Friday, June 4, 2021
Original post can be found on the Duke Global Health Innovation Center's Launch and Scale Speedometer website.
|High-income country confirmed dose total:||6 billion|
|Upper-middle-income country total:||2.2 billion|
|Lower-middle-income country total:||1.1 billion|
|Low-income country total:||270 million|
|COVAX total:||2.4 billion|
|Total worldwide confirmed purchases of Covid-19 vaccines:||11.9 billion doses|
How do COVID-19 variants impact vaccinations and the ability to end the acute phase of the pandemic?
Author: Blen Biru
Multiple COVID-19 genetic variants have been detected since the initial SARS-CoV-2 strain was found in China, the most significant of which are classified by the WHO as variants of concern or variants of interest, depending on their attributes and risk level.
The variants of concern are those that need to be rigorously tracked and monitored given their increased risk of transmissibility and/or severity; they were often referred to by the location of their country of origin (e.g. the UK variant). WHO recently announced that it will use Greek alphabet nomenclature instead of country of origin to refer to variants of concern, both to avoid discrimination as well as simplify communications.
Several of the variants of concern are particularly worrisome due to their potential to impact the effectiveness of existing vaccination efforts, therapeutics, and public health measures, likely stretching the pandemic timeline.
In South Africa, for example, the emergence of a dominant Beta variant raised concerns about the effectiveness of the AstraZeneca vaccine, especially in protecting against mild/moderate COVID-19 cases. The South African government pivoted its vaccine strategy, selling their existing stock of 1 million doses in March 2021 to the African Union for distribution to other countries less affected by the Beta variant.
The Alpha variant, first identified in the UK in September 2020, is significantly more infectious (and evidence suggests also deadlier) than the original strain. Rapidly rising hospitalizations prompted a national lockdown in December 2020 and January 2021. In the past few weeks, the UK has seen increased number of cases due to the Delta variant (B.1.617.2), originally identified in India, which was a driver of the recent second wave crisis India experienced. Furthermore, the UK is now assessing if the newly emergent C.36.3 variant, originally detected in Thailand, is of concern. The spread of these new variants in the UK threatens the timeline for lifting of the remaining lockdown restrictions that was planned for June 21.
The Delta variant has spread to 62 countries including the US (detected in 46 states so far). Similarly, a strain found in Japan (Gamma) has spread to 64 countries, likely leading to an increase in COVID-19 cases and deaths.
The rapid pace of emergence of new variants, with COVID-19 hotspots around the world, threatens to prolong the acute phase of the pandemic and may potentially pierce immunity from some current vaccines. The WHO has set up a Virus Evolution Working Group that advises countries to strengthen their routine genetic sequencing systems and share any emerging variants through an internationally accessible database, in order to track and address variants more systematically and transparently.
Other urgent efforts are also under way to modify existing therapeutics and vaccinations and innovate new ways to respond to the emerging variants. For example, a recent study published in Nature explores nasal spray antibody that holds promise in addressing variants.
Variants that are more transmissible and/or lead to more severe disease underscore the urgency needed to ramp up effective vaccination campaigns globally. Several countries that have previously maintained good levels of containment with strong public health measures, such as Vietnam, are now experiencing new waves likely driven by new variants. Achieving high rates of vaccination globally using high-quality, effective, and safe vaccines is our best hope to end the acute phase of the pandemic. We need to continue to track the efficacy and effectiveness of each available vaccine against variants of concern.
These dire situations in many parts of the world reiterate the need for equitable vaccine distribution and delivery across the world. It is in the best interests of every nation to ensure that all countries across the world are able to vaccinate their populations as soon as possible.
Significant updates, news, and trends we saw last week:
- US President Biden announced the detailed plan to share the first 25M of the 80M doses that the US will donate globally; 19 million doses will be distributed through COVAX and the remaining 6 million through direct donations to other countries.
- WHO announced that COVID-19 variants will be named based on the Greek alphabet pattern instead of places of origin both to avoid discrimination as well as simplify communications.
- Johnson and Johnson’s vaccine received approval in the UK, which makes it the 4th vaccine to be authorized in the UK.
- China’s Sinovac vaccine received Emergency Use Listing (EUL) by the WHO.
- New COVID-19 cases in South America are increasing, and are also being underreported in countries like Peru.
- UNICEF signed a supply agreement to possibly procure 220M doses of the Sputnik V vaccine, pending WHO EUL and a purchase agreement by Gavi/COVAX.
For more information on our research on Covid-19 vaccine supply, please see https://launchandscalefaster.org/COVID-19.