Most Americans say they should be vaccinated before the U.S. donates Covid-19 shots elsewhere

Three-quarters of Americans believe the U.S. government should start donating Covid-19 vaccines to other countries, but only after every person in the U.S. who wants a vaccine has received one, according to a new survey from STAT and The Harris Poll.

At the same time, just over half of Americans said they agree with the idea that the Biden administration should immediately start donating vaccines to other countries in order to achieve global herd immunity, which reflects growing concern that the coronavirus cannot be contained until most of the world is vaccinated.

“The data says that most everybody is on the same page — Americans clearly prioritize ensuring they get vaccinated as a top priority,” said Rob Jekielek, managing director at The Harris Poll, which queried 1,963 people between April 9 and 11. “But you also have a really good chunk of the population who also believes we need to put a global lens on the issue.”

The poll asked whether Americans agreed or disagreed with three notions: start donating vaccines immediately, start donating vaccines once everyone in the U.S. has been vaccinated, or skip donations altogether.

Not surprisingly, there are diverging views among different slices of those polled. More members of Gen Z and millennials — 59% and 65%, respectively — than middle-aged or older Americans believe the U.S. government should start to immediately donate Covid-19 vaccines to other countries. And 63% of Democrats support immediate donations, compared with just 43% of Republicans.

Meanwhile, 48% of those surveyed believe the U.S. government should not donate vaccines to other countries at all, and keep a stockpile instead. Many more Republicans — 58% to be exact — agreed with this position, compared with 44% of Democrats. This revealed something of a dichotomy among Republicans, given that 52% of Republicans polled indicated they are hesitant to get vaccinated or do not plan to do so.

“Republicans appear a little bit torn,” said Jekielek. “They’ve expressed skepticism and hesitancy toward vaccines, but on the other hand, some acknowledged there is a value to having a stockpile. And that sentiment fits in with the idea that, first and foremost, many people are saying we should take care of the U.S. first.”

The responses also appear to reflect confidence in the way the federal government is handling vaccination. Two-thirds of Americans say the campaign is going better in the U.S. than elsewhere with comparable numbers of Democrats and Republicans sharing this view, although more older than young Americans agreed.

The findings come amid growing concern that the majority of lower- and middle-income countries will not be able to sufficiently vaccinate enough of their populations to contribute to herd immunity, especially as variants of the coronavirus continue to emerge. Consequently, there is debate over the role the U.S. should play in ensuring greater access to Covid-19 vaccines across the globe.

Over the past year, the U.S. and other wealthy nations reached deals with vaccine makers for more than half of the nearly 9 billion doses locked up in purchase agreements, according to the Duke Global Health Innovation Center. Some middle-income countries have vaccine development programs, but low-income nations lack manufacturing and clinical testing capacity, so they cannot participate in the deal-making.

To compensate, the World Health Organization established the COVAX program to arrange for access to 92 low- and middle-income countries, but for now, this would only cover about 20% of their populations. Meanwhile, COVAX remains underfunded. The program’s proposed budget for 2020 and 2021 is $11.7 billion, but total contributions have so far only reached $8.6 billion, leaving a funding gap of $3.1 billion.

The Biden administration recently agreed to provide up to $4 billion to COVAX, but is being urged to do more to ensure global access. Last week, for instance, dozens of advocacy groups proposed the U.S. invest in a global vaccine manufacturing program — complete with regional hubs — and ensure that the technology is openly shared.

In a white paper released last week, the Duke team wrote the U.S. should pursue “vaccine diplomacy” by using additional funding mechanisms and supporting more licensing deals between vaccine makers and companies based in other countries. They also suggested making loans of currently available doses. (We should note the lead author was Mark McClellan, a Duke health policy professor and former Food and Drug Administration commissioner who also serves as a board member at Johnson & Johnson, which makes a Covid-19 vaccine).

Also last week, more than 170 former heads of state, government officials, and Nobel laureates urged the White House to adopt a proposal before the World Trade Organization to temporarily waive provisions in a trade agreement and make it easier for countries that permit compulsory licensing to allow a manufacturer to export vaccines.