EMBO Reports
Volume 22 Issue 3 3 March 2021
https://www.embopress.org/toc/14693178/current

Science & Society 21 February 2021 Free Access
A CRISPR response to pandemics?: Exploring the ethics of genetically engineering the human immune system
Federico Germani, Sebastian Wäscher, Nikola Biller‐Andorno
Ethical challenges should be addressed before gene editing is made available to improve the immune response against emerging viruses.
… It would therefore be extremely helpful from a public health perspective—and indeed lifesaving for those with elevated risk of developing severe course of the disease—if we could boost the human immune system by other means to better fight off SARS‐CoV‐2 and possibly other viruses. Recent studies showing that some individuals may be less susceptible to contract severe COVID‐19 depending on their genetic status support such visions (COVID‐¹⁹ Host Genetics Initiative, ²⁰²⁰). This could eventually inspire research projects on gene therapy with the aim of generally enhancing immunity against viral infections….

Expert Review of Vaccines
Vol 20 (1) 2021
https://www.tandfonline.com/toc/ierv20/current

Article
Quadrivalent influenza vaccine (Sinovac Biotech) for seasonal influenza prophylaxis
Yan-Yang Tao, Jing-Xin Li, Yue-Mei Hu, Yuan-Sheng Hu, Gang Zeng & Feng-Cai Zhu
Pages: 1-11
Published online: 01 Feb 2021

Expert Review of Vaccines
Vol 20 (1) 2021
https://www.tandfonline.com/toc/ierv20/current

Article
Multi-criteria decision analysis to prioritize the introduction of new vaccines in Indonesia by using the framework of the strategic multi-attribute ranking tool for vaccines (SMART vaccines)
Auliya A. Suwantika, Febby V. Purwadi, Neily Zakiyah, Irma M. Puspitasari, Rizky Abdulah, Ajeng Diantini, Cornelis Boersma & Maarten J. Postma
Pages: 83-91
Published online: 21 Jan 2021

Expert Review of Vaccines
Vol 20 (1) 2021
https://www.tandfonline.com/toc/ierv20/current

Review
COVID-19 vaccine: where are we now and where should we go?
Saman Soleimanpour & Atieh Yaghoubi
Pages: 23-44
Published online: 17 Feb 2021

Gates Open Research
https://gatesopenresearch.org/browse/articles
[Accessed 13 Mar 2021]

Research Article metrics
Revised
Tetanus vaccine coverage in recommended and more than recommended doses among mothers in a West Cameroon health district: a cross sectional study [version 2; peer review: 2 approved with reservations]
Igor Nguemouo Nguegang, Martin Nguetsop, Linda Evans Eba Ze, Trevor Anyambod Mboh, Dominique Majoric Omokolo, Ruth Noutakdie Fossi, Etienne Guenou, Jerome Ateudjieu
Peer Reviewers Jayani Pathirana; Ghose Bishwajt
Funder: Gates Foundation
LATEST VERSION PUBLISHED 10 Mar 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.

Infectious Diseases of Poverty
http://www.idpjournal.com/content
[Accessed 13 Mar 2021]

The application of social innovation in healthcare: a scoping review
Social innovation has been applied increasingly to achieve social goals, including improved healthcare delivery, despite a lack of conceptual clarity and consensus on its definition. Beyond its tangible artefacts to address societal and structural needs, social innovation can best be understood as innovation in social relations, in power dynamics and in governance transformations, and may include institutional and systems transformations.
Authors: Lindi van Niekerk, Lenore Manderson and Dina Balabanova
Citation: Infectious Diseases of Poverty 2021 10:26
Content type: Scoping Review
Published on: 8 March 2021

JAMA
March 9, 2021, Vol 325, No. 10, Pages 907-1016
https://jamanetwork.com/journals/jama/currentissue

Research Letter
Prevalence of SARS-CoV-2 in Karnataka, India
Manoj Mohanan, PhD; Anup Malani, PhD; Kaushik Krishnan, PhD; et al.
free access
JAMA. 2021;325(10):1001-1003. doi:10.1001/jama.2021.0332
In the context of large numbers of workers moving from urban to rural areas with less strict lockdown policies in low- and middle-income countries, this study describes community-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevalence in urban vs rural areas of Karnataka state, India.

JAMA
March 9, 2021, Vol 325, No. 10, Pages 907-1016
https://jamanetwork.com/journals/jama/currentissue

Viewpoint
Rapid Implementation of a Vaccination Superstation
Christopher A. Longhurst, MD, MS; Brendan Kremer, MHA; Patricia S. Maysent, MBA, MHA
free access
JAMA. 2021;325(10):931-932. doi:10.1001/jama.2021.0801
This Viewpoint details lessons learned from a county-private-university collaboration in San Diego to stand up a coronavirus vaccine superstation to immunize 4500-5000 people daily, detailing optimization of patient throughput and ways to monitor adverse events and document vaccine administration at scale.

JAMA
March 9, 2021, Vol 325, No. 10, Pages 907-1016
https://jamanetwork.com/journals/jama/currentissue

Medical News & Perspectives
The Price of Success—How to Evaluate COVID-19 Vaccines When They’re Available Outside of Clinical Trials
Rita Rubin, MA
free access has active quiz
JAMA. 2021;325(10):918-921. doi:10.1001/jama.2021.0641
This Medical News feature examines the challenge of continuing or launching placebo-controlled trials of COVID-19 vaccines now that some have been authorized for use in the community.

