Home COVID-19 vaccine: Call for employees in international transportation industries and international travelers as the first priority in global distribution
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COVID-19 vaccine: Call for employees in international transportation industries and international travelers as the first priority in global distribution

  • Zhuo Yu , Gang Wang , Emanuel Goldman , Barbara Zangerl , Ning Xie , Yanhong Cao , Jingyu Chen , Sara W. Day , Scott C. Howard , Marcello Maida , Kunal Ray , Monica M. Jablonski , Jiafu Ji , Arnold Postlethwaite , Weikuan Gu EMAIL logo , Dianjun Sun EMAIL logo and Lotfi Aleya EMAIL logo
Published/Copyright: January 11, 2021
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Open Medicine
From the journal Open Medicine Volume 16 Issue 1

Abstract

While countries are in a hurry to obtain SARS-CoV-2 vaccine, we are concerned with the availability of vaccine and whether a vaccine will be available to all in need. We predicted three possible scenarios for vaccine distributions and urge an international united action on the worldwide equitable access. In case the international community does not reach a consensus on how to distribute the vaccine to achieve worldwide equitable access, we call for a distribution plan that includes the employees in international transportation industries and international travelers to halt the disease transmission and promote the recovery of the global economy.

Keywords: COVID-19; priority; international collaboration; international transportation; vaccine

We are glad to see “the joint appeal” by 3,000 people and the comment on the journal [1,2]. We all appreciate the effort of United Nation on mobilizing $28 billion needed to secure vaccines for all [3]. However, we are concerned about the challenge in the production as well as in the capability of distribution of the vaccine in time. While the world is hoping the availability of a vaccine by the end of the year and optimistic about vaccine for all, there are many obstacles in the timely distribution and equal availability to all in the world. Additionally, the anticipated increase in respiratory diseases with winter approaching in the northern hemisphere leads to serious concerns whether a vaccine will be available to all in time [4,5,6,7].

Even under the assumption that a COVID-19 vaccine will become available in time, prioritization regarding its distribution to 195 countries and maintenance of worldwide equitable access will remain challenging [8]. Notably a few countries, including China and the US, are predicted to have the best chance and greatest resources to produce the vaccine and, thus, are most likely to have access to immediate distribution. This implies that worldwide equitable access will not be accomplished if the supply of an approved SARS-CoV-2 vaccine is inadequate [9,10], leading to three possible scenarios. First, the vaccine may only be produced and distributed in the country of origin with possible distribution to a few countries that have close ties with the vaccine-producing country. In the second scenario, the vaccine is successfully developed and produced in several countries at approximately the same time and distributed in those countries, again, possibly including additional countries with close ties. The third scenario assumes that the vaccine is first produced in one or several countries, but the vaccine is supplied worldwide on the basis of the most pressing need. In Table 1, we summarized the impact of these different usages of the SARS-CoV-2 vaccine.

Table 1

Impact of different usages of vaccine

Types of effects Scenario 1 Scenario 2 Scenario 3
Vaccine production One country A few countries One or a few countries
Vaccine usage One country or closely related countries A few countries or closely related countries Prioritized all over the world and first used in urgent places
Immediate benefit for disease control Under control in one country or closely related Under control in a few countries or closely related Stopping international spreading
Ultimate benefit for disease control Under control in one country or closely related Under control in a few countries or closely related Under control over the world
Immediate benefit for economy Back to normal in one country or closely related Back to normal in in a few countries or closely related Back to normal for international business
Ultimate benefit for economy World economy develops slowly because of pandemic in rest of the world World economy develops slowly because of pandemic in other countries Enhance the world economy to develop fast
Impact for future disease control No benefit or action upon individual country No benefit or action upon individual country or a few countries together United international action

To promote any collaborative framework discussing prioritization in access and distribution of the vaccine, it is imperative to understand that COVID-19 is an equal threat to all human societies and cannot be contained unless globally controlled. SARS-CoV-2 has demonstrated more resilient transmission capability than other viruses associated with respiratory diseases causing a single infected individual to precipitate a COVID-19 pandemic in a very short period of time [11,12,13,14].

