his school might become a vaccination center.

The daily average COVID-19 contagion rate has slowed in France, and the government aims to administer a third vaccine shot to some 18 million people by early 2022, a health ministry official said on Tuesday.

Students enter their classes on the first day of school for the 2021-2022 year at Gounod Lavoisier Primary school in Lille, northern France, Sept 2 2021. (MICHEL SPINGLER / AP)

US

Hospital admissions of COVID-19 patients in the US are declining for the first time since late June, a sign that the latest surge may have peaked – at least for now.

The seven-day average of new daily admissions with confirmed COVID-19 fell 2.4 percent from a week earlier to 12,280, the first such drop since June 27, according to the US Department of Health and Human Services. 

The US Food and Drug Administration has asked Pfizer, Eli Lilly & Co and AbbVie to include information about risks of serious conditions and death from the use of their drugs that belong to a class of treatments known as JAK inhibitors.

The warnings on Wednesday stem from the FDA's review of Pfizer's arthritis drug Xeljanz after initial results from a February trial showed an increased risk of serious heart-related problems and cancer with the drug.

Meanwhile, the FDA said on Wednesday its outside advisers will meet on Sept 17 to discuss additional doses of COVID-19 vaccines and specifically Pfizer Inc and partner BioNTech's application for the use of a booster vaccine dose.

As the United States gears up for a COVID-19 vaccine booster campaign, most vaccinated Americans want the additional dose, a Reuters/Ipsos opinion poll found, largely driven by concern over the highly contagious Delta variant of the coronavirus.

The national survey, conducted Aug 27-30, found that among those adults who received at least one dose of a coronavirus vaccine, 76 percent want a booster, while 6 percent do not and 18 percent were not sure. Among those aged 55 and over, 80 percent said they want one.

UK

Britain will give severely immunosuppressed people a third dose of COVID-19 vaccine to increase their chances of generating a better immune response, although officials stressed the offer was separate from any broader booster vaccine program.

Public Health England on Wednesday said the decision to offer third doses to the immunosuppressed followed data that showed 40 percent of immunosuppressed people generated only low levels of antibodies from two vaccine shots.

However, officials stressed the third dose was not a "booster" dose as it would be administered as part of the primary vaccination schedule and aimed at helping the initial process of generating an immune response.

Third doses will be given to people with immunosuppressive conditions such as HIV/AIDS, and those who have received immunosuppressive treatments like chemotherapy. The move will impact less than 1 percent of the population, around 400-500,000 people.

Officials said mRNA vaccines made by Pfizer and Moderna should be used as the third dose, as there was more data on these shots, but AstraZeneca's vaccine could be added later if the data supported the move.

The announcement came on the same day the UK recorded 207 additional deaths within 28 days of a positive COVID-19 test, marking the highest toll since March 9, likely reflecting delays in reporting deaths during the August bank holiday weekend.

The government data also showed 35,693 new cases, compared with 32,181 on Tuesday.

Overall, the UK has reported 6,825,074 confirmed cases with 132,742 fatalities.

The number of new infections in Scotland was 80 percent higher than last week, and five times higher than four weeks ago, said Scotland's First Minister Nicola Sturgeon said, describing the situation as "extremely concerning."

Vaccine passports could be needed for people to gain entry to nightclubs and large-scale events.

Mexico

Mexico reported more than 1,000 COVID-19 deaths Wednesday, the first time officials registered such a grim daily rise since March 2, according to Health Ministry data.

Deaths rose 1,177 to 260,503 while the number of cases increased by 17,337.

Cases hit record highs in mid-August with local officials attributing the surge to the spread of the delta variant. As cases rose, President Andres Manuel Lopez Obrador and Deputy Health Minister Hugo Lopez-Gatell, who’s overseen the country’s response to the pandemic, have maintained that the proportion of those seriously ill is lower than it was during the winter peak.

There are also signs the third wave is ebbing, Lopez-Gatell has said. The epidemic curve is descending in 30 states and hospital occupancy is declining, he said at a Tuesday morning press conference.