JAMA Network
COVID-19 Update March 13, 2021

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

Journal of Pharmaceutical Policy and Practice
https://joppp.biomedcentral.com/
[Accessed 13 Mar 2021]

Establishment of the African Medicines Agency: progress, challenges and regulatory readiness
Authors: Bakani Mark Ncube, Admire Dube and Kim Ward
Content type: Commentary
8 March 2021
Abstract
Insufficient access to quality, safe, efficacious and affordable medical products in Africa has posed a significant challenge to public health for decades. In part, this is attributed to weak or absent policies and regulatory systems, a lack of competent regulatory professionals in National Medicines Regulatory Authorities (NMRAs) and ineffective regional collaborations among NMRAs. In response to national regulatory challenges in Africa, a number of regional harmonisation efforts were introduced through the African Medicines Regulatory Harmonisation (AMRH) initiative to, among others, expedite market authorisation of medical products and to facilitate the alignment of national legislative frameworks with the AU Model Law on Medical Products Regulation. The goals of the model law include to increase collaboration across countries and to facilitate the overall regional harmonisation process. The AMRH initiative is proposed to serve as the foundation for the establishment of the African Medicines Agency (AMA). The AMA will, as one of its mandates, coordinate the regional harmonisation systems that are enabled by AU Model Law domestication and implementation. In this paper, we review the key entities involved in regional and continental harmonisation of medicines regulation, the milestones achieved in establishing the AMA as well as the implementation targets and anticipated challenges related to the AU Model Law domestication and the AMA’s establishment…

The Lancet
Mar 13, 2021 Volume 397 Number 10278 p941-1034, e8
https://www.thelancet.com/journals/lancet/issue/current

Editorial
Access to COVID-19 vaccines: looking beyond COVAX
The Lancet
Global health leaders have been in a congratulatory mood. On March 1, they celebrated the first vaccinations against COVID-19 in Africa delivered through COVAX—the scheme led by GAVI, CEPI, and WHO to support research and development, raise funding, and negotiate the bulk purchase and equitable global distribution of vaccines for COVID-19. As of March 9, 12 million doses have been shipped to 29 countries, marking the beginning of the largest vaccine roll-out in history. This is an unprecedented achievement. Yet COVAX is wholly unequipped to resolve many of the most pressing threats to its mission. Global vaccination is central to ending the pandemic, yet it has been dealt with at far too low a political level. Too many obstacles are going unchallenged. A high-level individual or group with political acumen, technical competency, and the ability to advocate for justice is needed to galvanise the effort.

There is a startling lack of solidarity between countries. As outlined in a Health Policy paper, the many bilateral deals struck between governments and vaccine manufacturers, independently of COVAX, threaten the supply of doses. Rich nations have given money to COVAX and paid lip service to the idea of vaccines for all while scrambling to buy up all the doses they can. Olivier Wouters and colleagues report that polities representing only 16% of the global population have secured 70% of the available doses for the five leading vaccines in 2021. As a result, dozens of countries have yet to administer a single dose, whereas others have already immunised large proportions of their populations. COVAX will continue to face competition for purchasing doses and risks being outbid; it can only bemoan such agreements. No one may be able to persuade countries to cease these deals entirely. But a well respected and dedicated former head of state with the ability to encourage and cajole prime ministers and presidents might have more success in encouraging countries to behave more equitably. It would be far better for countries that have made bilateral deals to donate a fixed proportion of their acquired doses to COVAX, for example, than simply promise to share their surpluses. An authoritative voice with moral credentials is needed to support global access to vaccines, to intervene when that goal is under threat, and to call out unfair practices.

Clearer leadership and oversight are also needed to bring greater cohesion to the complex patchwork of national governments, technical organisations (including GAVI, CEPI, WHO, UNICEF, and the World Bank), the private sector, and civil society that is aiming to ensure global access to vaccines. The list of well meaning but varied vaccination targets is growing. COVAX’s current conservative aim is to immunise 20% of people in each country, which it estimates is enough to cover high-risk groups and health workers. Most high-income countries seem set on a policy of mass vaccination. The African Union has set a target of 60% coverage, whereas Nigeria, for example, is aiming for 40%. Some order needs to be brought to these disparate goals.

A dedicated envoy or tsar could also help moderate disagreements between countries, which are hampering global COVID-19 vaccination. Last year, South Africa and India called on the World Trade Organization to waive intellectual property protections on COVID-19 drugs and vaccines to boost manufacturing. Despite support from the WHO Director-General, the proposal has languished under opposition from the UK, the USA, Canada, Norway, and the EU. Meanwhile, on March 4, the Italian Government blocked the export of 250 000 doses of the AstraZeneca–Oxford vaccine bound for Australia following disagreements between the manufacturer and the EU. These issues require political and diplomatic solutions. They cannot be solved by technical agencies.

Who should take on this role? If a UN Special Envoy, they must be more than a symbolic appointee, flying around the world to shake hands with political leaders and getting little done. Their tasks must be actionable. The Elders, a group of varied political leaders formed by Nelson Mandela to use public and private diplomacy to advance justice and human rights, have successfully championed causes such as universal health coverage, and have the requisite experience.

Whoever it is, they must above all be able to drive a worldwide movement. Although the roll-out of vaccines brings hope, case numbers are increasing again globally and there is a grave risk of complacency. Progress has been capricious and there are still many uncertainties about COVID-19, not least the impact of new variants. Global vaccination is essential to ending the pandemic but this fact has still not prompted the unity required to deliver it. Far more vision and ambition are needed. They must come from the highest political levels.