We as an international group of scientists call upon the world leaders to act together and develop a plan for worldwide distribution of a vaccine as opposed to multiple plans for individual countries. It is imperative that the public and government leaders understand that no single country is capable of stopping the pandemic individually and safeguard its inhabitants from repeated outbreaks, but a united front can achieve a global solution to the pandemic and, thus, prompt the recovery of the world economy.

Most importantly, the successful distribution of the vaccine in one or a few countries will not stop the pandemic and will not recover global economy (Table 1) [15,16]. It will also be a tremendous challenge to vaccinate a majority of the population in a short period of time in large countries, such as China or the US, with populations of 1.4 billion and 0.3 billion, respectively. Even if one or a few countries achieve widespread vaccination success, other factors will remain to halt the potential recovery of an economy hugely dependent on international trade [17]. Additionally, the tourism industry will not recover. Strict testing and isolation measures upon arrival would greatly reduce the number of international travelers [18,19]. This will include the number of people traveling to other countries for tourism or business, which must be greatly reduced or prohibited altogether under this vaccine distribution model. Consequently, neither tourism nor aviation industries can resume sustainable operations if the control of the epidemic remains restricted in a single or few countries [20,21].

Based on reasons mentioned above and that will be described in the subsequent paragraphs, we urge the following steps to accomplish equitable vaccine access: (1) international community to immediately start the discussion on how to form an organized approach to equitable distribution, (2) develop a vaccine distribution plan based on prioritization of needs, and (3) organize and carefully coordinate global distribution.

However, in case the international community does not reach a consensus on how to distribute the vaccine to achieve worldwide equitable access, at a minimum we call for a distribution plan that includes essential people for stopping disease transmission and promoting the recovery of the global economy [10]. Here we propose to vaccinate the employees in international transportation industries and international travelers. We recommend employees in the international transportation industries as the first priority for the vaccination, including international civilian aviation industry, global air freight industry, and global seaborne container trade industry [13,14,22]. These people are essential for the international business as well as for stopping international transmission of SARS-CoV-2. The total number of employees in these three groups are approximately 17 million (Figure 1).

Figure 1 Prioritized groups and their population sizes for vaccination.
Figure 1

Prioritized groups and their population sizes for vaccination.

Based on the Aviation Benefits Report of International Air Transport Association [23], around 10.2 million people work in the aviation industry directly, including 2.7 million working as flight and cabin crews, executives, ground services, check-in, training, and maintenance staff; and 5.6 million working for retail, car rental, customs and immigration, freight forwarders, and catering [24].

Based on the source of Wikipedia, in 2019, the world’s three biggest international air cargo companies have a total of 1,261,000 employees (FedEx 400,000; UPS 482,100; DHL 380,000) [25]. If we assume other companies contribute about 50%, the estimated number of employees in the global air freight industry is approximately 2,500,000.

Based on the reports from the World Shipping Council, the total number of direct jobs in the shipping industry is 4.2 million [26].

Second, we recommend all international travelers receive the vaccine. Based on the world air transport statistics 2019 [27], in 2018, the total number of carried air passengers was 4,377,670,000, comprising 1,811,324,000 international passengers and 2,566,346,000 domestic passengers, increasing to over 4.5 billion passengers in 2019. However, this includes “frequent flyers,” equating to 6.5 flights per year taken by an average traveler [28]. Similarly, the Institut de Publique Sondage d'Opinion Secteur (IPSOS) report cites an average of 4.8 trips per airline traveler in 2015 [29,30]. Accordingly, the actual number of international travelers is about 400,000,000 per year. Thus, approximately 30 million people can be expected to travel internationally each month (Figure 1).

We also propose to vaccinate all people working in indirect service, such as airport hotels and restaurants for the four prioritized groups, adding a population of similar size as the total number of people in the prioritized groups [23,30].

