Recent National Public Radio story, “Africa may have reached the pandemic’s holy grail,” raises interesting questions on a country’s age distribution and ability to get past the pandemic stage with lower vaccination rates

Every country that has had large numbers of COVID-19 cases and deaths reported have shared the experience that older populations and those with certain health conditions have been the groups at greatest risk, along with front line health care workers Vaccinations and booster shots can significantly reduce the risk of hospitalization and death for these groups and for younger age groups as well.

The COVID-19 pandemic has raised important questions on vaccine equity. Low income and lower-middle income countries have generally had much poorer access to vaccines and to getting vaccines received administered, although the rate of vaccination varies within income groups as well as between income groups. See, e.g., January 23, 2022:  COVID-19 Omicron variant – hopeful signs of peaking in the U.S. and Europe; supply disruptions continue from zero tolerance policy in China,

Much focus has been on low income countries and lower-middle income countries, particularly in Africa, where vaccination rates trail dramatically all other countries and income groups.

On Friday, January 28, 2022, National Public Radio in the U.S. posted an article, “Africa may have reached the pandemic’s holy grail,” The following excerpt reviews that large portions of the population in countries like Malawi were infected by the first waves of the COVID-19 virus which built up immunity to the omicron variant. Despite any reinfections that have occurred, hospitalizations and deaths were very low despite very low vaccination rates. The population of many low income countries is much younger than higher income countries and thus infections were typically much less severe. A few excerpts from the NPR article follow.

“When the results of his study came in, Kondwani Jambo was stunned.

“He’s an immunologist in Malawi. And last year he had set out to determine just how many people in his country had been infected with the coronavirus since the pandemic began.

“Jambo, who works for the Malawi-Liverpool-Wellcome Trust Clinical Research Programme, knew the total number of cases was going to be higher than the official numbers. But his study revealed that the scale of spread was beyond anything he had anticipated — with a huge majority of Malawians infected long before the omicron variant emerged. ‘I was very shocked,’ he says.

“Most important, he says, the finding suggests that it has now been months since Malawi entered something akin to what many countries still struggling with massive omicron waves consider the holy grail: the endemic stage of the pandemic, in which the coronavirus becomes a more predictable seasonal bug like the flu or common cold.

“In fact, top scientists in Africa say Malawi is just one of many countries on the continent that appear to have already reached — if not quite endemicity — at least a substantially less threatening stage, as evidenced by both studies of the population’s prior exposure to the coronavirus and its experience with the omicron variant.”

With global vaccine production dramatically up from this time last year and with much larger quantities getting shipped to low income and lower-middle income countries, the above article suggests that omicron has not done serious damage to most countries at the low income range and that significantly increased vaccinations in 2022 should help ensure a safer future.

Looking at UN population data by age group and by median age shows an interesting correlation between median age and income level of country. The median age for low income countries in 2020 (est.) was 19.0 years; for low-middle income countries, 26.6 years; for upper-middle income countries, 35.4 years and for high income countries, 41.0 years. See United Nations Population Division Department of Economic and Social Affairs, World Population Prospects 2019.

Looking at breakdowns by age groups, the UN data show the following percent of population in the World Bank income groups.

Age GroupLow IncomeLower-Middle IncomeUpper-Middle IncomeHigh Income
0-14 41.3% 29.4% 20.4% 16.6%
15-49 48.2% 52.8% 50.5% 45.6%
50+ 10.5% 17.8% 29.1% 37.7%
60+ 5.2% 9.1% 15.8% 24.4%
65+ 3.3% 5.9% 10.8% 18.4%
75+ 1.0% 1.9% 3.6% 8.4%

Age distribution has been a silver lining in an otherwise challenging global situation these last two years.

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