The Lancet
Mar 13, 2021 Volume 397 Number 10278 p941-1034, e8
https://www.thelancet.com/journals/lancet/issue/current

Comment
Priorities for the COVID-19 pandemic at the start of 2021: statement of the Lancet COVID-19 Commission
Commissioners of the Lancet COVID-19 Commission,
Task Force Chairs and members of the Lancet COVID-19 Commission,
Commission Secretariat and Staff of the Lancet COVID-19 Commission
The Lancet COVID-19 Commission calls for three urgent actions in the COVID-19 response. First, all regions with high rates of new COVID-19 cases, including the USA and the European Union (EU), should intensify measures to minimise community transmission alongside rapid deployment of COVID-19 vaccines. Second, governments should urgently and fully fund WHO and the Access to COVID-19 Tools (ACT) Accelerator,¹ including COVAX. Third, the G20 countries should empower the International Monetary Fund (IMF) and multilateral development banks to increase the scale of financing and debt relief. Success on all three priorities—containment of transmission, rapid vaccination, and emergency finance—will require improved global cooperation.

The Lancet
Mar 13, 2021 Volume 397 Number 10278 p941-1034, e8
https://www.thelancet.com/journals/lancet/issue/current

SARS-CoV-2 variants and ending the COVID-19 pandemic
Arnaud Fontanet, Brigitte Autran, Bruno Lina, Marie Paule Kieny, Salim S Abdool Karim, Devi Sridhar

The Lancet
Mar 13, 2021 Volume 397 Number 10278 p941-1034, e8
https://www.thelancet.com/journals/lancet/issue/current

Health Policy
Challenges in ensuring global access to COVID-19 vaccines: production, affordability, allocation, and deployment
Olivier J Wouters, Kenneth C Shadlen, Maximilian Salcher-Konrad, Andrew J Pollard, Heidi J Larson, Yot Teerawattananon, Mark Jit
Summary
The COVID-19 pandemic is unlikely to end until there is global roll-out of vaccines that protect against severe disease and preferably drive herd immunity. Regulators in numerous countries have authorised or approved COVID-19 vaccines for human use, with more expected to be licensed in 2021. Yet having licensed vaccines is not enough to achieve global control of COVID-19: they also need to be produced at scale, priced affordably, allocated globally so that they are available where needed, and widely deployed in local communities. In this Health Policy paper, we review potential challenges to success in each of these dimensions and discuss policy implications. To guide our review, we developed a dashboard to highlight key characteristics of 26 leading vaccine candidates, including efficacy levels, dosing regimens, storage requirements, prices, production capacities in 2021, and stocks reserved for low-income and middle-income countries. We use a traffic-light system to signal the potential contributions of each candidate to achieving global vaccine immunity, highlighting important trade-offs that policy makers need to consider when developing and implementing vaccination programmes. Although specific datapoints are subject to change as the pandemic response progresses, the dashboard will continue to provide a useful lens through which to analyse the key issues affecting the use of COVID-19 vaccines. We also present original data from a 32-country survey (n=26 758) on potential acceptance of COVID-19 vaccines, conducted from October to December, 2020. Vaccine acceptance was highest in Vietnam (98%), India (91%), China (91%), Denmark (87%), and South Korea (87%), and lowest in Serbia (38%), Croatia (41%), France (44%), Lebanon (44%), and Paraguay (51%).

Nature
Volume 591 Issue 7849, 11 March 2021
https://www.nature.com/nature/volumes/591/issues/7849

World View | 03 March 2021
COVID vaccination studies: plan now to pool data, or be bogged down in confusion
Incompatible research designs will obscure essential answers about vaccine effectiveness. It’s time to plan together.
Natalie Dean

Nature Genetics
Volume 53 Issue 3, March 2021
https://www.nature.com/ng/volumes/53/issues/3

World View | 08 March 2021
Genes do not operate in a vacuum, and neither should our research
It’s time for a paradigm shift in the scientific enterprise. Our social responsibilities, especially as stakeholders in a field such as genetics, are central to the responsible conduct of research.
Daphne Oluwaseun Martschenko & Markia Smith

Nature Genetics
Volume 53 Issue 3, March 2021
https://www.nature.com/ng/volumes/53/issues/3

Comment | 22 February 2021
The NCI Genomic Data Commons
The National Cancer Institute (NCI) Genomic Data Commons (GDC) contains more than 2.9 petabytes of genomic and associated clinical data from more than 60 NCI-funded and other contributed cancer genomics research projects. The GDC consists of five applications over a common data model and a common application programming interface.
Allison P. Heath, Vincent Ferretti & Robert L. Grossman

New England Journal of Medicine
March 11, 2021 Vol. 384 No. 10
http://www.nejm.org/toc/nejm/medical-journal

Perspective
Covid-19 Vaccine Injuries — Preventing Inequities in Compensation
Katharine Van Tassel, J.D., M.P.H., Carmel Shachar, J.D., M.P.H., and Sharona Hoffman, J.D., L.L.M., S.J.D.

