Editor's Note: (Megan Ranney, MD, MPH, FACEP is an emergency physician, associate dean at the School of Public Health at Brown University, and director of the Brown-Lifespan Center for Digital Health. She is also the co-founder of GetUsPPE and AFFIRM Research. Céline Gounder, MD, ScM, FIDSA is an internist, infectious disease specialist, and epidemiologist. She's the host of the Epidemic and American Diagnosis podcasts, the CEO of Just Human Productions, and a CNN medical analyst. She served on the Biden-Harris Transition COVID Advisory Board. The views expressed in this commentary belong to the authors. View more opinion at CNN.)
(CNN) On May 10, the US Food and Drug Administration authorized the Pfizer-BioNTech mRNA vaccine for emergency use among adolescents ages 12 to 15. Days later, the Centers for Disease Control and Prevention recommended the vaccine to everyone in this age group.
This expansion of vaccine eligibility marked a momentous step toward getting back to normal. But the news was immediately met with questions about whether people in India, for example, should be prioritized over American kids in the global vaccine drive.
We are frustrated by those who claim that our individual and collective decisions to vaccinate American children will harm the rest of the world. It's simplistic and frankly incorrect to pit Americans against everyone else. It's not one or the other; the US must step up its game to support global vaccine equity while simultaneously doubling down on vaccinating its own population.
It is indisputably true that we have a moral imperative to get the rest of the world vaccinated. The Biden administration can prevent millions of deaths by doing more to support international vaccine efforts. In doing so, the US can garner goodwill as a respected leader on the global stage and help prevent the emergence of new variants of the SARS-CoV-2 virus. This could also prevent the need for stringent lockdowns and any resulting economic fallout.
But we also have our own national security and economic and public health interests at stake. And for American parents, vaccinating their own children will only help the global effort to end this pandemic. Holding off is not going to address the systemic issues of vaccine production — nor will it help people in India or Brazil or South Africa. As one of our friends said, this is the equivalent of telling kids to clean their plates "because people in another country are starving." That's not how global vaccine supply and distribution chains operate.
It's also wrong to imply that our country's decision to vaccinate adolescents is somehow unethical. There are only about 25 million children ages 12 to 17 in the US. We have the supply and distribution capacity to easily vaccinate all of them in a couple weeks. The goal of herd immunity is still a difficult one to reach and any attempts to hold off on vaccinating the US population will only increase the risk of harming our own pandemic recovery. Sure, kids are less likely to get seriously ill, but they can still harbor variants and spread the virus.
We're struggling to get vaccines into arms, as it is. Saying that Americans should not get vaccinated in order to help the rest of the world is counterproductive. It's not us versus them. It's all of us against the SARS-CoV-2 virus, together.
Let's be clear: The real driver of global vaccine inequity isn't that the US is vaccinating its own population. It's the lack of investment in scaling up the vaccine supply. We need to produce about 11 billion doses to vaccinate 70% of the world's population. In the US, we are rapidly accumulating a surplus.
We should lift export restrictions on vaccines, raw materials and manufacturing equipment, and share our surplus with others now. We urgently need to enlist all viable manufacturing capacity at home and abroad, to increase production — from Canada's Biolyse to Bangladesh's Incepta. That means sharing not only intellectual property and the right to produce Covid-19 vaccines, but also the manufacturing know-how and the raw materials that go into them. We must also help train local staff to manufacture, regulate, distribute and track vaccines.
This debate harkens back to the shortage of personal protective equipment in the US in March of last year. The issue was both basic supply chain dynamics and the lack of domestic production capacity. To fix the PPE crisis, we needed to invest in local production and ensure greater equity in supply chains — not just ask China to ship us more masks. While perhaps not feasible in the short-term, we must build up regional vaccine manufacturing capacity as part of global pandemic preparedness and resilience.
It was clear the Trump administration was not particularly interested in global vaccine equity. Operation Warp Speed spent more than $12 billion developing and manufacturing vaccines against the novel coronavirus. And in the midst of the pandemic, President Donald Trump announced he was pulling the US out of the World Health Organization.
The US began to participate in international vaccination efforts long after efforts had been established at home. In February 2021, the Biden administration made a relatively paltry $2 billion initial commitment to support the Gavi COVAX consortium on behalf of 92 low and middle income countries.
COVAX is aiming to vaccinate up to 20% of people living in the poorest countries, and it's unclear whether it'll meet its goals for 2021. It also took far too long for the US to commit to sharing its stash of AstraZeneca vaccines, even though they are useless here since they haven't been authorized by the FDA. Just this week, Biden said the US would share another 20 million doses of Moderna, Pfizer and Johnson & Johnson vaccines with other countries.
But if we don't take steps now to dramatically scale up vaccine supply, it will take years for most countries to vaccinate their populations. The crumbs from our table are insufficient to provide for the rest of the world.
At the end of the day, the world's vaccine crisis will be solved through government action to support the vaccine drive in low and middle-income countries, rather than personal choices here at home.
So, yes, parents in the US should get their kids vaccinated — for the sake of their children and their communities. And yes, the Biden administration needs to step up to help countries across the globe. We can be smart and hold two truths in our heads at the same time.