Vaccine
COVID-19 vaccination campaigns are in full swing across the globe
“ There will be a need to develop the vaccine further and further because this is a global problem . There are enough doses for all citizens in production , but what will be interesting is how procurement is being done in low-income countries .”
We should also consider how societies will live with COVID-19 , even when they have the vaccine , Dr Piot said . For example , we don ’ t know yet if the vaccine prevents transmission of the disease in addition to preventing people from being hospitalised or dying from it . If it does not , we ’ ll need to continually adopt social distancing and personal protective behaviour and strengthen our public health institutions .
This was seen in East and Southeast Asia after the SARS epidemic of 2002-04 , which led to tighter national health protocols and more responsive facilities .
“ This is going to be a big wake up call for all of us , in Europe , North America , Asia and Africa . We might have to continue to change how we live , work , travel , and interact with nature . There ’ s no time to lose ,” he said .
In terms of testing the current vaccines for efficacy , Dr Piot said there were no shortcuts , even though regulators had rushed them through faster than ever . Even though regulators applied their usual standards , many questions remained that could only be answered in due time .
“ That ’ s why it ’ s really important to have postmarketing surveillance , meaning close monitoring of everybody who ’ s been vaccinated ,” he advised . “ That has been rolled out by the drug companies and also by governments — I know this is certainly the case in
Europe , but I also understand this will happen in Asia .”
What ’ s becoming increasingly evident is the need for multiple vaccines to protect all of the various subgroups of society . For example , one vaccine may work better in the elderly , while another might have a significant impact on transmission , but not so much on disease . This means that health authorities are likely to adopt a combination of vaccines .
Moreover , logistics are going to be very important for any roll-out . The Pfizer-BioNtech vaccine , for instance , requires a minus 70 degree Celsius environment for preservation and transport , which presents a logistical challenge .
“ This is the first generation of vaccines , and it would be unusual that the first generation is the optimal generation of products . That rarely happens .
“ There will be a need to develop the vaccine further and further because this is a global problem . There are enough doses for all citizens in production , but what will be interesting is how procurement is being done in low-income countries ,” said Dr Piot .
One way is for rich Western countries to pay for doses for poorer nations , which is what ’ s happening now through COVAX , the COVID-19 Vaccines Global Access . It ’ s a global initiative aimed at providing all countries access to vaccines regardless of their wealth , led by institutions such as the World Health Organization and Gavi , the Vaccine Alliance .
“ So with this , there ’ s equitable access , which is one of my main concerns that there is enough for everybody in the whole world . Yet , there are still a lot of uncertainties ,” said Dr Piot , adding that in the nineties , only people in high income countries had access to lifesaving drugs for HIV infection . It then took about 10 years to ensure wider access .
Dr Piot expects Southeast Asia will be able to implement successful vaccination programmes , with predictions suggesting that up to 95 percent of people in the region will be vaccinated . He points to the strength of central governments and people ’ s willingness to accept drugs endorsed by health officials , especially in the wake of the SARS epidemic , as important factors . Many nations have gained experience from years of mass vaccinations for diseases such as tuberculosis and polio .
“ I know that immunisation programmes for children are now putting a lot of emphasis on reaching remote parts of the region . We need to do the same thing for COVID immunisation .
“ Every crisis has an opportunity . The opportunity here is unprecedented collaboration through the sharing of information . In the SARS days , information and data were not shared , and we wasted a lot of time . Here it ’ s all in the open .
“ Industries and governments have risen to the challenge . But leadership will remain very important , so we have to keep up these measures until there ’ s widespread vaccination with herd immunity ,” he said . n
54 APRIL 2021 GlobalHealthAsiaPacific . com