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 13 Mar 2021)

How will COVID-19 transform global health post-pandemic? Defining research and investment opportunities and priorities
Michael Reid, Quarraisha Abdool-Karim, Elvin Geng, Eric Goosby
Editorial | published 11 Mar 2021 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1003564
…Achieving rapid pandemic control is possible but is predicated on decisive leadership and collaboration for COVID-19 responses—at global, national and local levels—and a commitment to leave no one behind. Global health diplomacy has a critical role to play in catalysing governments and non-state actors to enact effective, innovative and just policy solutions. An ‘every country for itself’ approach clearly does not hold up in this interdependent world, and we need reforms. In particular, the International Health Regulations, which govern all countries to have core health system capacities to detect future pandemics, need to be revitalized. More effective rules of the road are also needed to foster cooperation among countries seeking to manage future outbreaks and as a global trigger for the United Nations and other international organizations to take appropriate actions. A well-funded WHO is also essential to effective global health governance and offers a model for global collaboration. The WHO has a critical role to play in supporting all countries to prioritize universal health systems, not only because it will vastly improve health and be an important bulwark against future pandemics, but also to reap marked economic dividends.
Although we have much to learn about SARS-CoV-2, the epidemic and its consequences, the virus has made one thing clear: for any crisis that threatens the globe, the problems of any of us are the problems of all of us. Global post-pandemic recovery must therefore be coordinated and multi-dimensional. Governance systems that are inclusive, accountable and guided by approaches that prioritize transparent, multisectoral decision-making processes are urgently needed to respond effectively. Only a holistic response based on cross-sectoral collaboration at all levels of society can build the necessary resilience to respond to the immediate and long-term effects of COVID-19. The COVID-19 pandemic reminds us that no country acting alone can respond effectively to health threats in a globalized world [¹³]. The crisis has also created a unique opportunity to re-imagine and transform global health so that future pandemics are not nearly as devastating as this one, and that health gains made to date are sustained and strengthened rather than reversed.

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 13 Mar 2021)

Human papillomavirus vaccination for adults aged 30 to 45 years in the United States: A cost-effectiveness analysis
Jane J. Kim, Kate T. Simms, James Killen, Megan A. Smith, Emily A. Burger, Stephen Sy, Catherine Regan, Karen Canfell
Research Article | published 11 Mar 2021 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1003534
…A nonavalent human papillomavirus (HPV) vaccine has been licensed for use in women and men up to age 45 years in the United States. The cost-effectiveness of HPV vaccination for women and men aged 30 to 45 years in the context of cervical cancer screening practice was evaluated to inform national guidelines…Our results from 2 independent models suggest that HPV vaccination for adult women and men aged 30 to 45 years is unlikely to represent good value for money in the US.

PLoS One
http://www.plosone.org/
[Accessed 13 Mar 2021]

Medical disinformation and the unviable nature of COVID-19 conspiracy theories
David Robert Grimes
Research Article | published 12 Mar 2021 PLOS ONE
https://doi.org/10.1371/journal.pone.0245900

PLoS One
http://www.plosone.org/
[Accessed 13 Mar 2021]

Using Point of Care Testing to estimate influenza vaccine effectiveness in the English primary care sentinel surveillance network
Simon de Lusignan, Uy Hoang, Harshana Liyanage, Manasa Tripathy, Julian Sherlock, Mark Joy, Filipa Ferreira, Javier Diez-Domingo, Tristan Clark
Research Article | published 11 Mar 2021 PLOS ONE
https://doi.org/10.1371/journal.pone.0248123

PLoS One
http://www.plosone.org/
[Accessed 13 Mar 2021]

Informed consent rates for neonatal randomized controlled trials in low- and lower middle-income versus high-income countries: A systematic review
Jacquelyn K. Patterson, Stuti Pant, Denise F. Jones, Syed Taha, Michael S. Jones, Melissa S. Bauserman, Paolo Montaldo, Carl L. Bose, Sudhin Thayyil
Research Article | published 09 Mar 2021 PLOS ONE
https://doi.org/10.1371/journal.pone.0248263

PNAS – Proceedings of the National Academy of Sciences of the United States of America
March 02, 2021; vol. 118 no. 9
https://www.pnas.org/content/118/9

Psychological and Cognitive Sciences
Influence of a COVID-19 vaccine’s effectiveness and safety profile on vaccination acceptance
Robert M. Kaplan and Arnold Milstein
PNAS March 9, 2021 118 (10) e2021726118; https://doi.org/10.1073/pnas.2021726118
Significance
Acceptance of vaccines has been on the decline in recent years. Despite encouraging early results for coronavirus vaccine trials, achieving herd immunity requires substantial uptake. We presented scenarios varying vaccine efficacy, minor side effects, and severe reactions to a sample representative of the US population. Vaccine acceptance improved when the efficacy increased beyond 70%. Respondents were unaffected by the probability of minor side effects, such as a sore arm or fever lasting 24 h. The chances of accepting the vaccine were lower when the probability of serious adverse reactions was 1/100,000 in contrast to 1/million or 1/100 million. A replication showed that the results were largely unchanged following the public announcement that the vaccines were 95% effective.
Abstract
Although a safe and effective vaccine holds the greatest promise for resolving the COVID-19 pandemic, hesitancy to accept vaccines remains common. To explore vaccine acceptance decisions, we conducted a national survey of 1,000 people from all US states in August of 2020 and a replication in December of 2020. Using a 3 × 3 × 3 factorial experimental design, we estimated the impact of three factors: probability of 1) protection against COVID-19, 2) minor side effects, and 3) a serious adverse reactions. The outcome was respondents’ reported likelihood of receiving a vaccine for the coronavirus. Probability of vaccine efficacy (50%, 70%, or 90%) had the largest effect among the three factors. The probability of minor side effects (50%, 75%, 90%) including fever and sore arm, did not significantly influence likelihood of receiving the vaccine. The chances of a serious adverse reaction, such as temporary or permanent paralysis, had a small but significant effect. A serious adverse reaction rate of 1/100,000 was more likely to discourage vaccine use in comparison to rates of 1/million or 1/100 million. All interactions between the factors were nonsignificant. A replication following the announcement that vaccines were 95% effective showed small, but significant increases in the likelihood of taking a vaccine. The main effects and interactions in the model remained unchanged. Expected benefit was more influential in respondents’ decision making than expected side effects. The absence of interaction effects suggests that respondents consider the side effects and benefits independently.

