Milestones :: Perspectives :: Research

UNICEF fund aims to raise US$2.5 billion for COVID-19 health supplies; low- and middle-income countries set to benefit
Denmark makes first donation to support the global equitable access to COVID-19 tests, treatments and vaccines
NEW YORK/COPENHAGEN, 30 March 2021 – UNICEF has launched a fund to support low- and middle-income countries access to COVID-19 health supplies, including vital tests, treatments and vaccines. The fund, which leverages UNICEF’s Procurement Services to purchase supplies, provides an opportunity for donors to join the largest health and vaccines supply operation the world has ever seen.

The Access to COVID-19 Tools Accelerator Supplies Financing Facility (“ACT-A SFF”) aims to initially raise US$2.5 billion by the end of 2021. Of this, US$1 billion is intended for vaccines and associated immunization campaign supplies including those not covered financially by the COVAX Facility, such as AMC92 country cost-sharing doses through COVAX and support for self-financing participants’ vaccine and delivery costs. Another US$1 billion is for diagnostics and US$500 million is for therapeutics.
Contributions to the facility will help bring the world closer to the global ACT-A goal of providing low- and middle-income countries with the health supplies they need to help bring the acute phase of the pandemic to an end.

“An undertaking of this magnitude requires immediate support, which is why UNICEF has established the ACT-A Supplies Financing Facility,” said Etleva Kadilli, Director of UNICEF Supply Division. “The facility serves as one of the most efficient and most impactful vehicles for supporting the global COVID-19 response by making targeted interventions to get supplies to where they are needed at competitive prices.”

The Government of Denmark has contributed to the fund with a donation of US$4.8 million for immunization supplies to be used in Africa. These supplies will include cold chain and personal protective equipment (PPE) that are essential for carrying out safe COVID-19 immunization campaigns…

The launch of the SFF also complements UNICEF’s efforts to accelerate access to lifesaving supplies, including vaccines and other non-immunization commodities, through its Vaccine Independence Initiative (“VII”) financial mechanism. In 2020, VII supplied hundreds of millions of doses of vaccines for non-COVID-19 immunizations, as well as millions of gloves, masks and medical supplies, as well as other essential commodities.

Milestones :: Perspectives :: Research

New York Times
March 31, 2021
See How Rich Countries Got to the Front of the Vaccine Line
By Keith Collins and Josh Holder
More than half a billion vaccine doses have been administered worldwide so far, and well over three-quarters of them have been used by the world’s richest countries. The reason, experts say, lies in how — and when — deals for doses were struck…

…The result has been that, as of March 30, 86 percent of shots that have gone into arms worldwide have been administered in high- and upper-middle-income countries. Only 0.1 percent of doses have been administered in low-income countries…

…But even with that influx, poor countries may end up waiting years before their populations can be fully vaccinated. Kenya, for example, expects that by 2023 it will have just 30 percent of its population vaccinated, and that’s with Covax covering the first 20 percent. That long wait would give the virus more time to spread, and potentially give rise to new mutations.
The global race for doses has also affected which countries get which vaccines. With much of the supply of the Pfizer and Moderna vaccines already spoken for by wealthier countries, China, India and Russia have become important suppliers of vaccines to lower-income countries. And some experts believe those governments can use such relationships to gain sway…

Milestones :: Perspectives :: Research

Coronavirus [COVID-19] – WHO
Public Health Emergency of International Concern (PHEIC)
https://www.who.int/emergencies/diseases/novel-coronavirus-2019

Weekly Epidemiological and Operational updates
Last update: 23 January 2021
Confirmed cases :: 129 902 402 [week ago: 125 781 957] [two weeks ago: 121 969 223]
Confirmed deaths :: 2 831 815 [week ago: 2 759 432] [two weeks ago: 2 694 094]
Countries, areas or territories with cases :: 223

::::::

29 March 2021
Weekly operational update on COVID-19 – 29 March 2021

30 March 2021
Weekly epidemiological update on COVID-19 – 30 March 2021
Overview
Globally, new COVID-19 cases rose for a fifth consecutive week, with just over 3.8 million new cases reported in the last week. The number of new deaths increased for the second consecutive week, increasing by 5% compared to last week, with over 64 000 new deaths reported. All regions reported an increase in the number of cases this week, and all regions, except for the African Region, reported an increase in the number of deaths. The European Region and the Region of the Americas continue to account for nearly 80% of all the cases and deaths.
In this edition, special focus updates are provided on:
:: COVID-19 and Health and Care Workers (HCWs)
:: SARS-CoV-2 variants

::::::

WHO – Feature COVID stories from around the globe
31 March 2021
Zimbabwe: Data-driven decisions maintain availability and access to essential health services during the COVID-19 response

31 March 2021
WHO advises that ivermectin only be used to treat COVID-19 within clinical trials

30 March 2021
Uzbekistan strengthens its health system in the midst of COVID-19 crisis

29 March 2021
Caribbean countries boost the capacities of nurses in critical care during COVID-19

Milestones :: Perspectives :: Research

WHO – COVID Vaccines EUAL, Prequalification

Draft landscape and tracker of COVID-19 candidate vaccines
12 March 2021  | Publication
The COVID-19 candidate vaccine landscape and tracker database compiles detailed information on COVID-19 vaccine candidates in development.
The landscape is updated regularly – twice a week (Tuesday and Friday, 17:00 CET).
Download: https://cdn.who.int/media/docs/default-source/blue-print/12.03.2021-novel-coronavirus_landscape_covid-19.xlsx.zip?sfvrsn=c2a25511_3&download=true

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Status of COVID-19 Vaccines within WHO EUL/PQ evaluation process 01 April 2021
For 18 vaccine candidates, the presents Manufacturer, Name of Vaccine, NRA of Record, Platform, EOI Accepted Status, Pre-submission Meeting Held Status, Dossier Accepted for Review, Status of Assessment; Anticipated/Completed Decision Date
[click on the link above for full scale view]
*

Milestones :: Perspectives :: Research

UNICEF COVID-19 Vaccine Market Dashboard :: Agreements Table Accessed 3 Apr 2021
An overview of information collected from publicly announced bilateral and multilateral supply agreements [Agreements view from 2021-03-14 to date]

Milestones :: Perspectives :: Research

Our World in Data
Coronavirus (COVID-19) Vaccinations – Fully Vaccinated Population Percentage

Milestones :: Perspectives :: Research

U.S.: COVID-19 Vaccines – Announcements/Regulatory Actions/Deployment

FDA – COVID-19 Vaccines [to 3 Apr 2021]
www.fda.gov/covid19vaccines
News and Updates; Upcoming Events
04/01/2021
Coronavirus (COVID-19) Update: FDA Makes Two Revisions to Moderna COVID-19 Vaccine Emergency Use Authorization to Help Increase the Number of Vaccine Doses Available
Today, the U.S. Food and Drug Administration announced two revisions regarding the number of doses per vial available for the Moderna COVID-19 Vaccine.

White House [U.S.]
Briefing Room
Press Briefing by White House COVID-19 Response Team and Public Health Officials
April 02, 2021 • Press Briefings

Press Briefing by White House COVID-19 Response Team and Public Health Officials
March 31, 2021 • Press Briefings

Press Briefing by White House COVID-19 Response Team and Public Health Officials
March 31, 2021 • Press Briefings

FACT SHEET: President Biden Announces 90% of the Adult U.S. Population will be Eligible for Vaccination and 90% will have a Vaccination Site Within 5 Miles of Home by April 19
March 29, 2021 • Statements and Releases

Press Briefing by White House COVID-19 Response Team and Public Health Officials
March 29, 2021 • Press Briefings

::::::

COVID Data Tracker April 3, 2021

Milestones :: Perspectives :: Research

Europe: COVID-19 Vaccines – Announcements/Regulatory Actions/Deployment

EMA
News: AstraZeneca COVID-19 vaccine: review of very rare cases of unusual blood clots continues (new)
PRAC, Last updated: 31/03/2021

::::::

European Commission

European Union: Commission Amends Authorization Mechanism for Exports of COVID-19 Vaccines
(Apr. 1, 2021) On March 26, 2021, the European Commission’s Implementing Regulation (EU) 2021/521, which amends the authorization mechanism for exports of COVID-19 vaccines adopted on January 30, 2021, entered into force. The regulation adds the principles of reciprocity and proportionality as new criteria to be considered when a European Union (EU) member state authorizes exports.
[See Milestones above for detail]

Milestones :: Perspectives :: Research

Africa: COVID-19 Vaccines – Announcements/Regulatory Actions/Deployment

No new digest content identified.

Milestones :: Perspectives :: Research

Russia: COVID-19 Vaccines – Announcements/Regulatory Actions/Deployment

Russia: Sputnik V – “the first registered COVID-19 vaccine”
https://sputnikvaccine.com/newsroom/pressreleases/
Press Releases
Sputnik V vaccine authorized in Panama
Press release, 01.04.2021

RDIF and TopRidge Pharma agree to produce over 100 million doses of the Sputnik V vaccine in China
Press release, 01.04.2021

Sputnik V vaccine authorized in Mali
Press release, 30.03.2021

RDIF and Shenzhen Yuanxing Gene-tech agree to produce over 60 million doses of the Sputnik V vaccine in China
Press release, 29.03.2021

Milestones :: Perspectives :: Research

India: COVID-19 Vaccines – Announcements/Regulatory Actions/Deployment

Indian Council for Medical Research (ICMR)
https://www.icmr.gov.in/media.html
No new digest content identified.

