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Children and adolescents in African countries should also be vaccinated for COVID-19
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  • Published on: 15 February 2022
    Covid-19 vaccination in Africa: a call for equity (and not equality)
    • David Bell, MBBS, PhD, FRCP(UK). FAFPHM. Public health expert Independent consultant
    • Other Contributors:
      • Elisabeth Paul, Associate Professor

    Dear Editor,

    We agree with Sam-Agudu et al. on the importance of equity in public health (1), and for these reasons raise major concerns regarding the remainder of the Commentary’s focus, and similar view prevalent in this Journal (2) and the wider global health community. We respectfully outline these here, as they affect the current health focus being applied to over a billion people in sub-Saharan countries.

    Sam-Agudu and co-authors state that ‘Global, equitable access to safe and effective vaccines for all age groups is critical to ending the COVID-19 pandemic’. This statement, reflecting those of the COVAX programme of the World Health Organization (WHO) and other agencies, is flawed. Equity in health means opportunity for good health, based on individual need, not measured by access to a particular pharmaceutical. A vaccine that does not significantly reduce transmission (3,4) will not end a pandemic, and where risk of severity is low from intrinsic or acquired immune status, will not significantly change outcomes. This flawed assertion also ignores costs of vaccination, both in potential adverse effects, and in resource diversion from other health programmes (public health programmes do not operate in isolation).
    Regarding the evidence base used to support their argumentation, and related expected benefits of vaccination, much of Sam-Agudu et al.’s arguments are based on the African Forum for Research and Education in Health (AFREhealth) study r...

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    Conflict of Interest:
    None declared.