Preventive Medicine
Volume 144, March 2021
https://www.sciencedirect.com/journal/preventive-medicine/vol/144/suppl/C

From Science to Action to Impact: Eliminating Cervical Cancer
Editorial Full text access
A bold but morally necessary and attainable goal
Article 106461

Preventive Medicine
Volume 144, March 2021
https://www.sciencedirect.com/journal/preventive-medicine/vol/144/suppl/C

Research article Full text access
National action towards a world free of cervical cancer for all women
Julie Torode, Benda Kithaka, Raveena Chowdhury, Nothemba Simelela, … Vivien D. Tsu
Article 106313

Preventive Medicine
Volume 144, March 2021
https://www.sciencedirect.com/journal/preventive-medicine/vol/144/suppl/C

Research article Open access
HPV vaccination introduction worldwide and WHO and UNICEF estimates of national HPV immunization coverage 2010–2019
Laia Bruni, Anna Saura-Lázaro, Alexandra Montoliu, Maria Brotons, … Paul Bloem
Article 106399

Preventive Medicine
Volume 144, March 2021
https://www.sciencedirect.com/journal/preventive-medicine/vol/144/suppl/C

Research article Full text access
Elimination of cervical cancer: Lessons learned from polio and earlier eradication programs
Alan R. Hinman, Walter A. Orenstein
Article 106325

Preventive Medicine
Volume 144, March 2021
https://www.sciencedirect.com/journal/preventive-medicine/vol/144/suppl/C

Research article Full text access
Monitoring HPV vaccine impact on cervical disease: Status and future directions for the era of cervical cancer elimination
Carlos R. Oliveira, Linda M. Niccolai
Article 106363

Preventive Medicine
Volume 144, March 2021
https://www.sciencedirect.com/journal/preventive-medicine/vol/144/suppl/C

Research article Full text access
Current and future vaccine clinical research with the licensed 2-, 4-, and 9-valent VLP HPV vaccines: What’s ongoing, what’s needed?
Barbara J. Kuter, Suzanne M. Garland, Anna R. Giuliano, Margaret A. Stanley
Article 106321

Revista Panamericana de Salud Pública/Pan American Journal of Public Health (RPSP/PAJPH)
https://www.paho.org/journal/en

Selected Articles
12 Mar 2021
Embedding research into health services in Latin America and the Caribbean: experiences and challenges of the Technical Support Center*
Brief communication | English |

Risk Management and Healthcare Policy
https://www.dovepress.com/risk-management-and-healthcare-policy-archive56
[Accessed 13 Mar 2021]

Review
Towards Eradication of Malaria: Is the WHO’s RTS,S/AS01 Vaccination Effective Enough?
Arora N, Anbalagan LC, Pannu AK
Risk Management and Healthcare Policy 2021, 14:1033-1039
Published Date: 12 March 2021

Science
12 March 2021 Vol 371, Issue 6534
http://www.sciencemag.org/current.dtl

Editorial
COVID-19 lessons for research
By Francis S. Collins
Summary
As we mark the 1-year anniversary of the declaration by the World Health Organization (WHO) of COVID-19 as a global pandemic, the world has suffered a staggering and tragic human toll. During this dark time, the scientific community has been called to rise to the occasion in unprecedented ways. The intensity of the work and the sense of urgency have been unremitting and exhausting. As we sort out the triumphs and frustrations, we can begin to reflect on what we have learned.

Science
12 March 2021 Vol 371, Issue 6534
http://www.sciencemag.org/current.dtl

In Depth
As vaccine surpluses loom, donation plans urged
By Jon Cohen, Kai Kupferschmidt
Science12 Mar 2021 : 1087-1088 Restricted Access
Rich countries have ordered billions of doses more than needed for their populations.
Summary
Last week, U.S. President Joe Biden promised COVID-19 vaccine doses would be available for all U.S. adults by the end of May. That’s welcome news for the United States, and it could also be good news for nations that may benefit from the more than 1 billion extra doses the federal government has ordered. Like three dozen other countries, the United States contracted with multiple vaccine companies for several times the number of doses needed to cover its population. But by now, most of the prepurchased vaccines appear to offer solid protection—which means many countries will receive far more vaccine than they need. Over the next year or two, U.S. surplus doses and those from other countries could add up to enough to immunize everyone in the many poorer nations that lack any secured COVID-19 vaccine.

Science
12 March 2021 Vol 371, Issue 6534
http://www.sciencemag.org/current.dtl

Policy Forum
Market design to accelerate COVID-19 vaccine supply
By Juan Camilo Castillo, Amrita Ahuja, Susan Athey, Arthur Baker, Eric Budish, Tasneem Chipty, Rachel Glennerster, Scott Duke Kominers, Michael Kremer, Greg Larson, Jean Lee, Canice Prendergast, Christopher M. Snyder, Alex Tabarrok, Brandon Joel Tan, Witold Więcek
Science12 Mar 2021 : 1107-1109 Full Access
Build more capacity, and stretch what we already have
Summary
Each month, COVID-19 kills hundreds of thousands of people, reduces global gross domestic product (GDP) by hundreds of billions of dollars, and generates large, accumulating losses to human capital by harming education and health (1–4). Achieving widespread immunization 1 month faster would thus save many lives and mitigate short- and long-run economic harm. Although the value of vaccines may seem obvious, government action and investment in vaccines have not been commensurate with the enormous scale of benefits, with many countries not likely to achieve widespread immunization until the end of 2022.

