Israeli study: Western powers can protect own people by donating COVID shots abroad

Game theory analysis finds big, vaccine-rich countries could protect citizens’ lives more effectively by dispatching spare doses to developing countries than by stockpiling them

Nathan Jeffay is The Times of Israel's health and science correspondent

Illustrative image: a doctor in Afghanistan fills a syringe with a vaccine donated by the COVAX program on Sunday, July 11, 2021. (AP Photo/Rahmat Gul, File)
Illustrative image: a doctor in Afghanistan fills a syringe with a vaccine donated by the COVAX program on Sunday, July 11, 2021. (AP Photo/Rahmat Gul, File)

Giving away surplus coronavirus vaccines will save Western superpowers more lives than keeping them, Israeli scholars claim in a new game theory study.

If big Western states have enough vaccines to make a large difference to vaccination rates in developing countries, “it is optimal for them to donate their surplus vaccines,” they concluded in a peer-reviewed study just published in Communications Medicine last week.

The Israeli-Danish-German research team used a game theory model — meaning complex math to predict the impact of different choices that countries could take — to assess the impact of large vaccine donations.

Their study side-stepped the debates on what is moral or ethical on a global level, and boiled the issue down to a question of self-interest. They asked what gives vaccine-rich countries most benefit for themselves.

They wrote: “In an unequal world with open economies, pandemics do not stop at national borders. Higher-income countries may then benefit from helping lower-income countries.

“In particular, since new variants of a virus may emerge in vaccine-poor countries, vaccine-rich countries may have a strong incentive to donate their surplus vaccine doses rather than stocking these domestically.”

A worker at the National Center for Bio-preparations, Biocen, arranges the Cuban-made Soberana Plus COVID-19 vaccine vials for packaging in Bejucal, Cuba, Friday, July 15, 2022. (AP/Ramon Espinosa)

Prof. Raanan Sulitzeanu-Kenan of Hebrew University told The Times of Israel: “What we found is that in current circumstances it’s in the best interest of big countries to donate, because in the medium term of a year a two, the cost will be less for them in terms of lives and money, compared to if they don’t donate.”

The US and other superpowers have donated vaccines through the COVAX initiative. But it has taken too long and happened on too small a scale, Sulitzeanu-Kenan concluded, together with colleagues Adam Lampert, Pieter Vanhuysse and Markus Tepe.

Sulitzeanu-Kenan and his team modeled several variables in assessing whether or not it makes sense for countries to donate.

They wrote that the study is important because the pandemic has been characterized by “extremely unequal vaccine distribution.” They expect many people to lack vaccines until mid-2023, and stated: “Since about 85% of the global population resides in low- and middle-income countries, most of humanity remains exposed to continued outbreaks. This situation increases the risk that further virus variants will emerge, possibly undermining the efficacy of existing vaccines.”

The key to saving lives, according to the model, is avoiding the emergence of new variants. New COVID strains are most likely to emerge in areas with low vaccination, and have the effect of sparking new waves of infection that can skip existing immunity and prolong the pandemic.

Prof. Raanan Sulitzeanu-Kenan of Hebrew University (courtesy of Prof. Raanan Sulitzeanu-Kenan)

One basic question that Sulitzeanu-Kenan asked is how quickly variants are emerging. If they were few and far between, this would reduce the level of concern, and limit the value of vaccine donations, according to his model. But his analysis showed that variants are emerging today fast enough to mean that rich countries stand to benefit by managing the risk through vaccine donation.

Another key variable is how high immunity levels can be boosted in developing countries. The modeling concluded that if more than 75% vaccination can be achieved across these countries, this is likely to significantly decrease the chance of new variants emerging, and reduce caseloads, in a way that can serve the self interest of donor countries.

The central consideration for countries trying to calculate the self interest of donating is whether their donation alone has the power to dint the chances of variants emerging. Sulitzeanu-Kenan said the answer is yes, only for large countries.

For small states like Israel, any donation to the global vaccine supply would be too small to impact on its self interest, Sulitzeanu-Kenan suggested. (He stressed that asking what is best from an ethical or moral viewpoint was beyond the remit of his study.)

“It may be the right choice for the self interest of large wealthy countries that can make a big difference,” he said. “This would be the case for the US, UK, Canada, China, and Japan, though a donation from Israel is not going to have the same effect.”

Illustrative image: A coronavirus ward at the Martini hospital in Mogadishu, Somalia on Wednesday, Feb. 24, 2021. (AP Photo/Farah Abdi Warsameh)

Sulitzeanu-Kenan said that, according to his model, international health leaders actually made a mistake by calling for donations from all who could give. With such a global call, no country in particular felt it was in the spotlight.

“In retrospect health leaders should have approached the US and the EU first,” said Lampert. “It would have been best to urge them to give generously and quickly, saying that if they didn’t give a major donation then nothing would happen and others wouldn’t donate.

“This study is theoretical. What we plan to do now is to assess public opinion to see whether it is likely to be supportive of the policies we are discussing. And even before this, we hope our study influences policymakers,” Lampert added.

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