Milestones :: Perspectives :: Research

China: COVID-19 Vaccines – Announcements/Regulatory Actions/Deployment

[See China CDC section below]

Milestones :: Perspectives :: Research

COVID Vaccine Developer/Manufacturer Announcements [selected]

AstraZeneca
Press Releases – No new digest announcements identified

Janssen/JNJ
Johnson & Johnson Announces Advance Purchase Agreement with the African Vaccine Acquisition Trust for the Company’s COVID-19 Vaccine Candidate
:: Up to 400 million doses of the Company’s single-shot vaccine candidate will be made available to African Union member states
:: Availability of the vaccine is subject to national regulatory approvals
:: Data have demonstrated vaccine candidate protects against COVID-19 related hospitalization and death in broad geographic regions, including those with variants of significant concern
Mar 29, 2021, 03:09 ET

Moderna
Press Releases
April 1, 2021
Moderna Provides Storage Update & Announces the U.S. FDA Authorizes Up To 15-Doses Per Vial of its COVID-19 Vaccine

March 31, 2021
Moderna to Host Second Annual Virtual Vaccines Day on April 14, 2021

March 29, 2021
Moderna Announces Shipment of 100 Millionth Dose of its COVID-19 Vaccine to the U.S. Government

Novavax
News
GSK to support manufacture of Novavax’ COVID-19 vaccine
– GSK to support manufacture of up to 60 million doses of Novavax’ COVID-19 vaccine
– Manufacturing to take place at GSK UK facility at Barnard Castle
Mar 29, 2021, 16:02 ET

Pfizer
Recent Press Releases
04.01.2021
Pfizer and BioNTech Confirm High Efficacy and No Serious Safety Concerns Through Up to Six Months Following Second Dose in Updated Topline Analysis of Landmark COVID-19 Vaccine Study

03.31.2021
Pfizer-BioNTech Announce Positive Topline Results of Pivotal COVID-19 Vaccine Study in Adolescents

Serum Institute
NEWS & ANNOUNCEMENTS – No new digest announcements identified

Sinovac
Sinovac Announced Buildup of Two Billion Annual Capacity of Its COVID-19 Vaccine
April 01, 2021

Milestones :: Perspectives :: Research

COVID Vaccination: Incentives/Mandates/Certificates/Passports

WHO – Call for public comments: Interim guidance for developing a Smart Vaccination Certificate – Release Candidate 1
19 March 2021 Call for consultation
Interim Guidance pdf: https://cdn.who.int/media/docs/default-source/documents/interim-guidance-svc_20210319_final.pdf?sfvrsn=b95db77d_11&download=true

In response to the Statement on the sixth meeting of the International Health Regulations (2005) Emergency Committee regarding the coronavirus disease (COVID-19) pandemic, and the need for WHO to support Member States to deliver COVID-19 vaccines, at scale, with digital tools, WHO has developed this guidance and technical specifications document, in collaboration with a multi-disciplinary group of experts. The Guidance aims to support WHO Member States in adopting interoperability standards for digital documentation of vaccination status (i.e. Smart Vaccination Certificates). 

It is critical to reiterate that the Smart Vaccination Certificate (SVC) is not intended to serve as an “immunity passport”. Furthermore, as per the “Interim position paper: considerations regarding proof of COVID-19 vaccination for international travellers”, currently, proof of COVID-19 vaccination is not recommended as a condition of departure or entry for international travel. Countries are advised to take a risk-based approach to international travel in the context of COVID-19. Additionally, along with the digital implementation of SVCs, it is recommended that the COVID-19 vaccination status should still be recorded through the paper-based International Certificate for Vaccination, and Prophylaxis based on the model presented in Annex 6 of the IHR.

Due to the constantly evolving context of the COVID-19 pandemic, this document is intended to have three releases prior to the release of the final version, with public feedback and input considered for all three releases. This document is the first of three releases. Release candidate 1 (this document) contains the key business requirements for an SVC for national adoption that includes the prioritized scenarios of use, use cases, key workflows, a core data set with preferred terminology code sets, and an initial FHIR Implementation Guide for the content in Release Candidate 1. This document will also begin to outline the international trust framework and a high-level overview of a governance mechanism.

As this is Release Candidate 1, which is an initial release of the technical specification for the Smart Vaccination Certificate, no digital solutions have met this specification yet.

As part of the public consultation, you can provide constructive feedback on this document by 12 April 2021. Please use the link to the feedback form to provide your comments. For any additional inquiries, please contact smartvaccination@who.int.

Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)

Polio this week as of 31 March 2021

Summary of new WPV and cVDPV viruses this week (AFP cases and ES positives):
:: Afghanistan: five cVDPV2 cases and two cVDPV2 positive environmental samples
:: Pakistan: two WPV1 and one cVDPV2 positive environmental samples
:: Côte d’Ivoire: 34 cVDPV2 positive environmental samples
:: Guinea: one cVDPV2 positive environmental sample
:: Liberia: three cVDPV2 positive environmental samples
:: Niger: one cVDPV2 positive environmental sample
:: Senegal: two cVDPV2 cas es and one positive environmental sample
:: South Sudan: three cVDPV2 positive environmental samples

::::::

Statement by UNICEF Executive Director Henrietta Fore on killing of polio workers in Afghanistan
NEW YORK, 30 March 2021 – “Four polio vaccinators, three of them women, came under attack this morning, March 30, while carrying out their life-saving work for children in Nangarhar province, Jalalabad, Afghanistan. Tragically, the three women were killed.
“UNICEF is outraged by this attack.
“UNICEF expresses its deepest condolences to the families, colleagues and friends of the courageous vaccinators who were at the forefront of efforts to combat the spread of polio and keep Afghanistan’s children safe from this disabling disease.
“Frontline health workers should never be a target of violence. They must be able to carry out their life-saving activities in a safe and secure environment.
“UNICEF has been working for years with the Government, the World Health Organization, the Global Polio Eradication Initiative and partners on polio vaccination campaigns in the country.
“We remain committed to supporting polio eradication efforts in Afghanistan.”

::::::
::::::

WHO/OCHA Emergencies

Editor’s Note:
Continuing with this edition, we include information about the last apparent update evident on the WHO emergency country webpages, recognizing almost universal and significant interims since last update regardless of the level of the emergency listed.

WHO Grade 3 Emergencies [to 3 Apr 2021]

Democratic Republic of the Congo – No new digest announcements [Last apparent update: 12 Jan 2021]
Mozambique floods – No new digest announcements identified [Last apparent update: 3 November 2020]
Nigeria – No new digest announcements identified [Last apparent update: 29 Jun 2020]
Somalia – No new digest announcements identified [Last apparent update: 17 July 2020]
South Sudan – No new digest announcements identified [Last apparent update: 4 February 2020]
Syrian Arab Republic – No new digest announcements identified [Last apparent update: 24 October 2020]
Yemen – No new digest announcements identified [Last apparent update: 30 June 2020]

::::::

WHO Grade 2 Emergencies [to 3 Apr 2021]
Burkina Faso
:: Burkina Faso : visite du ministre de la santé et des Partenaires techniques financie… 01 avril 2021

Iraq
:: COVID Vaccines – Baghdad, 25 March 2021 – Amid a global shortage of COVID-19 vaccines, Iraq has received 336 000 doses of the AstraZeneca COVID-19 vaccine through the COVAX Facility…The AstraZeneca vaccines manufactured by SK-Bio Institute of South Korea arrived on Thursday 25 March 2021

Myanmar
:: 23 March 2021 News release Building Bangladesh Capacity on Infection Prevention and Control

Afghanistan – No new digest announcements identified [Last apparent update: 5 July 2020]
Angola – No new digest announcements identified [Last apparent update: 16 March 2021]
Burundi – No new digest announcements identified [Last apparent update: 04 July 2019]
Cameroon – No new digest announcements identified [Last apparent update: 22 August 2019]
Central African Republic – No new digest announcements identified [Last apparent update: 12 June 2018]
Ethiopia – No new digest announcements identified [Last apparent update: 22 August 2019]
Iran floods 2019 – No new digest announcements identified [Last apparent update: 2 March 2020]
Libya – No new digest announcements identified [Last apparent update: 7 October 2019]
Malawi Floods – No new digest announcements identified [Last apparent update 05 March 2021]
Measles in Europe – No new digest announcements identified [Last apparent update: 16-12-2020]
MERS-CoV – No new digest announcements identified [Last apparent update: 8 July 2019]
Mozambique – No new digest announcements identified [Last apparent update: 03 November 2020]
Niger– No new digest announcements identified [Last apparent update:06 mars 2021]
occupied Palestinian territory – No new digest announcements identified [Last apparent update: 4 September 2019]
HIV in Pakistan – No new digest announcements identified [Last apparent update: 27 August 2019]
Sao Tome and Principe Necrotizing Cellulitis (2017) – No new digest announcements
Sudan – No new digest announcements identified [Last apparent update: 24 June 2020]
Ukraine – No new digest announcements identified [Last apparent update: 1 May 2019]
Zimbabwe – No new digest announcements identified [Last apparent update: 10 May 2019]

::::::

WHO Grade 1 Emergencies [to 3 Apr 2021]

Chad – No new digest announcements identified [Last apparent update: 30 June 2018]
Djibouti – No new digest announcements identified [Last apparent update: 25 novembre 2020]
Kenya – No new digest announcements identified [Last apparent update: 06 March 2021]
Mali – No new digest announcements identified [Last apparent update: 3 May 2017]
Namibia – viral hepatitis – No new digest announcements identified [Last apparent update: 20 July 2018]
Tanzania – No new digest announcements identified [Last apparent update: 21 October 2020]

::::::
::::::

UN OCHA – Current Emergencies
COVID-19 – No new digest announcements identified
Syrian Arab Republic – No new digest announcements identified
Yemen – No new digest announcements identified

::::::
::::::

WHO & Regional Offices [to 3 Apr 2021]
1 April 2021 Departmental news
Living with the Times: new toolkit helps older adults maintain good mental health and wellbeing during the COVID-19 pandemic.