Social Science & Medicine
Volume 271, February 2021
https://www.sciencedirect.com/journal/social-science-and-medicine/vol/271/suppl/C

Social and behavioral science at the forefront of genomics: Discovery, translation, and health equity
Edited by Laura M. Koehly, Susan Persky, Philip Shaw, Vence L. Bonham, Christopher S. Marcum, Gustavo P. Sudre, Dawn E. Lea, Sharon K. Davis, Lawrence Brody

Vaccines — Open Access Journal
http://www.mdpi.com/journal/vaccines
(Accessed 13 Mar 2021)

Open Access Viewpoint
COVID-19 Vaccine Roll-Out in South Africa and Zimbabwe: Urgent Need to Address Community Preparedness, Fears and Hesitancy
by Tafadzwa Dzinamarira, Brian Nachipo, Bright Phiri and Godfrey Musuka
Vaccines 2021, 9(3), 250; https://doi.org/10.3390/vaccines9030250 (registering DOI) – 12 Mar 2021
Abstract
South Africa became one of the first African countries to receive the COVID-19 vaccine. As the rest of Africa prepares to receive COVID-19 vaccines, most countries in Africa have set up national-level coordination committees for developing national vaccination deployment plans. While the main […]

Vaccines — Open Access Journal
http://www.mdpi.com/journal/vaccines
(Accessed 13 Mar 2021)

Open Access Article
Factors Affecting Attitudes towards COVID-19 Vaccination: An Online Survey in Slovenia
by Luka Petravić, Rok Arh, Tina Gabrovec, Lucija Jazbec, Nika Rupčić, Nina Starešinič, Lea Zorman, Ajda Pretnar, Andrej Srakar, Matjaž Zwitter and Ana Slavec
Vaccines 2021, 9(3), 247; https://doi.org/10.3390/vaccines9030247 (registering DOI) – 12 Mar 2021
Abstract
While the problem of vaccine hesitancy is not new, it has become more pronounced with the new COVID-19 vaccines and represents an obstacle to resolving the crisis. Even people who would usually trust vaccines and experts now prefer to wait for more information. […]

Vaccines — Open Access Journal
http://www.mdpi.com/journal/vaccines
(Accessed 13 Mar 2021)

Open Access Article
Willingness of Taiwan’s Healthcare Workers and Outpatients to Vaccinate against COVID-19 during a Period without Community Outbreaks
by Shikha Kukreti, Mei-Yun Lu, Yi-Hsuan Lin, Carol Strong, Chung-Ying Lin, Nai-Ying Ko, Po-Lin Chen
and Wen-Chien Ko
Vaccines 2021, 9(3), 246; https://doi.org/10.3390/vaccines9030246 – 12 Mar 2021
Abstract
To control the spread of the novel coronavirus disease 2019 (COVID-19), COVID-19 vaccination has been quickly developed. However, the COVID-19 pandemic will not be controlled if the COVID-19 vaccination uptake willingness is low. Therefore, the study aim was to explore the COVID-19 vaccination […]

Vaccines — Open Access Journal
http://www.mdpi.com/journal/vaccines
(Accessed 13 Mar 2021)

Open Access Review
Emerging SARS-CoV-2 Variants and Impact in Global Vaccination Programs against SARS-CoV-2/COVID-19
by Carmen Elena Gómez, Beatriz Perdiguero and Mariano Esteban
Vaccines 2021, 9(3), 243; https://doi.org/10.3390/vaccines9030243 – 11 Mar 2021
Abstract
The emergence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants in different continents is causing a major concern in human global health. These variants have in common a higher transmissibility, becoming dominant within populations in a short time, and an accumulation of a […]

Media/Policy Watch
This watch section is intended to alert readers to substantive news, analysis and opinion from the general media and selected think tanks and similar organizations on vaccines, immunization, global public health and related themes. Media Watch is not intended to be exhaustive, but indicative of themes and issues CVEP is actively tracking. This section will grow from an initial base of newspapers, magazines and blog sources, and is segregated from Journal Watch above which scans the peer-reviewed journal ecology.
We acknowledge the Western/Northern bias in this initial selection of titles and invite suggestions for expanded coverage. We are conservative in our outlook in adding news sources which largely report on primary content we are already covering above. Many electronic media sources have tiered, fee-based subscription models for access. We will provide full-text where content is published without restriction, but most publications require registration and some subscription level.

The Atlantic
http://www.theatlantic.com/magazine/
Accessed 13 Mar 2021
Health
People Are Keeping Their Vaccines Secret
COVID-19 vaccinations have become a public spectacle, but they touch intensely private questions.
Katherine J. Wu March 11, 2021

BBC
http://www.bbc.co.uk/
Accessed 13 Mar 2021
[No new, unique, relevant content]

The Economist
http://www.economist.com/
Accessed 13 Mar 2021
Papers, please — Are vaccine passports a good idea?
They are likely to make the biggest difference to international travel
Mar 13th 2021

Shots fired — The many guises of vaccine nationalism
Italy will not be the last to block shipments
Mar 13th 2021

Financial Times
https://www.ft.com/
Accessed 13 Mar 2021
Covid-19 vaccines
EU member states squabble over vaccine distribution
Group of countries warn of heavy disparities in shipments across Europe
March 14, 2021
A row has broken out between EU member states over coronavirus vaccine allocation in the latest fallout from AstraZeneca’s worsening supply shortfalls to the bloc.
Leaders of a group of European states wrote to the presidents of the European Council and European Commission complaining of “huge disparities” in the allocations of vaccines between member states. The letter, which was signed by Austria, Bulgaria, Croatia, the Czech Republic, Latvia and Slovenia, calls for a debate at leaders’ level.
However, other member states countered that the six member states are complaining about the adverse results of their own procurement decisions. The commission defended the system, saying the allocation of doses had followed a “transparent process”…

