In just a few months, the U.S. has gone from a pandemic basket case to one of the world’s top performers, as its vaccination program has ramped up faster than that of any other large country except the U.K. As a result, the Biden administration has been under pressure for weeks to begin shipping vaccines abroad, but it has resisted, arguing that its first priority is the safety of Americans.
“We’re going to start off making sure Americans are taken care of first, but we’re then going to try to help the rest of the world,” President Joe Biden said in March. Just this week, after a phone call with Canadian Prime Minister Justin Trudeau, Biden said we still “don’t have enough to be confident to send it abroad.”
But recent events, both in the U.S. and overseas, are making this position increasingly untenable. After a long period in which it was difficult for Americans to obtain vaccines, even if they were legally eligible, we’re now rapidly approaching the point—if we haven’t reached it already—where the main obstacle to getting shots into arms isn’t the supply of vaccine but some Americans’ reluctance or indifference to getting them.
The same cannot be said of much of the rest of the world, where, far from petering out, the pandemic is the worst it’s ever been. As of Wednesday, 5.6 million new cases were reported worldwide over the previous week, which the Wall Street Journal notes is “more than double the level of mid-February, and higher than the previous peak of late December.” Much of the focus right now is, for good reason, on India, where the recent case growth resembles not so much a curve but a cliff:
India reported 295,041 new cases on Wednesday and 2,023 deaths. Its medical facilities appear stretched to the breaking point, with many patients dying as ventilators run out of oxygen. Less than 2 percent of India’s population is fully vaccinated. Other countries including Iran, Turkey, Brazil, and Peru are also seeing record surges.
America’s own COVID-19 outbreak is far from over. Yesterday saw more than 66,000 new cases, and some parts of the country are still seeing record surges. But at the very least, it feels as if the endgame is in sight. Nationwide, the growth in new cases has been flat for the last month; 27 percent of the U.S. population is now fully vaccinated and 41 percent have received at least one dose. All U.S. adults, everywhere in the country, are now eligible to receive the vaccine. In fact, after a rapid ramp-up in February and March, vaccinations have recently slowed in large part due to softening demand.
But the crisis in other countries is a serious concern for Americans, and not only for humanitarian reasons. These outbreaks are spawning new variants of COVID-19, some of which spread more rapidly and appear to be deadlier for younger patients. And as my colleague Nitish Pahwa recently noted, India’s outbreak in particular has serious ramifications for the global vaccine supply chain. India’s vaccine industry was supposed to provide tens of millions of shots for COVAX, the World Health Organization–backed effort to ship vaccines to developing countries. But the Indian government has now halted vaccine exports, meaning many parts of the world will have an even longer wait for vaccines. The consequences may be felt most acutely in Africa, which is home to 20 percent of the world’s population but has administered only 2 percent of vaccine does.
The Biden administration has done more than its predecessor—a low bar—to curb the global spread of disease. The U.S. has, for instance, quietly become the largest financial donor to the global vaccine access program COVAX, which the Trump administration declined to participate in at all. Biden has also suggested he at least understands the transnational nature of this threat. “This is not something that can be stopped by a fence, no matter how high you build a fence or a wall,” he said in March. “So we’re not going to be ultimately safe until the world is safe.”
But given that knowledge, the administration’s vaccine nationalism is getting harder to defend. The U.S. beat other countries—including other rich ones—in the vaccine race by negotiating contracts with drug manufacturers early, and not worrying too much about how much they cost or which vaccines still in development would pan out. White House spokeswoman Jen Psaki defended the U.S. position in March by pointing out that, technically speaking, the U.S. isn’t banning drug manufacturers from exporting vaccines: “They are free to export their products while also fulfilling the terms of our contracts.”
While that’s technically true, it’s also the case that the U.S. is currently sitting on a stockpile of 20 million doses of the AstraZeneca vaccine, part of an order of 80 million to 90 million doses, despite the fact that this vaccine is still not approved for use in the U.S. and—at this point—seems unlikely to factor into the U.S. vaccination effort in a major way. “Give them all away. By the time we even think about authorizing it, we are going to be in a glut situation domestically,” former Obama administration health adviser Zeke Emanuel told Bloomberg. The U.S. did agree to send 4 million doses of the AstraZeneca vaccine to Canada and Mexico in March, which only highlights the fact that we could be sending a lot more of them.
The issue isn’t only the finished vaccines. The Defense Production Act, which both the Trump and Biden administrations invoked to bolster domestic production to tackle the virus, also hinders the ability of companies to sell special materials needed for vaccine production abroad without special licenses, requiring special permission and onerous paperwork. The Indian government has been pushing the U.S. to lift the restrictions, including in a recent phone call between Foreign Minister Subrahmanyam Jaishankar and U.S. Secretary of State Antony Blinken.
Following that call, State Department spokesman Ned Price again defended the U.S. position, saying “we have a special responsibility to the American people” and that once “we are more comfortable in our position here at home, as we are confident that we are able to address any contingencies as they may arise, I expect we’ll be able to do more.”
Most Americans would probably agree that their government’s first responsibility is to the safety of Americans, and shipping vaccines overseas at a time when half of Americans are still unvaccinated is not going to be a political winner. But as Price himself said, “as long as the virus is spreading anywhere, it is a threat to people everywhere.”
At some point, building up stockpiles we won’t need, while allowing the virus to spread unchecked abroad, is not only morally indefensible but actually threatens Americans’ safety. So when does the Biden administration think we will reach that point?
In the seven years I’ve been covering news and politics for Slate, I’ve written about some of the United States’ best and worst moments, people, and ideas. Your continued support of Slate Plus will allow me to continue to give our country’s high-stakes struggle to define itself the coverage it deserves. Thank you! —Ben Mathis-Lilley, senior writer