Dear Commons Community,

Science had an article yesterday entitled, “Vaccinations for all.”  It references a new book by Seth Berkley that describes the effectiveness of the vaccines that were used to combat COVID.  Here is the article in its entirety.

“The COVID-19 pandemic is arguably the most traumatizing event the world has endured thus far in the 21st century, but vaccines ultimately brought the horrific outbreak to heel. In his new book, Fair Doses, epidemiologist Seth Berkley provides a definitive insider’s account of how effective vaccines against the pathogen that causes the disease were rapidly developed, distributed, and used during the pandemic.

Berkley reminds readers that panic was as widespread in the pandemic’s first year as the rapidly spreading virus and that traditional public health approaches, such as isolation and enhanced hygiene practices, proved ineffective at stopping its proliferation. The Trump administration in the US, along with governments in the UK, India, and Russia, quickly became convinced that vaccination was the only way to blunt the outbreak. This created a challenge that fuels the book’s narrative—how to ensure that any vaccines that were created were distributed worldwide to poor and rich communities alike.

Throughout his career, Berkley has advocated for equity as the guiding value for vaccine policy, both because it is the right thing to do and because it is an efficient strategy for ensuring herd immunity. He honed this belief while working on various public health issues at the Rockefeller Foundation in the early 1990s and, starting in 1995, through his leadership of the International AIDS Vaccine Initiative (IAVI). With the onset of the COVID-19 pandemic, he was thus committed to both vaccine equity and finding ways to get vaccines into arms all over the world. Although much attention is focused, and rightly so, on the mRNA science that permitted the rapid creation of a safe and effective vaccine, Fair Shots instead focuses on how Berkley used his many contacts and connections to create a novel program—COVID-19 Vaccines Global Access, or COVAX—that delivered nearly two billion doses of COVID-19 vaccines to 146 nations. Vaccines ultimately saved an estimated 2.5 million lives (¹).

How did Berkley manage to achieve this? He is unfailingly generous in giving credit to many other actors, but he himself played a critical role in navigating an incredibly complex maze of national and international public health groups, manufacturers, governments, foundations, politicians, scientists, businesspeople, and media outlets. Read the book to learn in detail how he did it, but be ready to encounter more acronyms than you ever thought existed. The complexities of navigating a global pandemic required interactions with nearly every health entity on the globe, and the resulting alphabet soup of participants can make for slow reading. But the sheer scale and scope of this effort offer a telling lesson in why preparation, cooperation, surveillance, transparency, patience, bold ethical thinking, and informed leadership are the keys to preparedness and the successful management of pandemics.

Berkley offers a number of insights about pandemic preparedness that he learned from his efforts to ensure the distribution of an effective COVID-19 vaccine. He emphasizes the importance of global surveillance, including, for example, collecting viral strains from all over the world; of strong national health and immunization systems with access for the most vulnerable; of systems for rapidly sharing information; and of stakeholder buy-in. He also acknowledges the importance of flexibility, which is essential as knowledge increases and viruses mutate; of ensuring that there is pharmaceutical manufacturing capability in many nations; of battling vaccine disinformation; and, most crucially, of there being a guiding ethic that strives to break down self-interest and shortsighted nationalism in favor of embracing global strategies that prevent the ongoing reoccurrence and spread of disease.

This is hard-earned wisdom. But, incredibly, almost none of it has been heeded. Distrust and censorship today undermine surveillance and information exchange, and people all over the world are awash in vaccine misinformation. Fingers are pointed not at viruses but at scientists, who some feel are to blame for the economic and social harms that occurred as a result of restrictions and lockdowns. Meanwhile, the pandemic’s legacy appears to include an uptick in fervent nationalism and egocentrism that is totally at odds with the equity concerns that inspired Berkley.

Fair Doses shows how the world’s leadership engaged with COVID-19, warts and all. The values, the wheeling and dealing that saved lives, and the decisions that shortened the pandemic are all here. The book is also a sharp warning that we are less ready now to confront a pandemic than we were when COVID-19 entered our lives.”

I believe that the COVID vaccines saved the lives of my wife and me.

Tony