The Billionth Dose

As of yesterday, we passed a remarkable milestone: the billionth COVID-19 vaccination dose has been administered.

A billion doses

The original data comes from the Bloomberg COVID-19 tracker. ^[1] Now, I don’t have an account with them, and have completely lost patience with companies that try to seduce me into giving them more of my personal info to create a “free” account.

So we’re going to rely on an extraordinarily reliable secondary source: Eric Topol, director of the Scripps Research Translational Institute, professor of molecular medicine, and former leader of the Cleveland Clinic. I always feel like Twitter is a sorta skeevy data source, but I’m willing to listen to Topol (who, to his credit, usually points to primary sources so you can check things out for a bit of mini-peer-review).

He points out that yesterday we passed an interesting milestone (base 10, anyway):

Not so fast! How meaningful is that?

On the more dour hand, I remind you that while 1 billion doses is a lot, there are approximatley 8 billion humans currently living. All else being equal, they would mostly like to continue living, and thus need vaccines.

So are we 1/8th of the way through, at least?

Not really:

• We’ve only reached the 1/8th of humanity that’s easiest to reach: primarily western countries, with high enough tech to support a distribution network with a demanding cold chain, and able to mobilize a literal army of vaccinators. The real work starts when we try reaching those with superstitious vaccine resistance, those in the developing world with poor transport or cold chain infrastructure, and so on.
• We are at least trying not to be racist about it in the US, though with mixed results.
• Most people are going to need 2 doses for maximal efficacy. Yes, the single-shot JnJ vaccine will help around the margin, but (a) it’s not going to do half of humanity and (b) it’s still in a clinical trial with a 2nd dose. I’m betting when that trial reads out next month, JnJ will be shown to have 90% or more efficacy with a 2-dose protocol and we’ll switch everybody on JnJ to 2 doses.

So… 8 billion people $\times$ 2 doses per person = 16 billion doses needed. Call it 14 billion, if you’re going to be optimistic about the reach of a single-shot JnJ protocol.

But for whom?

And we haven’t exactly been vaccinating “people in general”, mostly the rich countries. As Philip Schellekens, a senior economic advisor at the World Bank, points out in a tweet (now apparently deleted?):

Many countries have started vaccination. But let's keep in mind that the distribution of this 1 billion doses remains highly unequal relative to global needs.

Details: https://t.co/wvtoUmMveK pic.twitter.com/tSY9hHSCtq

— Philip Schellekens (@fibke) April 24, 2021

We’re not anywhere near done yet

We still have a lot of work to do: vaccinating all people, and making sure we don’t fall into the racist traditions of the past so we get everybody a shot at a shot. Especially in India, for now.

The first billion have been the easy ones.

---

Notes & References

1: Yeah, I’d love to cite Bloomberg properly. But their paywall defenses or requirement for a “free” account have successfully deterred me from reading. ↩