It is important to note that the total number of people in the first three priority categories is less than 20 million. This is less than half of the people of a middle-sized country and a small portion of the total population of China or the US. Vaccination of such a count of people in China, the US or any other country will not halt the pandemic of COVID-19 and will not improve the international business and transportation. Thus, neither the stopping of COVID-19 disease nor the economy will be improved by vaccination of these individual in a country. However, if these people in international transportation are vaccinated as we proposed, the international COVID-19 transmission will be greatly halted, and the world economy will be greatly benefited. Most importantly, as long as the world is united for it, it is realistically feasible to support such an approach and produce a globally and individually much more beneficial effect than prioritizing the complete or partial vaccination of people in a single or few countries.

In conclusion, we strongly urge the international community, especially the WHO, regardless of the other considerations regarding the distribution of a potential COVID-19 vaccine, to allow the worldwide distribution of the vaccine to at least the presented priority groups and make every effort including price adjustment, shipment, resource supplement, and personal training to accomplish this target. By doing so, the world economy can begin to recover and the international spreading of the disease will be largely halted. With regard to air passengers, if vaccination becomes mandatory for travelers and the vaccine is available to them, we will be able to achieve effective infection control and regain a functional global and local economy.

This article serves as a call to the public and the leaders of the world to support such an international collaboration and put the health of all humans and world economy in front of individual short-term gain.

These two authors contributed to this manuscript equally.

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  1. Author contributions: Conceived and designed the experiments: G. W., Z. Y., W. G., D. S., L. A. Performed data searching and collection: N. X., W. G. Analyzed the data: All Authors. Contributed analysis tools: W. G., D. S., L. A. Wrote the manuscript: All Authors. Revise and approve and manuscript: All authors.

  2. Funding: This work was partially supported by funding from merit grant I01 BX000671 to WG from the Department of Veterans Affairs and the Veterans Administration Medical Center in Memphis, TN, USA.

  3. Conflict of interest: The authors declare no competing financial interests.

  4. Availability of data and materials: All the data are available at the public databases as provided in the manuscript.

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Received: 2020-12-18
Accepted: 2020-12-21
Published Online: 2021-01-11

