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Here's what's driving the lowest COVID immunization rates around the world

MARY LOUISE KELLY, HOST:

Here in the United States, and in many other wealthy countries, anyone who wants to get vaccinated against COVID can get the jab for free at their local health clinic, pharmacy, even your supermarket. In many other places, however, it's a very different story. Globally, 36 countries still haven't gotten even 10% of their people vaccinated. NPR's Jason Beaubien has been looking at what is driving these low vaccination rates.

Hey there, Jason.

JASON BEAUBIEN, BYLINE: Hey, Mary Louise.

KELLY: So what countries are we talking about here? And do they have anything in common?

BEAUBIEN: You know, so some of these are countries that are in the midst of conflict, you know, such as Yemen, Ethiopia, Afghanistan. And then there's this other group of nations that, to be frank, you know, they lack economic and political muscle on the international stage. You know, if you look at some of the poorest countries in the world - Chad, South Sudan, Haiti, the Democratic Republic of Congo - these places all have less than 1% of their people fully immunized.

KELLY: Less than 1%. Now, I'm remembering back in the early part of the pandemic, when rich countries were buying up all the vaccines, all the vaccine contracts...

BEAUBIEN: Yeah.

KELLY: ...Even before they were produced. How much of the problem for these countries with low or really low vaccination rates - how much is they just - they still can't get vaccines?

BEAUBIEN: You know, that's certainly still part of the issue. You know, the African Union at one point said it had raised all this money to buy vaccine but couldn't get anyone to sell it to them until late into 2022. You know, basically, as you mentioned, you know, a lot of that vaccine production had been snapped up by these wealthier countries. But the problem now isn't just access to vaccines. The WHO's-backed COVAX program - it managed to nearly double its monthly deliveries late last year. You know, many governments, including U.S., China, Russia, even Cuba, have been distributing vaccine globally, so it is getting out there. The problem for many of these countries with super low vaccination rates is that they're dependent on the kindness of these wealthier nations. You know, they don't necessarily have the clout of some of their neighbors. So donations end up going, say, to Venezuela, which has lots of problems, but it also has lots of oil reserves. And Haiti, on the other hand, has hardly gotten any vaccine. China sold vaccine to Peru, which has lots of copper, and China happens to be Peru's leading trading partner. So Peru has managed to get 65% of its population vaccinated, while someplace like Sierra Leone, on the other hand, it only got a tiny donation from China, and now it's looking at a vaccination rate of just 5% of its people fully immunized.

KELLY: So just all over the place for all kinds of reasons. What has been the effect of this, Jason? I mean, has the pandemic been worse in these countries with really low vaccination rates?

BEAUBIEN: You know, it's not entirely clear because these are also some of the places with very limited monitoring of COVID. In Yemen, for instance, at one point, the death rate from the virus was calculated at 19%. Well, that's simply an astronomically skewed number because so few people were getting tested. It was only people who were really sick or dying that were getting tested. But these countries - they are being impacted both by the disease and by the lockdowns. Uganda, which has just 3% of its population immunized, it was only last week they allowed schools to reopen. So presumably, that could have happened sooner if teachers and staff were vaccinated. Kate O'Brien - she's the director of immunization and vaccines for the World Health Organization. She says low vaccination rates continue to be a threat to these countries.

KATE O'BRIEN: Countries that are struggling to get even above 10% - what this really means is that health care workers are not fully vaccinated yet. It means that those who are in older age populations, those who have underlying medical conditions - these are the people at highest risk - are not fully protected yet.

BEAUBIEN: And the WHO is worried that some of these places with super low vaccination rates could also be hotspots for new, potentially more dangerous, variants to emerge.

KELLY: Oh, please, no. No, thank you. NPR's global health correspondent Jason Beaubien.

Thank you.

BEAUBIEN: You're welcome. Transcript provided by NPR, Copyright NPR.