TEGUCIGALPA, Honduras — Victor Guevara knows people his age have been vaccinated against COVID-19 in many countries. His own relatives in Houston have been inoculated.
But the 72-year-old Honduran lawyer, like so many others in his country, is still waiting. And increasingly, he is wondering why the United States is not doing more to help, particularly as the American vaccine supply begins to outpace demand and doses that have been approved for use elsewhere in the world, but not in the U.S., sit idle.
“We live in a state of defenselessness on every level,” Guevara said of the situation in his Central American homeland.
Honduras has obtained a paltry 59,000 vaccine doses for its 10 million people. Similar gaps in vaccine access are found across Africa, where just 36 million doses have been acquired for the continent’s 1.3 billion people, as well as in parts of Asia.
In the United States, more than one-fourth of the population — nearly 90 million people — has been fully vaccinated and supplies are so robust that some states are turning down planned shipments from the federal government.
This stark access gap is prompting increased calls across the world for the U.S. to start shipping vaccine supplies to poorer countries. That’s creating an early test for President Joe Biden, who has pledged to restore American leadership on the world stage and prove to wary nations that the U.S. is a reliable partner after years of retrenchment during the Trump administration.
J. Stephen Morrison, senior vice president and director of the Global Health Policy Center at the Center for Strategic &International Studies in Washington, said that as the U.S. moves from vaccine scarcity to abundance, it has an opportunity to “shape the outcomes dramatically in this next phase because of the assets we have.”
Biden, who took office in January as the virus was raging in the U.S., has responded cautiously to calls for help from abroad.
He has focused the bulk of his administration’s vaccinations efforts at home. He kept in place an agreement struck by the Trump administration requiring drugmakers that got U.S. aid in developing or expanding vaccine manufacturing to sell their first doses produced in the country to the U.S. government. The U.S. has also used the Defense Production Act to secure vital supplies for the production of vaccine, a move that has blocked the export of some supplies outside the country.
White House aides have argued that Biden’s cautious approach to promises around vaccine supply and delivery was validated in the wake of manufacturing issues with the Johnson &Johnson vaccine and the subsequent safety “pause” to investigate a handful of reported blood clots. In addition, officials say they need to maintain reserves in the U.S. to vaccinate teenagers and younger children once safety studies for those age groups are completed and if booster shots should be required later.
The White House is aware that the rest of the world is watching. Last month, the U.S. shared 4 million vaccine doses with neighboring Canada and Mexico, and this past week, Biden said those countries would be targets for additional supplies. He also said countries in Central America could receive U.S. vaccination help, though officials have not detailed any specific plans.
The lack of U.S. vaccine assistance around the world has created an opportunity for China and Russia, which have promised millions of doses of domestically produced shots to other countries, though there have been production delays that have hampered the delivery of some supplies. China’s foreign minister Wang Yi said this month that China opposes “vaccine nationalism” and that vaccines should become a global public good.
Professor Willem Hanekom, director of the Africa Health Research Institute and a vaccinologist, said wealthy countries have a stake in the success of vaccination efforts in other corners of the world.
“Beyond the moral obligation, the problem is that if there is not going to be control of the epidemic globally, this may ultimately backfire for these rich countries, if in areas where vaccines are not available variants emerge against which the vaccines might not work,” Hanekom said.
The U.S. has also faced criticism that it is not only hoarding its own stockpiles, but also blocking other countries from accessing vaccines, including through its use of the law that gives Washington broad authority to direct private companies to meet the needs of the national defense.