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The long-awaited Covid-19 vaccines are almost here. Now the issue of how to distribute them to the masses.
Around the world, governments are gearing up to launch vaccination campaigns nationwide, as the development of a handful of experimental vaccines nears the finish line. They are prepared to face a number of challenges and make many judgments in their vaccination strategies.
With several vaccines proven effective in large clinical trials, regulators can grant approval for their use in the coming weeks, with distribution beginning immediately thereafter.
“We need to be able to make a lot of vaccines for the world quickly … (for) diversity to be good here,” said Professor Sarah Gilbert, leader of the team working on the vaccine from Britain’s Oxford University-AstraZeneca, in an Associated Press report earlier this week.
Who goes first and why?
Since most vaccine leaders involve Western developers, Asian nations are expected to receive less of the prized product initially and at later stages than their American and European counterparts.
The richest and most powerful countries, as well as those that helped test or produce the vaccines, may also have access to them earlier.
Upon receiving the vaccines, governments will have to put them in the arms of their citizens as soon as possible to quickly end the pandemic. Relevant questions include who in the population will be entitled to a spot at the head of the queue. Priorities will vary from country to country.
Malaysia, for example, has said it will focus on inoculating only adults, as the experimental vaccines have not yet been tested in children under 12 years of age. The US-German team working on the Pfizer-BioNTech vaccine has just begun testing. in adolescents.
Indonesia intends to cover two-thirds of its population aged 18 to 59 who are considered fit and without pre-existing health conditions, as most vaccine trials have excluded people outside this age group. Health and emergency services workers will get vaccinated before everyone else. The elderly can be vaccinated voluntarily.
Meanwhile, Japan plans to prioritize older people over people with chronic diseases, as research shows that older people face significantly higher risks of contracting severe Covid-19. The country has the largest elderly population in the world, at almost 29 percent, more than one in four people, aged 65 and over.
India is likely to give its healthcare and frontline workers the highest priority as they “have the highest risk of exposure to the virus,” a senior health ministry official said this week.
The strategy makes sense as it is paramount for India, with the second highest number of Covid-19 cases in the world after the United States, to keep its healthcare system running to deal with its onslaught of infections.
Malaysia and India are studying the possibility of offering free vaccines, and Japan has already confirmed that it will do so for all its residents. Indonesia is covering vaccines for 30 percent of those in its target vaccination group, while the rest have to pay for their own vaccinations.
However, speed is not a key concern for everyone. South Korea is in no rush to sign deals despite pharmaceutical companies offering it more than 30 million doses of vaccines.
“The important thing is to choose the safest and most effective vaccine and buy it at an acceptable and reasonable price,” Health Minister Park Neung-hoo said last Sunday.
South Korean drug makers such as SK Bioscience and Celltrion are also developing their own Covid-19 vaccines.
“There is no reason to take the risk and rush to reserve vaccines when you can maintain a (comparatively) low number of cases,” said Dr. Chul-woo Rhee, a research scientist at the International Vaccine Institute in Seoul. in a Wall Street Journal report last week. “South Korea is not in an urgent situation like the United States or Europe.”
A delicate balance
A recent US study has suggested that prioritizing vaccinating people over 60 would have the biggest impact on reducing Covid-19 deaths, while vaccinating young adults first would have the biggest impact on reduction transmission rates. In this sense, the vaccination strategies of most countries seem to be aimed above all at preventing deaths.
In Europe, Britain is taking a largely age-based approach, with nursing home residents and people over 80 at the top of its list. Staff in nursing homes and healthcare settings are also prioritized to minimize the risk of transmitting the disease to their patients. Getting inoculated will cost £ 25 (S $ 45) for a two-dose regimen.
France’s vaccination guidelines include prioritizing its five million workers in high-risk jobs, such as store clerks and transportation workers with frequent public contact. This came after a public consultation to ensure that a sufficient number of people chose to be vaccinated.
In the US, the National Academies of Sciences, Engineering, and Medicine have proposed a five-phase plan with healthcare workers and first responders at the top of the list, followed by people with high underlying conditions. risk and older adults in densely populated settings.
Experimental shooting
Meanwhile, large numbers of people in Russia and China have already received experimental vaccines.
Russia has administered its Sputnik V vaccine to at least tens of thousands of volunteers outside of clinical trials, including medical workers and school teachers.
However, geography professor Leonid Perlov, 60, told the Washington Post that he turned down a vaccination offer because “it has not passed all the necessary stages of testing.”
“Biology teachers (aren’t) in a rush to get vaccinated either,” Perlov said of his peers’ response.
“They are more cautious. But the history teachers are the ones who are willing to volunteer. “
In China, about a million people have been inoculated with a vaccine from Sinopharm, one of the country’s leading companies, despite the state-owned company not yet showing robust late-stage clinical data on its efficacy. Two doses will cost less than 1,000 yuan (200 Singapore dollars).
“Among foreign construction personnel, diplomats and students who have traveled to more than 150 countries around the world, there has not been a single case of infection after inoculation,” Sinopharm said this month.
Attitudes towards vaccines
Chinese citizens have one of the highest acceptance rates for the Covid-19 vaccine in the world, according to an Ipsos survey conducted in conjunction with the World Economic Forum, which surveyed more than 18,000 adults from 15 countries last month.
About 85 percent of Chinese respondents said they will definitely get vaccinated when a Covid-19 vaccine is available.
The poll also showed that Indians were the most willing to do so, with 87 percent, and South Koreans in third place with 83 percent. The French were the most resistant to the idea, at 54 percent.
Those who said they did not want to receive a coronavirus vaccine were primarily concerned about side effects, with respondents in Japan and China among the most concerned, or that clinical trials had been too rushed.
No doubt, vaccine manufacturers will need much more data on the performance of their treatments in different age and ethnic groups and among people with health problems, before regulators can give them the go-ahead for public use.
For now, no country has announced plans to make vaccination against Covid-19 mandatory.
Some governments have already ruled out this, including France, Britain and Japan, though they stressed that their citizens would be strongly encouraged to receive the vaccines.
“Mandatory vaccination is rarely justified,” said Dr Vageesh Jain of the Institute for Global Health at University College London. “Successful implementation of Covid-19 vaccines will require time, communication, and trust.”
Other health experts have argued in favor of mandatory inoculation for some groups, as it could significantly reduce the risk of seriously harming or even killing others.
Several airlines and employers are considering ways to implement mandatory vaccination policies.
“The less burdensome it is for an individual to do something that prevents harm to others, and the greater the harm prevented, the stronger the ethical reason to impose it,” said Dr. Alberto Giubilini of the Oxford Uehiro Center for Practical Ethics and author of the book, The Ethics of Vaccination.
Immunologists agree that countries would have to inoculate between 60% and 70% of their populations to achieve herd immunity against the coronavirus. Exactly how to do it will be a key challenge for governments around the world in the coming year.
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