31 March 2021 News release
Carl Bildt, former Prime Minister of Sweden, appointed WHO Special Envoy for the ACT-Accelerator

31 March 2021 Highlights
VSN membership

30 March 2021 Departmental news
New WHO-IUCN Expert Working Group on Biodiversity, Climate, One Health and Nature-based Solutions

30 March 2021 News release
WHO calls for further studies, data on origin of SARS-CoV-2 virus, reiterates that all hypotheses remain open
[See Milestones above for detail]

30 March 2021 News release
Global leaders unite in urgent call for international pandemic treaty
[See Milestones above for detail]

::::::

Weekly Epidemiological Record, Vol. 96, No. 13, pp. 105–112 2 April 2021
:: Pneumococcal vaccines: WHO position paper on their use in community outbreak settings
:: Monthly report on dracunculiasis cases, January-December 2020

::::::

WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: Bolstering community approach in Guinea’s Ebola fight 01 April 2021
A few days after he referred a patient from his clinic to the regional hospital, Emmanuel Goepogui, a private practitioner in N’Zerekore prefecture in south-eastern Guinea, received a visit by a community disease surveillance team. “They came to inform me that my patient had tested positive for Ebola and that I was a direct contact,” he says.
:: Genome sequencing in Ebola response 01 April 2021
Studies show that the Ebola virus can persist in bodily fluids – such as semen and breast milk – of survivors for months. The recent resurgence of Ebola in Guinea and the Democratic Republic of the Congo has been linked to bodily fluids of survivors.
Read more »
:: Better transport can save up 55 000 premature deaths in Accra, WHO report 01 April 2021

WHO Region of the Americas PAHO
No new digest content identified

WHO South-East Asia Region SEARO
No new digest content identified

WHO European Region EURO
:: Slow vaccine roll-out prolonging pandemic 01-04-2021
:: Minimizing COVID-19 risk around religious celebrations as European Region sees resurgence of cases 31-03-2021
:: Regional Director meets TB patients and policy-makers in Kyrgyzstan as COVID-19 continues to threaten health care across the Region 31-03-2021

WHO Eastern Mediterranean Region EMRO
:: Yemen receives 360 000 COVID-19 vaccine doses through the COVAX Facility 31 March 2021
:: WHO committed to ensuring fair distribution of COVID-19 vaccine in Syria 31 March 2021
:: WHO/KSrelief helping children to recover from malnutrition in Yemen 30 March 2021

WHO Western Pacific Region
No new digest content identified

CDC/ACIP [U.S.] [to 3 Apr 2021]
http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html
Latest News Releases, Announcements
CDC Issues Next Phase of the Conditional Sail Order for Cruise Ship Operators
Friday, April 2, 2021

CDC Issues Updated Guidance on Travel for Fully Vaccinated People
Friday, April 2, 2021
… Given recent studies evaluating the real-world effects of vaccination, CDC recommends that fully vaccinated people can travel at low risk to themselves. A person is considered fully vaccinated two weeks after receiving the last recommended dose of vaccine.
Fully vaccinated people can travel within the United States and do not need COVID-19 testing or post-travel self-quarantine as long as they continue to take COVID-19 precautions while traveling – wearing a mask, avoiding crowds, socially distancing, and washing hands frequently…

CDC Real-World Study Confirms Protective Benefits of mRNA COVID-19 Vaccines
Monday, March 29, 2021
A new CDC study provides strong evidence that mRNA COVID-19 vaccines are highly effective in preventing SARS-CoV-2 infections in real-world conditions among health care personnel, first responders, and other essential workers.  These groups are more likely than the general population to be exposed to the virus because of their occupations.
The study looked at the effectiveness of Pfizer-BioNTech and Moderna mRNA vaccines in preventing SARS-CoV-2 infections among 3,950 study participants in six states over a 13-week period from December 14, 2020 to March 13, 2021.
Results showed that following the second dose of vaccine (the recommended number of doses), risk of infection was reduced by 90 percent two or more weeks after vaccination. Following a single dose of either vaccine, the participants’ risk of infection with SARS-CoV-2 was reduced by 80 percent two or more weeks after vaccination…

MMWR News Synopsis Friday, April 2, 2021
:: Use of Selected Recommended Clinical Preventive Services — Behavioral Risk Factor Surveillance System, United States, 2018
:: Community-Associated Outbreak of COVID-19 in a Correctional Facility — Utah, September 2020–January 2021
:: Willingness to Receive a COVID-19 Vaccination Among Incarcerated or Detained Persons in Correctional and Detention Facilities — Four States, September–December 2020
:: Rapid Spread of SARS-CoV-2 in a State Prison After Introduction by Newly Transferred Incarcerated Persons — Wisconsin, August 14–October 22, 2020
:: Counties with High COVID-19 Incidence and Relatively Large Racial and Ethnic Minority Populations — United States, April 1–December 22, 2020 (Early Release March 24, 2021)
:: Symptoms of Anxiety or Depressive Disorder and Use of Mental Health Care Among Adults During the COVID-19 Pandemic — United States, August 2020–February 2021 (Early Release March 26, 2021)
:: Interim Estimates of Vaccine Effectiveness of BNT162b2 and mRNA-1273 COVID-19 Vaccines in Preventing SARS-CoV-2 Infection Among Health Care Personnel, First Responders, and Other Essential and Frontline Workers — Eight U.S. Locations, December 2020–March 2021 (Early Release March 29, 2021)

Coronavirus Disease 2019 (COVID-19)– CDC
Selected Resources
:: Overall US COVID-19 Vaccine Distribution and Administration Update as of Fri, 02 Apr 2021 06:00:00 EST

:: Science Brief: Background Rationale and Evidence for Public Health Recommendations for Fully Vaccinated People
Key Points
:: COVID-19 vaccines currently authorized in the United States are effective against COVID-19, including severe disease.
:: Preliminary evidence suggests that the currently authorized COVID-19 vaccines may provide some protection against a variety of strains, including B.1.1.7 (originally identified in the United Kingdom). :: Reduced antibody neutralization and efficacy have been observed for the B.1.351 strain (originally identified in South Africa). However, across studies, antibody neutralizing activity of sera from vaccinated people was still generally higher than that observed for convalescent sera from people who have recovered from COVID-19.
:: A growing body of evidence suggests that fully vaccinated people are less likely to have asymptomatic infection and potentially less likely to transmit SARS-CoV-2 to others. However, further investigation is ongoing.
:: Modeling studies suggest that preventive measures such as mask use and social distancing will continue to be important during vaccine implementation. However, there are ways to take a balanced approach by allowing vaccinated people to resume some lower-risk activities.
:: Taking steps towards relaxing certain measures for vaccinated people may help improve COVID-19 vaccine acceptance and uptake.
:: The risks of SARS-CoV-2 infection in fully vaccinated people cannot be completely eliminated as long as there is continued community transmission of the virus. Vaccinated people could potentially still get COVID-19 and spread it to others. However, the benefits of relaxing some measures such as testing and self-quarantine requirements for travelers, post-exposure quarantine requirements and reducing social isolation may outweigh the residual risk of fully vaccinated people becoming ill with COVID-19 or transmitting the virus to others.
:: At this time, there are limited data on vaccine protection in people who are immunocompromised. People with immunocompromising conditions, including those taking immunosuppressive medications, should discuss the need for personal protective measures after vaccination with their healthcare provider.
:: See updated guidance for fully vaccinated people including updated public health recommendations for domestic and international travel. This updated science brief reflects recent changes to the guidance document and will continue to be updated as more information becomes available.

Africa CDC [to 3 Apr 2021]
http://www.africacdc.org/
News
Statement of the Chairperson of the Africa CDC Governing Board on the Renewal of the Mandate of the Africa CDC Inaugural Director, Dr. John N. Nkengasong
29 March 2021
The Governing Board of Africa CDC held an Extraordinary meeting on February 20th, 2021 and deliberated on the renewal of the second four-year mandate of the Africa CDC’s Director, Dr. John N. Nkengasong.
The Board congratulated Dr. John N. Nkengasong for the tremendous work accomplished in his first term to build a respectable public health institution that is now well recognized globally.
The remarkable progress made by Africa CDC in supporting Member States to respond to the COVID-19 pandemic and Ebola outbreaks in Africa were highlighted.
The Board decided by an overwhelming majority to recommend to the Commission the renewal of the mandate of Dr John N. Nkengasong for a second four-year term in line with the Statute
of Africa CDC..

China CDC
http://www.chinacdc.cn/en/
No new digest content identified.

National Health Commission of the People’s Republic of China [to 3 Apr 2021]
http://en.nhc.gov.cn/
News
April 3: Daily briefing on novel coronavirus cases in China
On April 2, 31 provincial-level regions and the Xinjiang Production and Construction Corps on the Chinese mainland reported 26 new cases of confirmed infections.

Data sharing thorough in WHO report, expert says
2021-04-01

Foreign, Chinese experts had same access to virus data: Leading expert
2021-04-01

No animal products sampled in Huanan market tested positive: expert
2021-04-01

China, WHO joint research to boost global cooperation in COVID-19 origin tracing: spokesperson
2021-03-31

China providing vaccine aid to 80 countries, 3 int’l organizations: FM spokesperson
2021-03-31

WHO highlights importance to investigate early COVID-19 cases in different countries
2021-03-31

National Medical Products Administration – PRC [to 3 Apr 2021]
http://english.nmpa.gov.cn/news.html
News
Nearly 120m COVID-19 vaccine doses administered across China
2021-04-02
A total of 119.82 million doses of COVID-19 vaccines had been administered across China as of Wednesday, the National Health Commission said on April 1.