Still, the daily toll due to the virus has risen steadily through August. Though cases have declined, Enrique Perez Gutierrez, an official with the Pan American Health Organization, pointed out the country’s rising mortality and called on Mexican authorities to clearly state restrictions based on local conditions.

ALSO READ: New virus variant found in S. Africa has concerning mutations

Cuba

Cuba will begin vaccinating adolescents against COVID-19 this week and younger children from mid-September as part of a drive to immunize more than 90 percent of the population by December, state-run media reported on Wednesday.

All children ages 2 through 18 will receive at least two doses of the Cuban-developed Soberana-2 vaccine beginning Sept 3, the official Cubadebate digital news outlet reported.

Health Ministry official Ileana Morales Suarez was quoted as saying the campaign would resemble annual vaccinations against various childhood diseases, taking place at thousands of community-based family medical practices and clinics.

Trials of the vaccine in minors found it to be safe and that it elicited a stronger immune response than in adults, according to state-owned manufacturer Finlay Institute.

The decision was announced at a weekly meeting of leaders and scientists to confront the pandemic on the Caribbean island currently battling a Delta variant-driven surge that has strained its health system and hit the younger population much harder than previous versions of the virus.

Over the past week, Cuba averaged between 6,500 and 7,000 cases per day and 70 to 80 deaths, down significantly from a few weeks ago but still one of the highest rates in the world in terms of cases per 100,000 inhabitants.

Vaccination of the adult population primarily using another locally-developed shot, Abdala, will be stepped up with the goal of ensuring all eligible adults have at least begun the three-shot-treatment by the end of the month.

Currently around 50 percent of Cuba's 11.3 million residents have received at least one dose of vaccine, with more than 3.5 million fully vaccinated.

Moderna

Moderna Inc on Wednesday asked the US Food and Drug Administration (FDA) to allow the use of a third booster dose of its COVID-19 vaccine.

Moderna said it submitted initial data for the use of a 50-microgram booster dose of its two-shot vaccine. The original Moderna vaccine contains 100 micrograms of mRNA in each shot.

Recipients of the 50-microgram dose had robust antibody responses against the Delta variant, Moderna Chief Executive Stéphane Bancel said in a statement.

Although Moderna has said its COVID-19 vaccine was still about 93 percent effective 6 months after the second dose, it has observed that antibody levels had waned significantly at that point.

It said that nearly 350 participants of its original Phase II trial were given a third vaccine dose that generated a better immune response than what was seen after the second dose in its large Phase III clinical trial.

Moderna said the safety profile of the third dose was similar to that of the second dose.

The company said it expects to submit data to the European Medicines Agency (EMA) and other regulatory authorities around the world in the coming days.

A police officer checks for a Green Pass on a passenger's phone at Porta Garibaldi train station in Milan, Italy, Sept 2, 2021. (LUCA BRUNO / AP)

Italy

Italy broadened usage of Green Pass health documents on Wednesday, making them obligatory for anyone traveling on high-speed trains, planes, ferries and inter-regional coaches.

The Green Pass is a digital or paper certificate that shows whether someone has received at least one COVID-19 vaccine dose, has tested negative or has recently recovered from the virus.

Some 70 percent of all Italians over the age of 12 are now fully vaccinated and the vast majority of people seem to back the inoculation drive and the use of the Green Pass.

Italian Foreign Minister Luigi Di Maio on Tuesday denounced what he called a "climate of hatred" against the COVID-19 vaccination campaign, after he and a number of other politicians and medical experts received threats on social media. 

Italy reported 69 coronavirus-related deaths on Wednesday, down from 75 the previous day, while the daily tally of new infections rose to 6,503 from 5,498, the health ministry said.

A total of 129,290 deaths linked to COVID-19 have been registered in Italy and 4.55 million cases have been reported to date.

Spain

Spain said on Wednesday 70 percent of its population had been fully vaccinated against COVID-19, fulfilling a goal set by the government for August, while the incidence rate kept the decreasing tendency of the past month after a big surge.

