Eduardo Ortega Delgado, a professor in Havana, Cuba, is now fully vaccinated — and he’s feeling pretty happy about it.
“I feel more safe and more confident,” he told The World in Spanish from his home in Havana.
During the pandemic, the 73-year-old professor of plant physiology at the University of Havana has been teaching class remotely. He received the third and final dose of Cuba’s homegrown COVID-19 vaccine about two weeks ago and said he didn’t experience any side effects other than minor pain and itchiness after the final dose.
Cuba’s vaccine, known as Abdala, is in reference to a poem by Cuban liberation hero, Jose Martí. This month, the Cuban government granted Abdala emergency approval, making the country the first in Latin America to approve a homegrown vaccine.
“Latin American and the Caribbean, we are a very vulnerable region."
“Latin American and the Caribbean, we are a very vulnerable region,” Dr. Jarbas Barbosa, assistant director of the Pan American Health Organization, recently said at a news briefing.
The region needs more options, from Cuba and elsewhere, Barbosa said.
Latin America now accounts for more than a third of new COVID-19 cases and more than 40% of deaths worldwide as regions struggle to access and distribute vaccines.
Yet, amid these vaccine milestones as a world leader in medicine, the country also faces its largest anti-government demonstrations in decades. Chants of “Libertad!” or “Liberty” recently echoed in the streets as people protested shortages of food and medicine, a contracting economy, electricity outages and a growing COVID-19 outbreak.
In response, the government temporarily shut down the internet. On Wednesday, Cuban President Miguel Díaz-Canel admitted that the state needs to better understand its shortcomings. The government lifted restrictions on quantities of food and medicines that travelers can bring into the country with them.
Cuba’s strong history in medicine and health care may also be adding to the frustration, according to some experts. Expectations in the country run extremely high.
In spring 2020, the Cuban government issued a call: Anyone capable of developing a COVID-19 vaccine should do it. Scientists got to work on multiple vaccines. Shortly after, leaders from Cuba’s Finlay Institute introduced the first candidate to enter clinical trials: Soberana, meaning “sovereign” in Spanish.
About a quarter of the Cuban population, including tens of thousands of health workers, have received at least one dose of a vaccine.
Scientists recently reported that efficacy for both vaccines is above 90%, following the final dose.
Around the world, scientists are paying attention.
“It’s quite encouraging, they just add to the arsenal,” said Gary Kobinger, a renowned infectious disease specialist at the University of Laval in Canada.
Canada has not succeeded in developing a COVID-19 vaccine, he pointed out.
Cuba’s vaccines stand out because they use “more conventional and well-known vaccine strategies,” that tend to have less side effects, he said.
They’re easy to make and store, though they often require more doses to induce a strong response. Kobinger still wants to review the actual trial data, however, to understand their effectiveness.
Saad Omer, director of Yale Institute for Global Health and an adviser to the World Health Organization on vaccines, agrees that data must be assessed more judiciously. He said that if Cuba plans to file for WHO emergency-use listing, that would be “a good sign.”
“I am always concerned about vaccines that don’t go through that process."
“I am always concerned about vaccines that don’t go through that process,” Omer said.
Cubans want to be vaccinated as soon as possible, said Amilcar Perez Riverol, a Cuban molecular biologist. Perez Riverol, who works at the University of São Paulo in Brazil, has also worked at the Center for Genetic Engineering and Biotechnology, the research group behind the development of the Abdala COVID-19 vaccine.
Perez Riveral observed how Cuban scientists were overwhelmed by the general public's enthusiasm, even during the development process. Clinical trials require tens of thousands of participants, which is not hard to come by on the island nation of about 11 million people. At one point, researchers even had to turn down enthusiastic volunteers, he said.
A history of trust in state medicine
Unlike the United States, vaccine hesitancy is not prevalent in Cuba, according to Daniel Rodriguez, a historian at Brown University. He co-taught courses in Cuba, and recalled how when he discussed the recent comeback of measles in the US, his Cuban colleagues were shocked by Amercicans’ distrust in basic health institutions.
In Cuba, science and medicine are politicized in a different way. People trust it, he said, because it’s a priority built into the national identity.
“A major piece of the Cuban Revolution since 1959 is Cuba’s increasing medical excellence, the idea that Cuba has an excellent public health system, is able to protect its citizens, and that it’s the government’s responsibility to protect the Cuban people."
“A major piece of the Cuban Revolution since 1959 is Cuba’s increasing medical excellence, the idea that Cuba has an excellent public health system, is able to protect its citizens, and that it’s the government’s responsibility to protect the Cuban people,” Rodriguez said.
Vaccine names like “sovereign” allude to this, he said.
Even before the revolution, Cuba’s sovereignty centered on citizen care and became the first country in the world to have a Ministry of Health in 1909.
Cuba may be a low-resourced country, but it boasts a strong history of providing health care domestically and abroad, including the development of safe and effective vaccines, such as for meningitis and hepatitis B.
The government further ramped up its biotechnology sector amid the fall of the Soviet Union in the 1990s, Rodriguez said. A majority of vaccines deployed domestically are manufactured in-country, and exported, too.
When COVID-19 hit, the country stood out for its strong response. Everyone in Cuba has an appointed doctor within a regional health system who calls them in when a vaccine appointment is available. But growing anti-government sentiment due to mismanagement — along with US sanctions — may have all contributed to the discontent.
Rodriguez said the pandemic has further tested the government’s ability to protect its citizens.
Cuba is reporting its biggest rise in cases since the start of the pandemic — about 6,000 daily — mainly concentrated outside Havana, like in Matanzas. The country is racing to catch up with the viral spread.
Acquiring the necessary raw materials to make vaccines has been a struggle.
Still, the government aims to have the country fully vaccinated by the end of 2021. Its main manufacturer reports that it can produce 1 million to 2 million doses, monthly — a huge achievement compared to the rest of Latin America.
But Cuba’s vaccine rollout and public health vigilance have not kept pace with the pandemic spread, which has slipped out of the government’s grasp, Rodriguez said. Amid this month’s protests, people are also demanding greater access to vaccines.
“You really saw a pile of kindling on the ground that was lit," he said.