Vaccines – coronavirus: The next 5 steps for their development and distribution



The scientific community and the citizens of all countries are watching with bated breath the developments with the vaccines which are a step before the green light is given for their mass production. One of the bets of the scientists and those involved in the production process, is the speed of distribution of vaccines but also the identification of vulnerable groups that will have priority in vaccination. The fears that exist are whether some vaccine manufacturers focus primarily on the distribution of their products in high-income countries, thus creating two-speed countries. Nature 587, 194-196 (2020), recently published guidelines on the next steps in the development and distribution of SARS-CoV-2 vaccines. The Doctors of the Medical School of the National and Kapodistrian University of Athens, Ioannis Danasis, Maria Gavriatopoulou and Thanos Dimopoulos (Rector of EKPA), summarize the main points of the article. Development of vaccination pilot programsAll countries have a vaccination program for children. However, these for adults are few: by 2017, only 114 of the 194 World Health Organization (WHO) member states had adult vaccination programs against seasonal flu. In India, for example, the only vaccine currently recommended for adults is against tetanus in pregnant women. Some nations recommend seasonal flu immunizations only for certain groups, such as the elderly. The availability of vaccines for children and adults varies in terms of the supply process, social expectations, community involvement, the attitude of vaccine providers. It is recommended that nations around the world consider considering a pilot vaccination program for adults using the seasonal flu vaccine, which is usually provided in the Northern Hemisphere in October and November and in the Southern Hemisphere from April to May. Such a program would be an ideal opportunity to test the effectiveness of vaccine disposal procedures (including the ability to keep vaccines at low temperatures along the distribution chain, which will also be necessary for vaccines against SARS-CoV-2) as well as and the monitoring and evaluation system. This will ensure the effectiveness of the vaccine distribution process against SARS-CoV-2. Pre-selection procedures The rate at which vaccines are distributed worldwide can vary considerably. Vaccine manufacturers may focus primarily on making their products available in high-income countries. For example, a study has shown that it can take 4 to 7 years from the initial approval of a drug to its final release in sub-Saharan Africa. In this context, the economically weaker countries should participate in the World Health Organization (WHO) pre-selection program for vaccination against SARS-CoV-2. The pre-selection program is already being used to make drugs available for HIV, malaria and tuberculosis, and has also been used for Ebola vaccination. Identification of national action groups Each country must plan and shape its internal vaccination procedures. of SARS-CoV-2. Most nations – 170 – already have National Immunization Technical Advisory Groups (NITAGs) or similar bodies for vaccine selection, identification of populations to be vaccinated as a matter of priority, identification and coordination of the disposal process. The WHO Strategic Advisory Group (SAGE) also has a working group tasked with advising Member States on issues related to COVID-19 vaccines. Discouraging bilateral negotiations to prevent only the richest countries from having the phenomenon access to a vaccine against SARS-CoV-2, the WHO has launched a global mechanism for distributing vaccine doses as soon as they are available. The COVAX mechanism aims to ensure that each participating country can vaccinate 20% of its population, regardless of its income level. More than 170 nations are participating in discussions to get involved, including richer countries. However, many nations may not be willing to participate as the 20% vaccination coverage target is considered low, given that vaccination coverage levels of at least 60-70% are required to achieve herd immunity in the population. Determining success Every vaccination program must be judged not only by the number of people who have been vaccinated, but also by whether it enables people to live and work safely. Efficacy is likely to vary significantly between countries, due to different environmental and social factors and prioritization of the population groups to be vaccinated. Most nations are likely to vaccinate health care workers first. Prioritization will then depend on the type and characteristics of the vaccine, demographics and other socio-economic factors. Each country should not rely on success measures from other nations, but should make its own measurements of infection rates. disease and death among vaccinated and unvaccinated populations. Country-level monitoring and evaluation systems will be vital. This information will be needed to make decisions about easing SARS-CoV-2 transmission prevention measures. Follow it on Google News and be the first to know all the news See all the latest News from Greece and the World, at



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