With over 66 million doses administered, 70.3 percent of the Spanish population had received by Aug 31 a complete vaccination program while 77 percent had been partially vaccinated, Health Ministry data showed.

"We have achieved it thanks to the strength of the national public service, the effort by health professionals, the work from public agencies and the great awareness from citizens," Prime Minister Pedro Sanchez tweeted.

The average number of cases per 100,000 people in the last 14 days in Spain decreased to 221 on Wednesday from 233 the prior day, according to the Health Ministry, bringing the total number of confirmed cases to over 4.8 million.

But deaths registered in the past seven days grew, totalling 352 on Wednesday's report versus 319 on Tuesday, taking the overall number of fatalities caused by the virus to around 84,500.

Health Minister Carolina Darias urged citizens to remain cautious to achieve a lower incidence.

But in a sign of progress, central and regional authorities agreed to increase from 40 percent to a maximum of 60 percent the allowed occupancy in outdoor sports facilities, such as soccer stadiums, for the month of September, in a relief to clubs hard-hit by the pandemic's impact.

Canada

Canada reported 1,346 new cases of COVID-19 on Wednesday, bringing the cumulative total to 1,500,520 cases, including 26,947 deaths, according to CTV.

Ontario, Canada's most populous province, said on Wednesday that people would have to show digital proof they had been inoculated against COVID-19 to enter a wide range of establishments, dropping earlier opposition to the idea.

From Sept 22 people will need proof of full vaccination to visit bars, restaurants, nightclubs and indoor sporting facilities. Beginning on Oct 22, the information will be stored as a digital vaccine passport on mobile devices.

Premier Doug Ford, who initially opposed the idea on grounds that it would "create a split society," said the spread of the Delta variant had shown the need for additional steps.

Officials say 76 percent of Ontarians have had both shots.

Ontario is the fourth province to opt for the passports. Quebec, the second-most populous province, introduced its own version on Wednesday while British Columbia and Manitoba have announced plans to do so.

READ MORE: COVID-19: US adds Canada to its 'do not travel' advisory list

Brazil

Brazil recorded 27,345 newly confirmed cases of the coronavirus in the past 24 hours, along with 737 deaths from COVID-19, the Health Ministry said on Wednesday.

Brazil has registered more than 20 million cases since the pandemic began, while the official death toll has risen to 581,150, according to ministry data.

An elderly man is injected with a dose of the Pfizer COVID-19 vaccine during a third dose campaign for elderly residents in long-term care institutions, at a retreat for elderly artists in Rio de Janeiro, Brazil, Sept 1, 2021. (BRUNA PRADO / AP)

Trials of oral COVID-19 drugs

Pfizer Inc and Merck & Co Inc announced on Wednesday new trials of their experimental oral antiviral drugs for COVID-19 as the race to develop an easy-to-administer treatment for the potentially fatal illness heats up.

Pfizer said its latest mid-to-late-stage trial will enroll 1,140 non-hospitalized adults diagnosed with coronavirus infection who are not at risk of severe illness. Patients in the trial will be given Pfizer's pill, known as PF-07321332, and a low dose of ritonavir, an older medication widely used in combination treatments for HIV infection.

Pfizer's drug is designed to block the activity of a key enzyme that is needed for the coronavirus to multiply.

Merck said its new trial will study experimental drug molnupiravir for the prevention of COVID-19 among adults in the same household as someone diagnosed with symptomatic coronavirus infection. Merck and partner Ridgeback Biotherapeutics are already conducting a late-stage trial of the treatment in non-hospitalized patients to see if it reduces the risk of hospitalization or death.

Molnupiravir is a type of antiviral designed to introduce errors into the RNA of the virus that eventually prevent it from replicating.

Morocco

The total number of people fully vaccinated against COVID-19 in Morocco reached 15,020,548, the Ministry of Health said on Wednesday.

The announcement came on the same day Morocco reported 6,020 new cases, taking the tally to 866,968.

The death toll rose by 100 to 12,749 while the total recoveries increased by 7,057 to 800,664, according to the ministry.