WHO: Animal-to-human virus transmission most likely
2021-03-31
The virus that caused the COVID-19 pandemic is “extremely unlikely” to have originated in a lab, but most likely jumped from an animal to humans, according to a World Health Organization report released on March 30 by a joint international and Chinese team probing the virus’ origins.
[See COVID above for WHO statement]

Country working on vaccines for novel coronavirus variants
2021-03-29
China is advancing the development of COVID-19 vaccines against variants of the novel coronavirus, and experiments have shown the inactivated vaccines currently used in the country are effective against them.

Organization Announcements
Editor’s Note:
Careful readers will note that the number and range of organizations now monitored in our Announcements section below has grown as the impacts of the pandemic have spread across global economies, supply chains and programmatic activity of multilateral agencies and INGOs.

Paul G. Allen Frontiers Group [to 3 Apr 2021]
https://alleninstitute.org/what-we-do/frontiers-group/news-pr ess/
News
No new digest content identified.

BARDA – U.S. Department of HHS [to 3 Apr 2021]
https://www.phe.gov/about/barda/Pages/default.aspx
News
March 31, 2021: HHS launches $500,000 contest for design of new, effective, comfortable masks for general public use
…, the Biomedical Advanced Research and Development Authority (BARDA) is collaborating with the National Institute for Occupational Safety and Health, part of the U.S. Centers for Disease Control and Prevention, on the personal use mask design challenge. NIOSH administers the nation’s respirator approval program.
The first phase of the challenge, which opens today, invites new mask designs that meet specific criteria and asks the submitter to describe how that design idea fits the criteria and solves the hurdles to mask wearing. Up to 10 winning ideas will be selected to split $100,000. Submissions are due by 5 p.m. EDT April 21, 2021…

BMGF – Gates Foundation [to 3 Apr 2021]
https://www.gatesfoundation.org/ideas/media-center
Press Releases and Statements
No new digest content identified.

Bill & Melinda Gates Medical Research Institute [to 3 Apr 2021]
https://www.gatesmri.org/
The Bill & Melinda Gates Medical Research Institute is a non-profit biotech organization. Our mission is to develop products to fight malaria, tuberculosis, and diarrheal diseases—three major causes of mortality, poverty, and inequality in developing countries. The world has unprecedented scientific tools at its disposal; now is the time to use them to save the lives of the world’s poorest people
No new digest content identified.

CARB-X [to 3 Apr 2021]
https://carb-x.org/
News
03.30.2021  |
CARB-X is funding University of Oxford’s Jenner Institute to develop a new vaccine to prevent gonorrhea
CARB-X is awarding up to US$2 million to the Jenner Institute, part of the University of Oxford, UK, to develop a novel vaccine to prevent gonorrhea, a common sexually-transmitted bacterial infection that has developed resistance to most antibiotics. Under the award, the Institute would be eligible for up to $5.3 million more if the project progresses through certain project milestones, subject to available funding.

Center for Vaccine Ethics and Policy – GE2P2 Global Foundation [to 3 Apr 2021]
https://centerforvaccineethicsandpolicy.net/
News/Analysis/Statements
:: Past weekly editions of Vaccines and Global Health: The Week in Review are available here.

CEPI – Coalition for Epidemic Preparedness Innovations [to 3 Apr 2021]
http://cepi.net/
Latest News
CEPI launches funding call to advance development of broadly protective coronavirus vaccines
:: Up to US$200 million in funding to be allocated for development of vaccines that provide broad protection against SARS-CoV-2 and betacoronaviruses.
:: R&D will focus on novel immunogens for use in vaccines that can elicit durable broadly protective immune responses.
:: Funding call forms part of CEPI’s longer term $3.5bn investment strategy, announced earlier in March, 2021, which is being activated now to mitigate the urgent threat posed by COVID-19.
31 Mar 2021

CEPI Board membership updates
30 Mar 2021
CEPI is pleased to announce that Professor Dr Veronika von Messling has been appointed to the Board where she will sit as an Investor representative. Dr von Messling replaces Dr Joachim Klein, who has stood down after 3 years of service.
Alongside her role on the Board, Dr von Messling will also join the Nominations, Compensation, Diversity and Inclusion committee.
Dr von Messling is Director General of the Life Science Division at the German Federal Ministry of Education and Research…

DARPA – Defense Advanced Research Projects Agency [to 3 Apr 2021
https://www.darpa.mil/news
News
No new digest content identified.

Duke Global Health Innovation Center [to 3 Apr 2021]
https://dukeghic.org/
No new digest content identified.

EDCTP [to 3 Apr 2021]
http://www.edctp.org/
The European & Developing Countries Clinical Trials Partnership (EDCTP) aims to accelerate the development of new or improved drugs, vaccines, microbicides and diagnostics against HIV/AIDS, tuberculosis and malaria as well as other poverty-related and neglected infectious diseases in sub-Saharan Africa, with a focus on phase II and III clinical trials
No new digest content identified.

Emory Vaccine Center [to 3 Apr 2021]
http://www.vaccines.emory.edu/
Vaccine Center News
No new digest content identified.

European Commission [to 3 Apr 2021]
http://europa.eu/rapid/search-result.htm?query=18&locale=en&page=1
Latest
Statement 31 March 2021
Statement of Commissioner Reynders on the referral of Poland to the European Court of Justice to protect independence of Polish judges and asks for interim measures

Press release 31 March 2021
Rule of Law: European Commission refers Poland to the European Court of Justice to protect independence of Polish judges and asks for interim measures
Today, the European Commission decided to refer Poland to the Court of Justice of the European Union regarding the law on the judiciary of 20 December 2019, which entered into force on 14 February 2020.

Press release 30 March 2021
Syrian crisis: €5.3 billion mobilised by donors for 2021 and beyond at 5th Brussels Conference
At the fifth Brussels Conference on ‘Supporting the future of Syria and the Region’ co-chaired today by the European Union and the United Nations, the international community pledged €5.3 billion for 2021 and beyond for Syria and the neighbouring countries hosting Syrian refugees.

European Medicines Agency [to 3 Apr 2021]
http://www.ema.europa.eu/ema/
News & Press Releases
News: AstraZeneca COVID-19 vaccine: review of very rare cases of unusual blood clots continues (new)
PRAC, Last updated: 31/03/2021

News: EU recommendations for 2021-2022 seasonal flu vaccine composition (new)
Last updated: 30/03/2021

European Vaccine Initiative [to 3 Apr 2021]
http://www.euvaccine.eu/
Latest News
No new digest content identified.

FDA [to 3 Apr 2021]
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
Press Announcements /Selected Details
April 2, 2021 – Coronavirus (COVID-19) Update: April 2, 2021

March 30, 2021 – Coronavirus (COVID-19) Update: March 30, 2021

Fondation Merieux [to 3 Apr 2021]
http://www.fondation-merieux.org/
News, Events
Mérieux Foundation co-organized event
Vaccine Acceptance webinars: managing vaccine misinformation in the midst of a pandemic
April 15, 2021 – Virtual Event

Gavi [to 3 Apr 2021]
https://www.gavi.org/
News Releases
31 March 2021
Gavi and Save the Children form global partnership to immunise zero-dose and vulnerable children
:: The partnership will focus on reaching children who are currently receiving no routine vaccines and marginalised communities in line with Gavi’s vision to ‘leave no-one behind with immunisation’
:: In addition, the partnership will support equitable access to COVID-19 vaccines by engaging with community champions on joint activities
:: Anuradha Gupta: “A disproportionate number of children who are not receiving vaccines come from hard-to-reach areas including fragile and conflict settings which is why we’re delighted to partner with Save the Children whose worldwide network and deep expertise will enable us to reach them”

29 March 2021
United States to host launch event for Gavi COVAX AMC 2021 investment opportunity
:: The virtual event will bring together world leaders, the private sector, civil society, and key technical partners to galvanize resources and commitment to the Gavi COVAX Advance Market Commitment (AMC)
:: The event, featuring the Secretary of State and the USAID Administrator on behalf of the United States government, and Gavi Board Chair José Manuel Barroso, will take place on April 15
:: The Gavi COVAX AMC is a financing mechanism that supports access to COVID-19 vaccines for 92 lower-income economies

GHIT Fund [to 3 Apr 2021]
https://www.ghitfund.org/newsroom/press
GHIT was set up in 212 with the aim of developing new tools to tackle infectious diseases that
March 31, 2021
GHIT Fund Announces New Investments: A Total of 2.3 Billion Yen in Drugs for Malaria, Tuberculosis, Chagas Disease and Visceral Leishmaniasis, Vaccine for Malaria and Diagnostics for Tuberculosis
… As of March 31, GHIT’s portfolio includes 57 ongoing projects, including 30 in discovery stages, 20 in preclinical and seven in clinical trials (Appendix 3). The total amount of investments since 2013 is 25.1 billion yen (US$236 million).

Global Fund [to 3 Apr 2021]
https://www.theglobalfund.org/en/news/
News & Stories
News
The Global Fund’s Sixth Partnership Forums Generate Recommendations for the Next Global Fund Strategy
01 April 2021
The Sixth Partnership Forums ended on 15 March, having convened approximately 350 representatives from across the Global Fund partnership in a series of engaging, inclusive and energetic discussions to contribute to the development of the next Global Fund Strategy…

Global Research Collaboration for Infectious Disease Preparedness [GloPID-R] [to 3 Apr 2021]
https://www.glopid-r.org/news/
News
No new digest content identified.

Hilleman Laboratories [to 3 Apr 2021]
http://www.hillemanlabs.org/
No new digest content identified.

Human Vaccines Project [to 3 Apr 2021]
http://www.humanvaccinesproject.org/media/press-releases/
No new digest content identified.