© 2021 Zhuo Yu et al., published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  151. Downregulation of RAB7 and Caveolin-1 increases MMP-2 activity in renal tubular epithelial cells under hypoxic conditions
  152. Educational program for orthopedic surgeons’ influences for osteoporosis
  153. Expression and function analysis of CRABP2 and FABP5, and their ratio in esophageal squamous cell carcinoma
  154. GJA1 promotes hepatocellular carcinoma progression by mediating TGF-β-induced activation and the epithelial–mesenchymal transition of hepatic stellate cells
  155. lncRNA-ZFAS1 promotes the progression of endometrial carcinoma by targeting miR-34b to regulate VEGFA expression
  156. Anticoagulation is the answer in treating noncritical COVID-19 patients
  157. Effect of late-onset hemorrhagic cystitis on PFS after haplo-PBSCT
  158. Comparison of Dako HercepTest and Ventana PATHWAY anti-HER2 (4B5) tests and their correlation with silver in situ hybridization in lung adenocarcinoma
  159. VSTM1 regulates monocyte/macrophage function via the NF-κB signaling pathway
  160. Comparison of vaginal birth outcomes in midwifery-led versus physician-led setting: A propensity score-matched analysis
  161. Treatment of osteoporosis with teriparatide: The Slovenian experience
  162. New targets of morphine postconditioning protection of the myocardium in ischemia/reperfusion injury: Involvement of HSP90/Akt and C5a/NF-κB
  163. Superenhancer–transcription factor regulatory network in malignant tumors
  164. β-Cell function is associated with osteosarcopenia in middle-aged and older nonobese patients with type 2 diabetes: A cross-sectional study
  165. Clinical features of atypical tuberculosis mimicking bacterial pneumonia
  166. Proteoglycan-depleted regions of annular injury promote nerve ingrowth in a rabbit disc degeneration model
  167. Effect of electromagnetic field on abortion: A systematic review and meta-analysis
  168. miR-150-5p affects AS plaque with ASMC proliferation and migration by STAT1
  169. MALAT1 promotes malignant pleural mesothelioma by sponging miR-141-3p
  170. Effects of remifentanil and propofol on distant organ lung injury in an ischemia–reperfusion model
  171. miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway
  172. Identification of LIG1 and LIG3 as prognostic biomarkers in breast cancer
  173. MitoQ inhibits hepatic stellate cell activation and liver fibrosis by enhancing PINK1/parkin-mediated mitophagy
  174. Dissecting role of founder mutation p.V727M in GNE in Indian HIBM cohort
  175. circATP2A2 promotes osteosarcoma progression by upregulating MYH9
  176. Prognostic role of oxytocin receptor in colon adenocarcinoma
  177. Review Articles
  178. The function of non-coding RNAs in idiopathic pulmonary fibrosis
  179. Efficacy and safety of therapeutic plasma exchange in stiff person syndrome
  180. Role of cesarean section in the development of neonatal gut microbiota: A systematic review
  181. Small cell lung cancer transformation during antitumor therapies: A systematic review
  182. Research progress of gut microbiota and frailty syndrome
  183. Recommendations for outpatient activity in COVID-19 pandemic
  184. Rapid Communication
  185. Disparity in clinical characteristics between 2019 novel coronavirus pneumonia and leptospirosis
  186. Use of microspheres in embolization for unruptured renal angiomyolipomas
  187. COVID-19 cases with delayed absorption of lung lesion
  188. A triple combination of treatments on moderate COVID-19
  189. Social networks and eating disorders during the Covid-19 pandemic
  190. Letter
  191. COVID-19, WHO guidelines, pedagogy, and respite
  192. Inflammatory factors in alveolar lavage fluid from severe COVID-19 pneumonia: PCT and IL-6 in epithelial lining fluid
  193. COVID-19: Lessons from Norway tragedy must be considered in vaccine rollout planning in least developed/developing countries
  194. What is the role of plasma cell in the lamina propria of terminal ileum in Good’s syndrome patient?
  195. Case Report
  196. Rivaroxaban triggered multifocal intratumoral hemorrhage of the cabozantinib-treated diffuse brain metastases: A case report and review of literature
  197. CTU findings of duplex kidney in kidney: A rare duplicated renal malformation
  198. Synchronous primary malignancy of colon cancer and mantle cell lymphoma: A case report
  199. Sonazoid-enhanced ultrasonography and pathologic characters of CD68 positive cell in primary hepatic perivascular epithelioid cell tumors: A case report and literature review
  200. Persistent SARS-CoV-2-positive over 4 months in a COVID-19 patient with CHB
  201. Pulmonary parenchymal involvement caused by Tropheryma whipplei
  202. Mediastinal mixed germ cell tumor: A case report and literature review
  203. Ovarian female adnexal tumor of probable Wolffian origin – Case report
  204. Rare paratesticular aggressive angiomyxoma mimicking an epididymal tumor in an 82-year-old man: Case report
  205. Perimenopausal giant hydatidiform mole complicated with preeclampsia and hyperthyroidism: A case report and literature review
  206. Primary orbital ganglioneuroblastoma: A case report
  207. Primary aortic intimal sarcoma masquerading as intramural hematoma
  208. Sustained false-positive results for hepatitis A virus immunoglobulin M: A case report and literature review
  209. Peritoneal loose body presenting as a hepatic mass: A case report and review of the literature
  210. Chondroblastoma of mandibular condyle: Case report and literature review