Coronavirus Business Update
US intensifies vaccine diplomacy
Indo-Pacific initiative with ‘Quad’ allies aims to counter Chinese influence
March 12, 2021
Top of Form
Bottom of Form

The FT View
The editorial board
A tantalising glimpse of a post-vaccine world
First, Americans had Dolly Parton singing of vaccines to the tune of “Jolene” to encourage them to get the jab (“I’m begging of you, please don’t hesitate/ ’cause once you’re dead then that’s a bit too late”). Now they have a further incentive. The Centers for Disease Control and Prevention this week said fully vaccinated adults could meet each other or people at low risk of contracting Covid-19 indoors, without social distancing or masks. If Americans needed any more impetus, they could look across to Israel, whose population is celebrating after its superfast vaccine rollout led to most restrictions being lifted, or disregarded.

For locked-down citizens elsewhere, the US and Israeli moves offer enticing glimpses of a post-vaccination world. Yet the US guidelines, in particular, prompted surprise elsewhere. In the UK, which has vaccinated a bigger proportion of its adults than the US, distancing rules remain in place for all. England’s chief medical officer warned this week the virus could surge again in autumn, long after inoculations are supposed to be completed.

The CDC argued it was important to spell out how life could begin to return to normal. The benefits of reducing social isolation for the vaccinated outweighed the risks, it said, and might “help improve . . . vaccine acceptance and uptake” among the hesitant. Social distancing and mask-wearing have also met more resistance in the US than anywhere; with infections still raging, governors in Texas and Mississippi have lifted statewide mask requirements for all — which President Joe Biden called “Neanderthal thinking”.

In Israel, 4m of its nearly 7m adults are fully vaccinated, with a further 1m awaiting their second shot. The rest are deemed unlikely to get the jab, through scepticism or perceived lack of need. The government’s laissez-faire approach to enforcing remaining restrictions may partly reflect the fact that it is facing another election on March 23, the fourth in two years. But, while it is pondering how to persuade sceptics to get jabs, the government appears to be following a tacit policy of monitoring hospital admissions while being ready to let the virus circulate among the young unvaccinated.

Other governments may in time opt for a similar approach. One reason for maintaining measures such as mask-wearing even with vaccinations well under way has been uncertainty over whether jabs prevent transmission as well as infection. Evidence is slowly mounting that they do. Israel’s health ministry found shots were 94 per cent effective at preventing symptomatic infections, and 89 per cent against infections of any kind, including those without symptoms. If little or no virus can be detected, many scientists assume it cannot be passed on. Recommended Covid-19 vaccines Covid-19 vaccine tracker: the global race to vaccinate

The big threat to the “dream” scenario of governments being able to ease restrictions almost entirely as inoculation programmes end is the emergence of new variants that resist existing vaccines or cause worse symptoms and higher hospitalisations even among the young and healthy. Later rounds of jabs — booster shots against mutated strains — seem inevitable. Testing programmes may be needed for some time to hunt down new variants, and as an alternative to “vaccine passports” for those who cannot or choose not to be jabbed.

Little by little, however, outlines of the post-pandemic normal are becoming discernible. Rich-world governments that are making good progress with vaccinations now need to prepare to donate their surplus doses to the developing world — to ensure they are not the only ones that can enjoy that brighter future.

Bottom of Form

Forbes
http://www.forbes.com/
Accessed 13 Mar 2021
[No new, unique, relevant content]

Foreign Affairs
http://www.foreignaffairs.com/
Accessed 13 Mar 2021
Snapshot March 11, 2021
Vaccine Diplomacy Is Paying Off for China
China’s vaccine diplomacy is off to a strong start, but Beijing still faces stiff competition and tough questions from abroad.
Yanzhong Huang

Snapshot March 9, 2021
How Many Vaccine Doses Can Nations Ethically Hoard?
A new framework sets the obligatory threshold for sharing vaccine doses at the point where deaths directly and indirectly caused by COVID-19 begin to resemble those from…
Ezekiel J. Emanuel, Cécile Fabre, Daniel Halliday, R. J. Leland, Allen Buchanan, Kok-Chor Tan, and Shuk Ying Chan
…We propose a novel framework to answer that question—the Fair Priority for Residents (FPR) framework—which sets the obligatory threshold for sharing vaccine doses at the point where deaths directly and indirectly caused by COVID-19 begin to resemble those from influenza. Tens of thousands of Americans die every year from the flu, but the U.S. government treats these deaths as normal background risk. The government takes modest measures to provide vaccines but does not mandate vaccination or mask wearing, even though doing so would save lives. We propose that governments have a duty to give “fair priority” to their residents when distributing vaccines in order to reduce COVID-19-related mortality to pre-crisis, or “flu risk,” levels. Once they have reached that point, however, their duty to assist people threatened by COVID-19 abroad outweighs their duty to further reduce mortality in their own countries….