IAVI [to 3 Apr 2021]
https://www.iavi.org/newsroom
PRESS RELEASES/FEATURES
FEATURES
April 2, 2021
Donor Spotlight: Government of India
IAVI recognizes the Government of India for their unwavering support of the development of safe, effective, accessible, preventive HIV vaccines and biomedical prevention products for use throughout the world.

International Coalition of Medicines Regulatory Authorities [ICMRA]
http://www.icmra.info/drupal/en/news
Selected Statements, Press Releases, Research
No new digest content identified.

International Generic and Biosimilar Medicines Association [IGBA]
https://www.igbamedicines.org/
*News
Press Releases/Announcements
No new digest content identified.

IFFIm
http://www.iffim.org/
Press Releases/Announcements
No new digest content identified.

IFRC [to 3 Apr 2021]
http://media.ifrc.org/ifrc/news/press-releases/
Selected Press Releases, Announcements
Global
Statement on International Treaty on Pandemics “We need bold new solutions – both in international and domestic laws – to avoid the same mistakes”
Geneva, 30 March 2021 In response to a common call for an International Treaty on Pandemics by the WHO and world leaders today, Jagan Chapagain, Secretary General of the International Federation of Red Cross Red Crescent Societies, said: We are encouraged by this commitment from the WHO and world leaders today to develop a new treaty on pandemic prevention and response. The COVID-19 response has been hugely impaired by gaps in global cooperation and inequities affecting some of the most vulnerable of our societies. This treaty is an opportunity to address these for the next time.
“We need bold new solutions – both in international and domestic laws – to avoid the same mistakes. These must include a firm commitment to preparedness at all levels of society, including at the community level, and equitable access to testing, vaccines and treatment for all at greatest risk. We must also ensure that health and emergency staff and volunteers are supported to operate safely to provide life-saving aid, and access communities in need. And we must guard against the economic ruin of the poorest and most vulnerable as a result of pandemic responses.
“With our experience in supporting states to develop and implement disaster law and policy around the world, IFRC and its members stand ready to provide their expertise and advice to governments and to support such a treaty to not only be powerful on paper but transformative in reality.”

Institut Pasteur [to 3 Apr 2021]
https://www.pasteur.fr/en/press-area
No new digest content identified.

IRC International Rescue Committee [to 3 Apr 2021]
http://www.rescue.org/press-release-index
Media highlights [Selected]
Press Release
Statement from the International Rescue Committee on the Generation Equality Forum
April 1, 2021

Statement
Ethiopia: IRC statement on the killing of humanitarian aid workers
April 1, 2021

Press Release
Las continuas caravanas migrantes son síntomas de la emergencia en el norte de Centroamérica, advierte IRC
March 31, 2021

Press Release
Ongoing migrant caravans are symptoms of the emergencies in northern Central America, warns IRC
March 31, 2021

Press Release
México: Postura del IRC sobre la muerte de Victoria Salazar
March 30, 2021

IVAC [to 3 Apr 2021]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
Updates; Events
Improving the Health of Women and Children in India
March 2021 A Director’s Message
On New Year’s Day in 2021, approximately 68,000 babies were born across India. Their mothers would have traversed the arduous journey of pregnancy to reach the miraculous day of their birth. How many of these babies will be alive and thriving by the end of the year 2021? About five decades ago, […]

IVI [to 3 Apr 2021]
http://www.ivi.int/
Selected IVI News, Announcements, Events
International Vaccine Institute and Institut Pasteur Korea Sign MOU for Research and Development of Infectious Disease Therapeutics and Vaccines
April 1, 2021, GYEONGDO-DO and SEOUL, Korea – The International Vaccine Institute (IVI) and the Institut Pasteur Korea (IPK) signed a memorandum of understanding (MOU) for mutual collaboration in the research and development of therapeutics and vaccines for infectious diseases…
Towards the shared goal of improving public health, the IPK and IVI will promote research collaboration and information exchange, holding joint workshops and seminars to connect biomedical scientists and infectious disease experts of the two organizations and their partners worldwide.
In particular, the collaboration combines IPK’s research and technology in infectious disease and IVI’s capabilities and know-how in developing and designing new vaccines and in supporting clinical trials to accelerate new therapeutics and vaccine development. IPK and IVI have common fields of research interest in COVID-19, MERS, Dengue, TB, etc…

JEE Alliance [to 3 Apr 2021]
https://www.jeealliance.org/
Selected News and Events
No new digest content identified.

Johns Hopkins Center for Health Security [to 3 Apr 2021]
https://www.centerforhealthsecurity.org/news/center-news/
Center News
No new digest content identified.

MSF/Médecins Sans Frontières [to 3 Apr 2021]
http://www.msf.org/
Latest [Selected Announcements
Democratic Republic of Congo
In DRC, measles is spreading and killing again in what seems to be a never-ending fight
Project Update 31 Mar 2021

Coronavirus COVID-19 pandemic
“Only vaccination will end the ferocious spread of COVID-19 in Iraq”
Op-Ed 31 Mar 2021

Tuberculosis
Sustainable solutions for children and adolescents at risk of drug-resistant tuberculosis
Project Update 30 Mar 2021

National Academy of Medicine – USA [to 3 Apr 2021]
https://nam.edu/programs/
Accessed 3 April 2021
Programs
Advancing Pandemic and Seasonal Influenza Vaccine Preparedness and Response
An International Committee will inform and facilitate efforts to advance global influenza pandemic preparedness. This International Committee will provide an iterative, interactive, multi-disciplinary, expert-informed process for assessing the global impact that capabilities, technologies, processes, and policies developed for COVID-19 could have on pandemic and seasonal influenza global preparedness and response, especially regarding vaccine development.
Upcoming Events:
:: Overview of Vaccine Science: Establishing Priorities to Improve Influenza Vaccines (April 15)
:: Major Barriers to Effective Global Coordination and Financing for Influenza Vaccination- Day 1 (April 9)
:: Major Barriers to Effective Global Coordination and Financing for Influenza Vaccination- Day 2 (April 16)
Past Events:
Overview of Vaccine Science: Existing Evidence and Lessons from COVID-19 (March 30)

National Vaccine Program Office – U.S. HHS [to 3 Apr 2021]
https://www.hhs.gov/vaccines/about/index.html
Upcoming Meetings/Latest Updates
No new digest content identified.

NIH [to 3 Apr 2021]
http://www.nih.gov/news-events/news-releases
News Releases
NIH clinical trial evaluating Moderna COVID-19 variant vaccine begins
March 31, 2021 — Early-stage trial to evaluate safety and immunogenicity.

CDC and NIH bring COVID-19 self-testing to residents in two locales
March 31, 2021 — Participating households will receive free month-long supply of rapid tests aimed at reducing community transmission.

T cells recognize recent SARS-CoV-2 variants
March 30, 2021 — NIH research suggests protective effects of vaccination remain intact.

UN OCHA Office for the Coordination of Humanitarian Affairs [to 3 Apr 2021]
https://www.unocha.org/
Press Releases
No new digest content identified.

PATH [to 3 Apr 2021]
https://www.path.org/media-center/
Press Releases
No new digest content identified.

Sabin Vaccine Institute [to 3 Apr 2021]
http://www.sabin.org/updates/pressreleases
Statements and Press Releases
No new digest content identified.

UNAIDS [to 3 Apr 2021]
http://www.unaids.org/en
Selected Press Releases/Reports/Statements
1 April 2021
President of Afghanistan declares ‘unwavering support’ for a People’s Vaccine for COVID-19

1 April 2021
New study recommends strategies to serve the under-protected Caribbean transgender community

31 March 2021
UNAIDS joins human rights community in mourning Christof Heyns, legal academic and expert

31 March 2021
(Wo)man in the Mirror: seeing your true self

30 March 2021
Solidarity fund helping transgender people during the COVID-19 pandemic

30 March 2021
Fighting transphobia and violence one social media post at a time

30 March 2021
Transgender communities in Asia and the Pacific respond to COVID-19 through activism

UNDP United Nations Development Programme [to 3 Apr 2021]
http://www.undp.org/content/undp/en/home/presscenter.html
Latest from News Centre
UNDP releases SDG Impact Standards for Bond Issuers
SDG Impact Standards are already being piloted in the market with New Development Bank’s (NDB) SDG bond issuance in China Interbank Bond Market earlier this month.
Posted on April 1, 2021

New UNDP study reveals the magnitude of limited debt relief eligibility for developing economies
Two-thirds of external ‘debt service at risk’ is not covered by current relief initiatives, putting at risk years of progress on poverty and the future resources needed to deal with climate change
Posted on April 1, 2021

UNESCO [to 3 Apr 2021]
http://en.unesco.org/news
Selected Latest News
No new digest content identified.