  211. Trauma-induced complete pacemaker lead fracture 8 months prior to hospitalization: A case report
  212. Primary intradural extramedullary extraosseous Ewing’s sarcoma/peripheral primitive neuroectodermal tumor (PIEES/PNET) of the thoracolumbar spine: A case report and literature review
  213. Computer-assisted preoperative planning of reduction of and osteosynthesis of scapular fracture: A case report
  214. High quality of 58-month life in lung cancer patient with brain metastases sequentially treated with gefitinib and osimertinib
  215. Rapid response of locally advanced oral squamous cell carcinoma to apatinib: A case report
  216. Retrieval of intrarenal coiled and ruptured guidewire by retrograde intrarenal surgery: A case report and literature review
  217. Usage of intermingled skin allografts and autografts in a senior patient with major burn injury
  218. Retraction
  219. Retraction on “Dihydromyricetin attenuates inflammation through TLR4/NF-kappa B pathway”
  220. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part I
  221. An artificial immune system with bootstrap sampling for the diagnosis of recurrent endometrial cancers
  222. Breast cancer recurrence prediction with ensemble methods and cost-sensitive learning
https://doi.org/10.1515/med-2021-0210
Keywords for this article
COVID-19; priority; international collaboration; international transportation; vaccine
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  169. MALAT1 promotes malignant pleural mesothelioma by sponging miR-141-3p
  170. Effects of remifentanil and propofol on distant organ lung injury in an ischemia–reperfusion model
  171. miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway
  172. Identification of LIG1 and LIG3 as prognostic biomarkers in breast cancer
  173. MitoQ inhibits hepatic stellate cell activation and liver fibrosis by enhancing PINK1/parkin-mediated mitophagy
  174. Dissecting role of founder mutation p.V727M in GNE in Indian HIBM cohort
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  186. Use of microspheres in embolization for unruptured renal angiomyolipomas
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  188. A triple combination of treatments on moderate COVID-19
  189. Social networks and eating disorders during the Covid-19 pandemic
  190. Letter
  191. COVID-19, WHO guidelines, pedagogy, and respite
  192. Inflammatory factors in alveolar lavage fluid from severe COVID-19 pneumonia: PCT and IL-6 in epithelial lining fluid
  193. COVID-19: Lessons from Norway tragedy must be considered in vaccine rollout planning in least developed/developing countries
  194. What is the role of plasma cell in the lamina propria of terminal ileum in Good’s syndrome patient?
  195. Case Report
  196. Rivaroxaban triggered multifocal intratumoral hemorrhage of the cabozantinib-treated diffuse brain metastases: A case report and review of literature
  197. CTU findings of duplex kidney in kidney: A rare duplicated renal malformation
  198. Synchronous primary malignancy of colon cancer and mantle cell lymphoma: A case report
  199. Sonazoid-enhanced ultrasonography and pathologic characters of CD68 positive cell in primary hepatic perivascular epithelioid cell tumors: A case report and literature review
  200. Persistent SARS-CoV-2-positive over 4 months in a COVID-19 patient with CHB
  201. Pulmonary parenchymal involvement caused by Tropheryma whipplei
  202. Mediastinal mixed germ cell tumor: A case report and literature review
  203. Ovarian female adnexal tumor of probable Wolffian origin – Case report
  204. Rare paratesticular aggressive angiomyxoma mimicking an epididymal tumor in an 82-year-old man: Case report
  205. Perimenopausal giant hydatidiform mole complicated with preeclampsia and hyperthyroidism: A case report and literature review
  206. Primary orbital ganglioneuroblastoma: A case report
  207. Primary aortic intimal sarcoma masquerading as intramural hematoma
  208. Sustained false-positive results for hepatitis A virus immunoglobulin M: A case report and literature review
  209. Peritoneal loose body presenting as a hepatic mass: A case report and review of the literature
  210. Chondroblastoma of mandibular condyle: Case report and literature review
  211. Trauma-induced complete pacemaker lead fracture 8 months prior to hospitalization: A case report
  212. Primary intradural extramedullary extraosseous Ewing’s sarcoma/peripheral primitive neuroectodermal tumor (PIEES/PNET) of the thoracolumbar spine: A case report and literature review
  213. Computer-assisted preoperative planning of reduction of and osteosynthesis of scapular fracture: A case report
  214. High quality of 58-month life in lung cancer patient with brain metastases sequentially treated with gefitinib and osimertinib
  215. Rapid response of locally advanced oral squamous cell carcinoma to apatinib: A case report
  216. Retrieval of intrarenal coiled and ruptured guidewire by retrograde intrarenal surgery: A case report and literature review
  217. Usage of intermingled skin allografts and autografts in a senior patient with major burn injury
  218. Retraction
  219. Retraction on “Dihydromyricetin attenuates inflammation through TLR4/NF-kappa B pathway”
  220. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part I
  221. An artificial immune system with bootstrap sampling for the diagnosis of recurrent endometrial cancers
  222. Breast cancer recurrence prediction with ensemble methods and cost-sensitive learning
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