#covid-19, #vaccination, #wholeworld, #health, #developing countries
Seven billion.
Yes, you read correctly.
7 billion is the population of the world at the moment.
Can the world really achieve vaccinating 7 billion people? With all the logistics that is required to manufacture, store, transport, deliver to sites and then provide 2 doses at specified intervals.
Does the world have that capacity? Or is this another project doomed to fail before it hits the ground? Will this not further demonstrate the big socioeconomic gap existing already?
How have polio eradication programs fared in countries most hit by that disease?
Your response is as good as mine.
Historical Perspective
About a year ago, to be specific; in January 2020, the world was hit with news of a strange virus in Wuhan China, that would end up damaging not only the economies of the world; but also waste the lives of several people. Research swung into action with landmark discoveries that would lead to the implementation of mass vaccination programs.
The UK started to vaccinate its own population, followed by other Western countries, whilst voices in African countries continue to argue whether or not "this chipped product" is of any immediate priority to them whilst several of their children die from endemic infections such as malaria, tuberculosis, etc.
Immediate Logistical Issues with Implementation of COVID-19 vaccination
There was palpable media excitement when the Pfizer and other pharmaceutical companies announced outcomes of their trials. Soon enough, wealthy countries swung into action regarding vaccinating their populace. To achieve 95% protection, an individual would need 2 doses of the vaccine spread across 3 weeks. The implications, besides cost suggest robust resources that would see several developing countries struggle to meet up to the challenges.
Whereas the manufacturers have demonstrated 2 dose success rates of achieving sustainable immunity against covid-19, there have been calls by political institutions to embark on single dose vaccinations, at least for now. The manufacturers of the vaccine have responded by distancing themselves from that recommendation.
Clearly, there is need to build confidence in the program and also demonstrate the scientific rationale for "vaccinating the world."
Pertinent questions that need answers:
If someone has had the covid-19 infection and recovered, do they need to be vaccinated as well?
If they have to be vaccinated, why is plasma from those that have recovered useful for those that are infected (convalescent plasma)?
Do we have a guidance for vaccinating people, apart from the number of doses that are recommended and also the fact that if one has history of severe drug reactions, they should not recieve the vaccine?
Is the current recommendation, driven by the pharma, financially viable for medium income countries?
Will a single vaccination of all eligible persons produce a longterm cheaper option that identifying at-risk vulnerable persons and vaccinate them?
I guess you can insert your own questions here ....
Edivence of Protection
Based on available literature, there are 2 ways by which immunity against covid-19 can be gained.
A publication in the NEJM based on 6 month observation of patients that were previously infected (and who had immunity, demonstrated by positive anti-Spike IgG) and who recovered from covid-19, with those that were never infected on the control arm, has demonstrated an interesting outcome. The presence of anti-spike or anti-nucleocapsid IgG antibodies was associated with a substantially reduced risk of SARS-CoV-2 reinfection in the ensuing 6 months. Please read journal . Therefore, natural immunity can be developed based on previous infection. Yet no guidance is available to define whether or not vaccination should be given to those that were previously infected.
2. Vaccination has demonstrated more than 95% efficacy in the prevention of new infections - given in 3 doses.
CURRENT APPROACH
Vaccinate Everyone
General clamour for people to possess vaccination passport
Very soon, some app will be forced into our mobile devices to light-up whether or not we have been vaccinated
All of these approaches breed suspicions - the fact that some desire to control humans is the basis for the vaccination program.
SUGGESTED MODEL
A shift from the concept to vaccinate everyone to vaccinate those that need the vaccine is not only cost effective and viable, but also scientifically sound.
Looking at all the current evidence before us, I have drawn up a model that should provoke discussions.
Above are my thoughts, based on studies of the published evidence available as at current.
The table suggests the following:
Those who have never had covid-19, based on negative anti-Spike IgG should be the ones to be vaccinated
Those to be vaccinated are to be prioritised based on risk profiles
The cost considerations will be substantially reduced, if one takes into account the model for vaccinating 7 billion people whether or not they have had covid-19, against performing antibody screening for high risk populations and administering the vaccine.
The definition of "high risk population" remains to be brought to the fore - which can greatly define the path forward.
Until then, people shall continue to brew worries and theories about the intentions of vaccination program promoters.
Nimzing Ladep is a consultant Hepatologist, NNUH, UK and Director of Worthy Works Ltd.