UNHCR Office of the United Nations High Commissioner for Refugees [to 3 Apr 2021]
http://www.unhcr.org/en-us/media-centre.htmlS
Selected Announcements
News Comment: Six refugees among 137 killed in Niger’s recent attack
This news comment is attributable to Gillian Triggs, UNHCR’s Assistant High Commissioner for Protection
1 Apr 2021

News comment: UNHCR calls on Myanmar’s neighbours to protect people fleeing violence
This news comment is attributable to Gillian Triggs, UNHCR’s Assistant High Commissioner for Protection
31 Mar 2021

UNHCR alarmed at brutal attacks by insurgent armed group in Mozambique
30 Mar 2021

UNHCR rushing support and aid to Rohingya refugees affected by last week’s massive fire
30 Mar 2021

United Nations Chiefs urge donors to support record appeals for Syrians and the region
Joint OCHA/UNHCR/UNDP Press Release
29 Mar 2021

UNICEF [to 3 Apr 2021]
https://www.unicef.org/media/press-releases
Selected press releases, news notes and statements
Press release 04/01/2021
Pre-pandemic data show 1 in 8 countries spends more on debt than on education, health and social protection combined – UNICEF
UNICEF is calling for the extension of debt service relief and debt restructuring so that countries – and their children – can bounce back

Press release 03/31/2021
Yemen receives 360,000 COVID-19 vaccine doses through the COVAX Facility
… The AstraZeneca vaccines licensed and manufactured by the Serum Institute of India will enable health workers and other priority populations vulnerable to COVID-19 to be protected against the virus…

Statement 03/30/2021
Statement by UNICEF Executive Director Henrietta Fore on killing of polio workers in Afghanistan
[See Polio above for detail]

Press release 03/30/2021
UNICEF fund aims to raise US$2.5 billion for COVID-19 health supplies; low- and middle-income countries set to benefit
Denmark makes first donation to support the global equitable access to COVID-19 tests, treatments and vaccines
[See COVID above for detail]

Statement 03/29/2021
UNICEF Executive Director Henrietta Fore’s remarks at the World Immunisation & Logistics Summit, hosted by the HOPE Consortium

Unitaid [to 3 Apr 2021]
https://unitaid.org/
Featured News
31 March 2021
Unitaid statement regarding Ivermectin as a potential COVID-19 treatment
Geneva – Ivermectin, as well as other repurposed and new products, has been under evaluation in clinical trials as a potential treatment for COVID-19.
After updating the independent living network meta-analysis, the WHO Guidelines Development Group has updated the WHO Living Guidelines: Therapeutics and COVID-19 (today March 31).  In this updated version, WHO recommends not to use ivermectin in patients with COVID-19 except in the context of clinical trials based on very low certainty of evidence.
Unitaid, in collaboration with the University of Liverpool, has tracked the evidence available for ivermectin from randomised clinical studies from around the world, with various studies still to be completed.
In addition, to support the acquisition of the necessary remaining evidence as soon as possible, the ANTICOV consortium – coordinated by DNDi and partly funded by Unitaid – is preparing to add ivermectin in a combination therapy, as a new treatment arm to the clinical trial. This large platform trial aims to identify treatments that can be used to treat mild and moderate cases of COVID-19, preventing them from progressing to severe COVID-19, and is being conducted in 13 countries in Africa, nine of which are funded by Unitaid.”

Vaccination Acceptance Research Network (VARN) [to 3 Apr 2021]
https://vaccineacceptance.org/news.html#header1-2r
Announcements
No new digest content identified.

Vaccine Confidence Project [to 3 Apr 2021]
http://www.vaccineconfidence.org/
News, Research and Reports
Coronavirus global impact
Launched April 2, 2020 and recurring every 3 days, Premise Data is utilizing its global network of Contributors to assess economic, social, and health sentiment surrounding the coronavirus (COVID-19).

Vaccine Education Center – Children’s Hospital of Philadelphia [to 3 Apr 2021]
http://www.chop.edu/centers-programs/vaccine-education-center
News
No new digest content identified.

Wellcome Trust [to 3 Apr 2021]
https://wellcome.ac.uk/news
News and reports
Explainer
Why is a global Covid-19 vaccine rollout vital?
30 March 2021

Opinion
Our new funding will support bold and creative discovery research to improve health
29 March 2021
Michael Dunn shares more information about our new discovery research funding schemes, and the role of the Discovery Research team in Wellcome’s new strategy.

The Wistar Institute [to 3 Apr 2021]
https://www.wistar.org/news/press-releases
Press Releases
Apr. 1, 2021
Wistar Scientists Discover New Mechanism Through Which Senescent Cells Turn On Genes That Encode for Secreted Tumor-regulating Factors
New insights into expression of the senescence-associated secretory phenotype.

WFPHA: World Federation of Public Health Associations [to 3 Apr 2021]
https://www.wfpha.org/
Latest News
Stop Blocking the Scale-up of Vaccines and Put Health over Profit!
Mar 31, 2021
On the occasion of World Health Day, WFPHA has joined a broad coalition of civil society organisations across Europe urgently calling on governments and EU institutions to implement a COVID-19 response based on global solidarity and to act to ensure that COVID-19 vaccines and medical products are available to everyone, everywhere in the world by waiving intellectual property rights (IPR) and sharing know-how and technology widely.

World Bank [to 3 Apr 2021]
http://www.worldbank.org/en/news/all
Selected News, Announcements
Event – COVID-19: Vaccines for Developing Countries
Friday, April 9th | 11:00 am ET
The rollout of COVID-19 vaccines in developing countries is critical to protecting lives, building human capital, and stimulating economic recovery. The current crisis is exacerbating inequalities throughout the world and, without access to vaccines, the gap will widen further. Ensuring developing countries can access, as well as safely distribute vaccines, calls for strong partnership and cooperation at the national, regional & global levels. This event will explore:
:: The work underway in developing countries to prepare for large scale vaccine rollouts; the strengths and gaps in country readiness; measures to ensure access and distribution; and the importance of partnerships and cooperation across all stakeholders for success.
:: The private sector’s essential role in driving innovation, production and manufacturing to meet the enormous needs for COVID-19 vaccines, tests and therapeutics.
:: Taking a broad view of COVID-19 to reflect on opportunities and challenges across research, finance and policy, as we work to build more resilient health and economic systems now –and in the future.

Government of Nepal and World Bank sign $75 million additional financing agreement for COVID-19 vaccines
KATHMANDU, April 2, 2021 – The Government of Nepal and the World Bank today signed an agreement for additional financing of $75 million to support access to safe and effective COVID-19 vaccines for…
Date: April 02, 2021 Type: Press Release

WBG Vaccine Announcement– Key Facts
COVID-19 vaccines, alongside widespread testing, improved treatment and strong health systems are critical to save lives and strengthen the global economic recovery. To provide relief for vulnerable populations…
Date: March 30, 2021 Type: Factsheet

World Customs Organization – WCO [to 3 Apr 2021]
http://www.wcoomd.org/
Latest News – Selected Items
30 March 2021
COVID-19 vaccine awareness: WCO completes three series of webinars involving the private sector
The World Customs Organization (WCO) successfully carried out three series of webinars between late January and late March 2021, to raise awareness about COVID-19 vaccines. The first series of webinars was held from 21 to 28 January in collaboration with Pfizer, the second from 15 to 17 March with Moderna, and the third one on 24 and 25 March with AstraZeneca.
The 11 webinars, which brought together more than 1,300 participants in total, focused on the essential specifications of COVID-19 vaccines as well as details of their distribution patterns, the aim being to make Customs better equipped to identify counterfeit or sub-standard COVID-19 vaccines at borders and curb trafficking, notably during this important period of COVID-19 vaccine delivery to governments…

World Organisation for Animal Health (OIE) [to 3 Apr 2021]
https://www.oie.int/en/for-the-media/press-releases/2021/
Press Releases
No new digest content identified.

WTO – World Trade Organisation [to 3 Apr 2021]
http://www.wto.org/english/news_e/news_e.htm
WTO News and Events
World trade primed for strong but uneven recovery after COVID-19 pandemic shock
31 March 2021
Prospects for a quick recovery in world trade have improved as merchandise trade expanded more rapidly than expected in the second half of last year. According to new estimates from the WTO, the volume of world merchandise trade is expected to increase by 8.0% in 2021 after having fallen 5.3% in 2020, continuing its rebound from the pandemic-induced collapse that bottomed out in the second quarter of last year.

::::::

ARM [Alliance for Regenerative Medicine] [to 3 Apr 2021]
Press Releases – Alliance for Regenerative Medicine (alliancerm.org)
Press Releases
No new digest content identified.

BIO [to 3 Apr 2021]
https://www.bio.org/press-releases
Press Releases
No new digest content identified.

DCVMN – Developing Country Vaccine Manufacturers Network [to 3 Apr 2021]
http://www.dcvmn.org/
News; Upcoming events
No new digest content identified.

ICBA – International Council of Biotechnology Associations [to 3 Apr 2021]
https://internationalbiotech.org/news/
News
No new digest content identified.

IFPMA [to 3 Apr 2021]
http://www.ifpma.org/resources/news-releases/
Selected Press Releases, Statements, Publications
COVID-19 vaccine and treatment innovators response to global leaders urgent call for international pandemic treaty
30 March 2021 –
[See Milestones above for detail]

Identification & Traceability of Medicinal Products – A tool towards strengthening health systems
30 March 2021

PhRMA [to 3 Apr 2021]
http://www.phrma.org/
Selected Press Releases, Statements
Strengthening a culture dedicated to patients and equity: A conversation with Vas Narasimhan, CEO of Novartis
March 31, 2021
Strengthening a culture dedicated to patients and equity: A conversation with Vas Narasimhan, CEO of Novartis

Journal Watch
Vaccines and Global Health: The Week in Review continues its weekly scanning of key peer-reviewed journals to identify and cite articles, commentary and editorials, books reviews and other content supporting our focu-s on vaccine ethics and policy. Journal Watch is not intended to be exhaustive, but indicative of themes and issues the Center is actively tracking. We selectively provide full text of some editorial and comment articles that are specifically relevant to our work. Successful access to some of the links provided may require subscription or other access arrangement unique to the publisher.
If you would like to suggest other journal titles to include in this service, please contact David Curry at: david.r.curry@centerforvaccineethicsandpolicy.org

AMA Journal of Ethics
Volume 23, Number 3 Apr 2021
https://journalofethics.ama-assn.org/issue/compassionate-force

Compassionate Force
Using force in caregiving is most often justified based on risk-benefit or best interest analyses. Careful, inclusive deliberation about whether force should be used in the course of a patient’s care is a rise-to-the minimum precursor of responsible force implementation, as is minimizing a patient’s risk of harm. Even when clinically indicated and ethically justifiable, force protocols drawing on physical, pharmaceutical, and legal means of restraint or seclusion can undermine therapeutic capacity in patient-clinician relationships, erode trust, and exacerbate emotional and moral distress for both patients and clinicians. These high stakes cum patients’ extreme vulnerability prompt us to consider how clinicians’ and organizations’ clinical and ethical obligations extend beyond harm minimization to compassion maximization. Although the words “compassion” and “force” rarely appear together, this issue investigates what their union could mean for and make possible in the enterprise of health care.

