Booster shot

"Public acceptance is a challenge we forget at our own risk."


Last week, we noted that the global economy is expected to be on the mend sooner rather than later with the expanded roll out of COVID-19 vaccines in most developed countries and in an increasing number of middle-income and even developing ones. There is universal consensus that the key to a real, sustainable recovery in all aspects of day-to-day living is a full-blown vaccination program across the board. For all intents and purposes, the rollout is the kind of booster shot which animates freeing the energies that a full year of global lockdown held back.

Take what happened on Monday with the arrival of the first batch of vaccines in Manila. While the carping from the usual suspects remained unabated a sigh of relief was evident nationwide especially since senior officials publicly took the first jabs. So far, the roll out though limited is going on smoothly with Cebu and Davao as satellite inoculation centers. Hopefully, we should be able to have a sizable percentage of d population in the most vulnerable areas and sectors inoculated by year end as more vaccines get off the production lines.

That expected outcome, however, is fraught with loads of challenges which will require committed leadership from the lowest administrative units, public and private, in each and every country and, of course, by the UN and its agencies such as the WHO and UNICEF, among others, regional groupings such as the ASEAN, financial institutions, public and private, and the pharmaceutical companies.

A health policy paper authored by noted scientists and public health specialists published in LANCET, the prestigious medical journal, outlined the basic issues and challenges facing such a global effort. It noted that basic components of this initiative, namely, development and production, pricing (affordability), allocation (accessibility) and deployment are so interrelated that failure in one can derail the anticipated global rebound and degrade public confidence.

As the paper correctly noted, developing and producing the vaccine are not enough. It has to be of such efficacy and scale as to be affordable and readily available for deployment to the farthest ends of the earth to enhance such trust and confidence needed to get the world moving again. Things will not be easy. In fact, they can be so complicated and tortuous that it will take active intervention by international institutions like the WHO, WTO and UNICEF not to mention NGOs like COVAX (Covid 19 Vaccine Global Access Facility) and GAVI (The Vaccine Alliance) and CEPI (Coalition for Epidemic Preparedness Innovations), the global foundation funded by business and philanthropic organizations to finance independent research projects to develop vaccines against emerging infectious diseases, among others, to get things right.

It is the role of private companies and foundations such as the Bill and Melinda Gates Foundation, among a number of trusts, which have attracted conspiracy theories.

That buzz is taking on wings, as observers noticed that a good number of the 289 experimental vaccines under development have been funded interchangeably by CEPI and the Bill and Melinda Gates Foundation. Be that as it may this is not the time and the place to entertain such thoughts. What matters now is for us to urge these developers to proceed with all deliberate speed in getting their products injected to as many people as possible. The sooner, the better.

In any event, there is every reason to hope that in the next two or three years we will finally get back to the robust economic and social life we enjoyed before the pandemic, albeit with marked changes in the manner by which peoples and nations interact with each other.

It is worth noting, for example, that of the 26 vaccines in advanced stages of development, six ( Pfizer/BioNTech, Moderna, AstraZeneca/Oxford, SinoPharm, SinoVac, Sputnik/Gamaleya) are being ramped up in production and two more (Johnson and Johnson/Jannsen and NovoVax) about to finish with Stage 3 trials. The problem is this is just the start of the long and tortuous journey to get the jabs safely to as many people as needed.

To achieve global control of COVID-19, these vaccines have to be produced at such a scale as will deter widespread transmission. This year the target is to have at least 20 percent of the global population vaccinated –a tall order by current production standards. Reports have it that nine developers have promised to deliver 700 million doses each this year while 10 others are looking at ramping up to one billion doses each.

Whether such can be achieved at all is problematic to say the least given the need to have the basic ingredients (reagents, syringes, glass vials, etc) in such quantities as required in place at the limited production facilities. To ramp things up, the WHO and WTO are looking at fast tracking collaboration agreements between the vaccine developers and local (national) producers by relaxing licensing arrangements and technology transfer rules. That may take some time.

Added to such a production constraint is the need to ensure that the vaccines are priced affordably and allocated responsibly and equitably – issues which can put a squeeze on the global vaccination effort no end. Already, countries like the Philippines are finding it hard to get even one dose of any of the authorized vaccines in place for one reason or the other. Untangling those knotty problems as outlined not to mention local (national) concerns such as the availability of facilities and personnel to undertake the job will truly make things harder than expected.

The problem is, the longer things get tangled up, the more problematic things become as the public’s trust and confidence in the vaccination program gets degraded. Vaccine acceptance even in developed countries has become a critical issue. As the paper noted, vaccine acceptance has been critical in a country’s Covid 19 response effort. It was highest in countries which have been quite successful like Vietnam (98 percent), China (91 percent), Denmark (87 percent), and South Korea (87 percent), and lowest in those still reeling from the virus such as Serbia (38 percent), Croatia (41 percent), France (44 percent), Lebanon (44 percent), and Paraguay (51 percent).

Indeed, public acceptance is a challenge we forget at our own risk.

Topics: Jonathan Dela Cruz , booster shot , COVID-19 vaccines
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