The vaccination dilemma continues to emerge as worldwide data with somewhat, but not yet enough, increased statistical validity are becoming widely available (http://knoema.com/infographics/vzmsqj/covid-19-vaccine-effectiveness-in-data-over-120-countries-at-risk-for-new-covid-spikes). There are several key issues in this respect on the global, regional and country/local levels. The global and regional levels are dealt with primarily by the WHO. Though its considerable value in assessing the global data and monitoring the global trends of infection and its spreading, it has limited economic potential to influence the worldwide vaccination. This is part of great global discrepancies in the vaccination rates and frequencies. This creates huge constraints in the global health issues, in particular to achieve the UN-SDGs what regards health, education and poverty. There are no other worldwide organisations that have either economic capacity or economic responsibility to raise the vaccination rates on the global scale.

So, we still have an ongoing global dialogue about who will be vaccinated and who will get a boost of a third shot of vaccine (https://www.nbcnews.com/think/opinion/covid-vaccine-booster-shots-delta-variant-are-being-over-hyped-ncna1275507). This adds new dimensions to how to handle the vaccination resources on the global scale. There are several reasons for the existing cloudy situation of the vaccination what regards its effectiveness, accessibility and availability. The Pfizer shot, for example, was only 39 percent effective in preventing symptomatic Covid infection from late June to mid-July, a nosedive from levels seen this winter and early spring. Though this observation is based on small group and covered narrow window of time, it has however triggered the needs for offering a booster of a third shot to people over 60 who were vaccinated more than five months ago. According to different sources the delta variant is more contagious and likely more severe than its predecessors, this has also raised prompt discussions on whether booster shots can stem them and once again restore the impenetrable immunity of vaccinated people.

The global penetration of vaccination is still a serious problem as some countries are almost ready with the vaccination of their overall populations while others have very low vaccination rates with only few percent of the total population are vaccinated. On the other hand countries with very high vaccination rates of 80% have more or less the same spreading rates of COVID as the countries with very small vaccination rates. This raises new worries that vaccines are not a guarantee against further surge in COVID cases and thereby additional risks for development of new mutations. For example, European countries where cases are increasing serve as a reminder that vaccination progress is not a guarantee against a new surge in COVID cases even in other parts of the world.

We still are getting new data about the efficiency of vaccines, for example moderna claims that their COVID-vaccine booster produces more robust response against the delta variant (https://www.cnbc.com/2021/08/05/moderna-covid-vaccine-booster-produces-robust-response-against-delta.html). Data from different countries that used different vaccines, e.g. from China, also suggest that we still have little, or not enough, knowledge on the global effectiveness of vaccines specially what regards their long-term and large-scale behaviour with consideration to all the parameters involved in assessing the wicked issues COVID spreading in relation to vaccination and opening of economies.