American Journal of Preventive Medicine
April 2021 Volume 60 Issue 4p453-594
http://www.ajpmonline.org/current

Research Articles
Determinants of Human Papillomavirus Vaccine Uptake by Adult Women Attending Cervical Cancer Screening in 9 European Countries
Claudia Robles, Laia Bruni, Amelia Acera,… Christine Clavel, Silvia de Sanjosé, F. Xavier Bosch
Published online: December 24, 2020
p478-487
Open Access

American Journal of Public Health
April 2021 111(4)
http://ajph.aphapublications.org/toc/ajph/current

EDITORIALS
Addressing Vaccine Concerns: A Hopeful Path Forward for Vaccine Confidence
Jessica R. Cataldi and Sean T. O’Leary
111(4), pp. 556–558

American Journal of Public Health
April 2021 111(4)
http://ajph.aphapublications.org/toc/ajph/current

PERSPECTIVES
Preparing for SARS-CoV-2 Vaccines in US Immigrant Communities: Strategies for Allocation, Distribution, and Communication
Eva H. Clark, Karla Fredricks, Laila Woc-Colburn, Maria Elena Bottazzi and Jill Weatherhead
111(4), pp. 577–581

American Journal of Public Health
April 2021 111(4)
http://ajph.aphapublications.org/toc/ajph/current

BUILDING BRIDGES
Overcoming Barriers to COVID-19 Vaccination in African Americans: The Need for Cultural Humility
Keith C. Ferdinand
111(4), pp. 586–588

American Journal of Tropical Medicine and Hygiene
Volume 104 (2021): Issue 3_Suppl (Mar 2021):
https://www.ajtmh.org/view/journals/tpmd/104/3_Suppl/tpmd.104.issue-3_Suppl.xml

Pragmatic Recommendations for the Management of Hospitalized COVID-19 Patients in Low- and Middle-Income Countries
Editorial
Open access
Recommendations for the Management of COVID-19 in Low- and Middle-Income Countries
Arjen M. Dondorp, Alfred C. Papali, Marcus J. Schultz, and for the COVID-LMIC Task Force and the Mahidol-Oxford Research Unit (MORU)

BMJ Global Health
April 2021 – Volume 6 – 4
https://gh.bmj.com/content/6/4

Intellectual property rights need to be subverted to ensure global vaccine access (1 April, 2021)
Salla Sariola

BMJ Global Health
April 2021 – Volume 6 – 4
https://gh.bmj.com/content/6/4

Commentary
Cocreated regional research agenda for evidence-informed policy and advocacy to improve adolescent sexual and reproductive health and rights in sub-Saharan Africa (2 April, 2021)

BMC Medical Ethics
http://www.biomedcentral.com/bmcmedethics/content
(Accessed 3 Apr 2021)

Research article
A scoping review of genetics and genomics research ethics policies and guidelines for Africa
Authors: Joseph Ali, Betty Cohn, Erisa Mwaka, Juli M. Bollinger, Betty Kwagala, John Barugahare, Nelson K. Sewankambo and Joseph Ochieng
Citation: BMC Medical Ethics 2021 22:39
Published on: 2 April 2021
Background
Genetics and genomics research (GGR) is increasingly being conducted around the world; yet, researchers and research oversight entities in many countries have struggled with ethical challenges. A range of ethics and regulatory issues need to be addressed through comprehensive policy frameworks that integrate with local environments. While important efforts have been made to enhance understanding and awareness of ethical dimensions of GGR in Africa, including through the H3Africa initiative, there remains a need for in-depth policy review, at a country-level, to inform and stimulate local policy development and revision on the continent.
Conclusions
Enforceable policies that are indispensable to the ethical conduct and review of GGR are either deficient or missing in many African countries. Existing international, GGR-specific ethics guidelines can be used to inform GGR policy development at a country-level, in conjunction with insight from country specific ethics committees and other local stakeholders.

BMC Medicine
http://www.biomedcentral.com/bmcmed/content
(Accessed 3 Apr 2021)

Commentary
Research priorities for Long Covid: refined through an international multi-stakeholder forum
In December 2020 ISARIC (the International Severe Acute Respiratory and emerging Infection Consortium), the research funders group GloPID-R (The Global Research Collaboration for Infectious Disease Preparedness) and global group, Long Covid Support, jointly organised a ‘Long Covid Forum’ [⁸]. This public forum aimed to gain a better understanding of ‘Long Covid’ and to define research priorities for funders and researchers to take forward.
Authors: Gail Carson
Citation: BMC Medicine 2021 19:84
Published on: 31 March 2021

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 3 Apr 2021)

How can community engagement in health research be strengthened for infectious disease outbreaks in Sub-Saharan Africa? A scoping review of the literature
Community engagement (CE) is a well-established practical and scholarly field, recognised as core to the science and ethics of health research, for which researchers and practitioners have increasingly asked q…
Authors: Samantha Vanderslott, Manya Van Ryneveld, Mark Marchant, Shelley Lees, Sylvie Kwedi Nolna and Vicki Marsh
Citation: BMC Public Health 2021 21:633
Content type: Research article
Published on: 1 April 2021

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 3 Apr 2021)

Scaling up public health interventions: case study of the polio immunization program in Indonesia
The scaling up of public health interventions has received greater attention in recent years; however, there remains paucity of systematic investigations of the scaling up processes. We aim to investigate the overall process, actors and contexts of polio immunization scaling up in Indonesia from 1988 until 2018.
Authors: Utsamani Cintyamena, Luthfi Azizatunnisa’, Riris Andono Ahmad and Yodi Mahendradhata
Citation: BMC Public Health 2021 21:614
Content type: Research article
Published on: 29 March 2021

BMJ
03 April 2021(vol 373, issue 8286)
https://www.bmj.com/content/373/8286

Research
The PRISMA 2020 statement: an updated guideline for reporting systematic reviews
BMJ 2021; 372 :n71 (Published 29 March 2021)
The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.

Bulletin of the World Health Organization
Volume 99, Number 4, April 2021, 241-320
https://www.who.int/bulletin/volumes/99/4/en/

POLCY & PRACTICE
Improving care of migrants is key for viral hepatitis elimination in Europe
— Jin Un Kim, Patrick Ingiliz, Yusuke Shimakawa, & Maud Lemoine
http://dx.doi.org/10.2471/BLT.20.260919

Bulletin of the World Health Organization
Volume 99, Number 4, April 2021, 241-320
https://www.who.int/bulletin/volumes/99/4/en/

Eliminating mother-to-child transmission of human immunodeficiency virus, syphilis and hepatitis B in sub-Saharan Africa
— Jennifer Cohn, Morkor N Owiredu, Melanie M Taylor, Philippa Easterbrook, Olufunmilayo Lesi, Bigirimana Francoise, Laura N Broyles, Angela Mushavi, Judith Van Holten, Catherine Ngugi, Fuqiang Cui, Dalila Zachary, Sirak Hailu, Fatima Tsiouris, Monique Andersson, Dorothy Mbori-Ngacha, Wame Jallow, Shaffiq Essajee, Anna L Ross, Rebecca Bailey, Jesal Shah & Meg M Doherty
http://dx.doi.org/10.2471/BLT.20.272559

Bulletin of the World Health Organization
Volume 99, Number 4, April 2021, 241-320
https://www.who.int/bulletin/volumes/99/4/en/

PERSPECTIVES
Supply chain transparency and the availability of essential medicines
— Christine Årdal, Enrico Baraldi, Peter Beyer, Yohann Lacotte, DG Joakim Larsson, Marie-Cécile Ploy, John-Arne Røttingen & Ingrid Smith
http://dx.doi.org/10.2471/BLT.20.267724

Clinical Therapeutics
Volume 43 Issue 2 p211-430, e33-e56
http://www.clinicaltherapeutics.com/current

Commentary
Artificial Intelligence in Pharmacovigilance: Scoping Points to Consider
Manfred Hauben, Craig G. Hartford
Published online: January 18, 2021
Abstract
Artificial intelligence (AI), a highly interdisciplinary science, is an increasing presence in pharmacovigilance (PV). A better understanding of the scope of artificial intelligence in pharmacovigilance (AIPV) may be advantageous to more sharply defining, for example, which terms, methods, tasks, and data sets are suitably subsumed under the application of AIPV. Accordingly, this article explores relevant points to consider regarding defining the scope of AIPV and offers a potential working definition of the scope of AIPV.

