A year after the first news about the new coronavirus, Latin America wonders if mass vaccination will be the only way out of the pandemic. It does so in the midst of a new wave of infections, possibly favored by the holidays, meetings and trips in December. And not only in individual terms: the vaccine today seems to be the only bet of governments that have not succeeded – or have barely tried – to restrict the movement of their citizens as much as possible, especially in economies with high levels of formality.
Most of the countries in the region have not yet begun to apply the vaccine. Only Argentina, Chile, Costa Rica and Mexico have programs underway with numbers that are beginning to be significant, and yet they all remain below 0.2%: just a few thousand people.
In acquisitions through bilateral agreements with the pharmaceutical producers, Chile stands out well above the rest of the countries in the region. However, the difference that exists between, for example, Mexico and Venezuela or El Salvador is also notable. Not to mention countries where there is no record of specific purchases: in some, such as Uruguay or Paraguay, because bilateral negotiations have not yet taken place that are being hinted at by governments; in others, like Cuba, because they are developing their own initiatives. And in others, due to an apparent lack of resources. In them, in the absence of purchase confirmations, access to vaccines currently depends on supranational purchasing mechanisms, particularly one: COVAX.
COVAX, an agreement sponsored by the WHO to guarantee the access of all the countries of the world to the vaccine, will in any case probably be used by all the countries of the region. The authorities in Colombia or Peru, for example, have emphasized their intention to complete the coverage programs for their populations thanks to vaccines that have arrived through this mechanism. The Peruvian authorities expect that part of the 13.2 million doses purchased in this way will begin to arrive in the first quarter of the year. In Colombia, COVAX plans reach 20 million doses. In Guatemala, 6.7 million doses are expected (the only ones confirmed for now) by this route; 1.9 to Honduras, which does plan bilateral acquisitions (another almost 2 million to AstraZeneca). In both Central American countries, among the poorest in the region, immunization will depend on the sustainability of the agreement, and will in any case arrive late with respect to its neighbors.
Most governments are therefore developing a mixed strategy in which the vaccines they have purchased on their own in direct negotiations with pharmaceutical companies will represent only part of the immunization. But that fraction is, for now, for which there are data available and programs underway in the four countries mentioned. The origin of these doses is varied. Argentina is using the vaccine developed by AstraZeneca with the University of Oxford (double dose, and with an estimated effectiveness of 65% in disease reduction probabilities), but also Sputnik V, produced by Gamaleya under the umbrella of the Vladimir government Putin. According to the Russian authorities, its effectiveness exceeds 90%, similar to that of Pfizer (also double-dose, and the most common right now on the continent: Chile, Costa Rica and Mexico are using it; Colombia expects to start with it in February ) or Moderna (whose high cost per unit seems to have left it out of the packages purchased in Latin America.
Although AstraZeneca and Pfizer dominate the market, vaccines of Chinese origin have also seen significant purchases in the region. Chile soon acquired up to 60 million doses of Sinovac, the effectiveness of which the Chinese government takes for granted (it is already using it), and that the São Paulo state government announced today that it reaches 78% in the middle of a political dispute with the Government of Jair Bolsonaro. Colombia was ahead of the one developed by Jannsen / Johnson & Johnson, whose tests are being practiced in the large countries of Latin America, but without public results yet (the Colombian Minister of Health, Fernando Ruiz, remarked that the pharmaceutical company would reveal them in the second week of January, announcing them as “promising”).
All these speculations, calculations and comparisons between countries or between vaccines come in no small measure from the cracking that COVAX has suffered, without actually breaking down. Through this mechanism, conceived so that all countries can access the vaccine regardless of their income level, the poorest nations (Guatemala or Bolivia, for example) would be net recipients, while those with middle income (Colombia, Mexico , Peru) or alto (Chile) could use the system for procurement, but they should also contribute to global immunization. All of Latin America and the Caribbean are committed to COVAX (Cuba established a non-binding relationship). However, the most powerful countries in the region chose from the beginning not to entrust everything to the agreement, and rushed to establish the aforementioned bilateral purchases: Chile or Mexico were quick to go to market.
This is probably due to internal pressure, from citizens anxious to have a clear horizon of the end of the pandemic that only complete vaccination can provide, facilitated by the comparison between neighbors that move governments to show that they are taking measures to bring that horizon closer along with other countries in the region.
The paradox is that this occurs in a climate of uncertainty and a certain public distrust of vaccines. MIT has been conducting a periodic international survey via Facebook. In the four main countries in the region for which it maintains biweekly data, the percentage of people who say they will get the vaccine when it is available has only declined during the second half of 2020.
These figures are not so much an accurate indicator of how many people will end up accepting the vaccine (the number is likely to rise as doctors, authorities, family and friends apply it, creating chains of trust), as a way to gauge trust which exists in the entire scientific and logistical apparatus, but also inevitably political, which is expected to act as the true, the only firewall to a virus whose contagion is intensifying these days throughout Latin America. For now, the only certainty is that during the coming months the region will continue to live with the pandemic, although it may do so with the relief of seeing its most vulnerable populations and workers on the front lines of battle against the virus progressively immunized.