`
Clinical Trials

Volume 18 Issue 2, April 2021
https://journals.sagepub.com/toc/ctja/18/2
Ethics
An ethics framework for consolidating and prioritizing COVID-19 clinical trials
Michelle N Meyer, Luke Gelinas, Barbara E Bierer, Sara Chandros Hull, Steven Joffe, David Magnus, Seema Mohapatra, Richard R Sharp, Kayte Spector-Bagdady, Jeremy Sugarman, Benjamin S Wilfond, Holly Fernandez Lynch
First Published February 2, 2021; pp. 226–233
Preview
Given the dearth of established safe and effective interventions to respond to COVID-19, there is an urgent ethical imperative to conduct meaningful clinical research. The good news is that interventions to be tested are not in short supply. Unfortunately, the human and material resources needed to conduct these trials are finite. It is essential that trials be robust and meet enrollment targets and that lower-quality studies not be permitted to displace higher-quality studies, delaying answers to critical questions. Yet, with few exceptions, existing research review bodies and processes are not designed to ensure these conditions are satisfied. To meet this challenge, we offer guidance for research institutions about how to ethically consolidate and prioritize COVID-19 clinical trials, while recognizing that consolidation and prioritization should also take place upstream (among manufacturers and funders) and at a higher level (e.g. nationally). In our proposed three-stage process, trials must first meet threshold criteria. Those that do are evaluated in a second stage to determine whether the institution has sufficient capacity to support all proposed trials. If it does not, the third stage entails evaluating studies against two additional sets of comparative prioritization criteria: those specific to the study and those that aim to advance diversification of an institution’s research portfolio. To implement these criteria fairly, we propose that research institutions form COVID-19 research prioritization committees. We briefly discuss some important attributes of these committees, drawing on the authors’ experiences at our respective institutions. Although we focus on clinical trials of COVID-19 therapeutics, our guidance should prove useful for other kinds of COVID-19 research, as well as non-pandemic research, which can raise similar challenges due to the scarcity of research resources.

Global Health: Science and Practice (GHSP)
Vol. 9, No. 1 April 01, 2021
http://www.ghspjournal.org/content/current

PROGRAM CASE STUDIES
Blended Learning Using Peer Mentoring and WhatsApp for Building Capacity of Health Workers for Strengthening Immunization Services in Kenya
Iqbal Hossain, Isaac Mugoya, Lilian Muchai, Kirstin Krudwig, Nicole Davis, Lora Shimp and Vanessa Richart
Global Health: Science and Practice April 2021, 9(1):201-215; https://doi.org/10.9745/GHSP-D-20-00421
Innovative learning strategies are needed to improve frontline health workers’ skills for achieving immunization coverage goals—now even more important with COVID-19. Peer mentoring and WhatsApp networking are low-cost and useful blended learning methods for need-based and individualized capacity building of health workers for improving immunization services that don’t disrupt the health care workers’ regular work.

Health Research Policy and Systems
http://www.health-policy-systems.com/content
[Accessed 3 Apr 2021]

Lessons from the pandemic on the value of research infrastructure
The COVID-19 pandemic has shed a spotlight on the resilience of healthcare systems, and their ability to cope efficiently and effectively with unexpected crises. If we are to learn one economic lesson from the…
Authors: Laurence S. J. Roope, Paolo Candio, Vasiliki Kiparoglou, Helen McShane, Raymond Duch and Philip M. Clarke
Citation: Health Research Policy and Systems 2021 19:54
Content type: Commentary
Published on: 1 April 2021

Humanitarian Exchange Magazine
Number 78, October 2020
https://odihpn.org/magazine/inclusion-of-persons-with-disabilities-in-humanitarian-action-what-now/

Disability inclusion in humanitarian action
by HPN October 2020
The theme of this edition of Humanitarian Exchange, co-edited with Sherin Alsheikh Ahmed from Islamic Relief Worldwide, is disability inclusion in humanitarian action. Persons with disabilities are not only disproportionately impacted by conflicts, disasters and other emergencies, but also face barriers to accessing humanitarian assistance. At the same time, global commitments and standards and the IASC Guidelines on the inclusion of persons with disabilities in humanitarian action all emphasise how persons with disabilities are also active agents of change. Disability and age-focused organisations have led on testing and demonstrating how inclusion can be done better. Yet despite this progress, challenges to effective inclusion remain.

As Kirstin Lange notes in the lead article, chief among these challenges is humanitarian agencies’ lack of engagement with organisations of persons with disabilities. Simione Bula, Elizabeth Morgan and Teresa Thomson look at disability inclusion in humanitarian response in the Pacific, and Kathy Al Jubeh and Alradi Abdalla argue for a ‘participation revolution’, building on learning from the gender movement. Tchaurea Fleury and Sulayman AbdulMumuni Ujah outline how the Bridge Article 11 training initiative is encouraging constructive exchange between humanitarian and disability actors. The lack of good, disaggregated data is highlighted by Sarah Collinson; Frances Hill, Jim Cranshaw and Carys Hughes emphasise the need for training resources in local languages and accessible formats; and Sophie Van Eetvelt and colleagues report on a review of the evidence on inclusion of people with disabilities and older people.

Rebecca Molyneux and co-authors analyse the findings of a review of a DFID programme in north-east Nigeria, while Carolin Funke highlights the importance of strategic partnerships between disability-focused organisations, drawing on her research in Cox’s Bazar. Sherin Alsheikh Ahmed describes Islamic Relief Worldwide’s approach to mainstreaming protection and inclusion, while Pauline Thivillier and Valentina Shafina outline IRC’s Client Responsive Programming. The edition ends with reflections by Mirela Turcanu and Yves Ngunzi Kahashi on CAFOD’s SADI approach.

JAMA Network
COVID-19 Update April 3, 2021

These articles on COVID-19 were published across the JAMA Network in the last week.

Journal of Infectious Diseases
Volume 223, Issue 4, 15 February 2021
https://academic.oup.com/jid/issue/223/4

REVIEW
Outdoor Transmission of SARS-CoV-2 and Other Respiratory Viruses: A Systematic Review
Tommaso Celeste Bulfone, Mohsen Malekinejad, George W Rutherford, Nooshin Razani
The Journal of Infectious Diseases, Volume 223, Issue 4, 15 February 2021, Pages 550–561, https://doi.org/10.1093/infdis/jiaa742
This systematic review found that while outdoor environments do seem at lower risk for transmission of SARS-CoV-2 and other respiratory viruses than indoor environments, there are data showing that infection transmission is possible outdoors, thus warranting further rigorous investigation.

Journal of Infectious Diseases
Volume 223, Issue 4, 15 February 2021
https://academic.oup.com/jid/issue/223/4

Safety and Immunogenicity of the Ad26.RSV.preF Investigational Vaccine Coadministered With an Influenza Vaccine in Older Adults
Jerald Sadoff, Els De Paepe, Wouter Haazen, Edmund Omoruyi, Arangassery R Bastian …
The Journal of Infectious Diseases, Volume 223, Issue 4, 15 February 2021, Pages 699–708, https://doi.org/10.1093/infdis/jiaa409
Coadministration of Fluarix with the Ad26.RSV.preF vaccine had an acceptable safety profile and showed no evidence of interference in immune response in healthy adults aged ≥60 years.

Journal of Pediatrics
Volume 231 p1-304
http://www.jpeds.com/current

Reflections on Ethics and Advocacy in Child Health
Global Ethical Considerations Regarding Mandatory Vaccination in Children
Julian Savulescu, Alberto Giubilini, Margie Danchin
Published online: January 20, 2021
p10-16
Open Access
Whether children should be vaccinated against coronavirus disease-2019 (COVID-19) (or other infectious diseases such as influenza) and whether some degree of coercion should be exercised by the state to ensure high uptake depends, among other things, on the safety and efficacy of the vaccine. For COVID-19, these factors are currently unknown for children, with unanswered questions also on children’s role in the transmission of the virus, the extent to which the vaccine will decrease transmission, and the expected benefit (if any) to the child. Ultimately, deciding whether to recommend that children receive a novel vaccine for a disease that is not a major threat to them, or to mandate the vaccine, requires precise information on the risks, including disease severity and vaccine safety and effectiveness, a comparative evaluation of the alternatives, and the levels of coercion associated with each. However, the decision also requires balancing self-interest with duty to others, and liberty with usefulness. Separate to ensuring vaccine supply and access, we outline 3 requirements for mandatory vaccination from an ethical perspective: (1) whether the disease is a grave threat to the health of children and to public health, (2) positive comparative expected usefulness of mandatory vaccination, and (3) proportionate coercion. We also suggest that the case for mandatory vaccine in children may be strong in the case of influenza vaccination during the COVID-19 pandemic.

Journal of Pediatrics
Volume 231 p1-304
http://www.jpeds.com/current

In the Wake of a Pandemic: Revisiting School Approaches to Nonmedical Exemptions to Mandatory Vaccination in the US
Erin Talati Paquette
Published online: January 20, 2021
p17-23

Journal of Pediatrics
Volume 231 p1-304
http://www.jpeds.com/current

Adolescent Consent for Human Papillomavirus Vaccine: Ethical, Legal, and Practical Considerations
Gregory D. Zimet, Ross D. Silverman, Robert A. Bednarczyk, Abigail English
Published online: January 20, 2021
p24-30
We address ethical, legal, and practical issues related to adolescent self-consent for human papillomavirus (HPV) vaccination. HPV vaccination coverage continues to lag well behind the national goal of 80% series completion. Structural and behavioral interventions have improved vaccination rates, but attitudinal, behavioral, and access barriers remain. A potential approach for increasing access and improving vaccination coverage would be to permit adolescents to consent to HPV vaccination for themselves. We argue that adolescent self-consent is ethical, but that there are legal hurdles to be overcome in many states. In jurisdictions where self-consent is legal, there can still be barriers due to lack of awareness of the policy among healthcare providers and adolescents. Other barriers to implementation of self-consent include resistance from antivaccine and parent rights activists, reluctance of providers to agree to vaccinate even when self-consent is legally supported, and threats to confidentiality. Confidentiality can be undermined when an adolescent’s self-consented HPV vaccination appears in an explanation of benefits communication sent to a parent or if a parent accesses an adolescent’s vaccination record via state immunization information systems. In the context of the COVID-19 pandemic, which has led to a substantial drop in HPV vaccination, there may be even more reason to consider self-consent. The atmosphere of uncertainty and distrust surrounding future COVID-19 vaccines underscores the need for any vaccine policy change to be pursued with clear communication and consistent with ethical principles.