Foreign Policy
http://foreignpolicy.com/
Accessed 13 Mar 2021
Argument
Quad Summit’s Vaccine Deal Is Biden’s Bold First Move in Asia
It’s a smart step to counter China, but the next ones won’t be as easy.
Michael J. Green

Argument
Scarcity and Ethics
The pandemic is offering a crash course to wealthy countries on dealing with problems they can’t buy their way out of.
By Malka Older
| March 12, 2021, 9:48 AM

The Guardian
http://www.guardiannews.com/
Accessed 13 Mar 2021
[No new, unique, relevant content]

New Yorker
http://www.newyorker.com/
Accessed 13 Mar 2021
Annals of Medicine
Why COVID-19 Vaccines Aren’t Yet Available to Everyone
President Biden has promised that all adults will be eligible to receive a vaccine by May. But manufacturing and distributing enough doses will depend on a lot of things going right.
By Sue Halpern
6:00 A.M.

Letter from the U.K.
The Fight Against Vaccine Misinformation
Society’s return to normal depends on widespread acceptance of the vaccine. Distrust stands in the way.
By Anna Russell
March 10, 2021

Q. & A.
Life After Vaccination
Dr. Ashish K. Jha considers what restrictions should remain in place once a large number of Americans have received protection against COVID-19.
By Isaac Chotiner
March 9, 2021

New York Times
http://www.nytimes.com/
Accessed 13 Mar 2021
World
China asks visa applicants to get inoculated with Chinese-made vaccines.
A new rule for foreigners applying in Hong Kong for visas gives preference to those who choose shots produced in China.
By Keith Bradsher March 13

Politics
Biden Takes First Tentative Steps to Address Global Vaccine Shortage
Under pressure to play catch-up on “vaccine diplomacy,” President Biden says he will help finance vaccine manufacturing capacity but is still resisting exports of doses.
By Sheryl Gay Stolberg and Michael Crowley March 12

Washington Post
https://www.washingtonpost.com/
Accessed 13 Mar 2021
China aims to vaccinate 70-80% of population by mid-2022
Associated Press · Mar 13, 2021

ICE has no clear plan for vaccinating thousands of detained immigrants fighting deportation
Maria Sacchetti · Mar 12, 2021

Think Tanks et al

Brookings
http://www.brookings.edu/
Accessed 13 Mar 2021
Brown Center Chalkboard
Coronavirus and schools: Reflections on education one year into the pandemic
Daphna Bassok, Lauren Bauer, Stephanie Riegg Cellini, Helen Shwe Hadani, Michael Hansen, Douglas N. Harris, Brad Olsen, Richard V. Reeves, Jon Valant, and Kenneth K. Wong
Friday, March 12, 2021
 
 
Center for Global Development [to 13 Mar 2021]
http://www.cgdev.org/page/press-center
Publication
March 8, 2021
A Moral Failure in Pandemic Response
As the virus spread and shut down life as we know it, global response became increasingly tainted by provincialism. From seizing masks and medical supplies en route to other countries to preventing vaccine exports, the world’s richest countries turned inward and neglected the global response effort. It is not too late to correct what has been an egregious failure in leadership.
W. Gyude Moore

March 8, 2021
Financing for Global Health Security and Pandemic Preparedness: Taking Stock and What’s Next
The COVID-19 pandemic has exposed the ways in which global pandemic preparedness and response are under-prioritized and under-resourced. But the good news is that today’s shortfalls are finally eliciting global action.
Amanda Glassman and Eleni Smitham
 
 
Chatham House [to 13 Mar 2021]
https://www.chathamhouse.org/
Accessed 13 Mar 2021
[No new digest content identified]

 
 
CSIS
https://www.csis.org/
Accessed 13 Mar 2021
Podcast Episode
Dr. Peter Hotez: Anti-Vaccine Movement, Resistance and the Texas Turmoil
March 11, 2021 | By H. Andrew Schwartz, J. Stephen Morrison

Transcript
A Conversation with Dr. Anthony Fauci and Professor Paul Kelly
March 9, 2021
 
 

Kaiser Family Foundation
https://www.kff.org/search/?post_type=press-release
Accessed 13 Mar 2021
March 11, 2021 News Release
KFF COVID-19 Vaccine Monitor: The Impact of the COVID-19 Pandemic on LGBT People
The latest report from the KFF COVID-19 Vaccine Monitor examines how the COVID-19 pandemic has impacted the lives of lesbian, gay, bisexual and transgender (LGBT) people and finds that larger shares of LGBT adults report economic losses and mental health struggles than their non-LGBT counterparts. Based on data gathered on…

March 10, 2021 News Release
Updated KFF Calculator Estimates Marketplace Premiums to Reflect Expanded Tax Credits in COVID-19 Relief Legislation
KFF has updated its 2021 Health Insurance Marketplace Calculator to reflect the expanded premium tax credits available to people who purchase their own coverage through their state’s health insurance exchange as passed by Congress in the American Rescue Plan Act and expected to be signed into law soon. The calculator…

March 10, 2021 News Release
Early COVID-19 Vaccination Efforts Through Community Health Centers Are Reaching People of Color
More than half of those who received their first dose of a COVID-19 vaccine through a community health center were people of color, suggesting that health centers appear to be doing a better job of reaching people of color than are overall vaccination efforts, finds a new KFF analysis. People of…

March 9, 2021 News Release
KFF COVID-19 Vaccine Monitor Probes Americans’ Experiences Trying to Sign Up for a Vaccine and to Find Relevant Information
Many Relied on Another Person’s Help to Try to Get a Vaccine Appointment As many states and local authorities ramp up their COVID-19 vaccination efforts, the latest KFF COVID-19 Vaccine Monitor report provides the first in-depth look at Americans’ experiences trying to gather relevant information and sign up to get…

Urban Institute [to 13 Mar 2021]
https://www.urban.org/publications
Publications
Historic Vaccination Patterns Provide Insights for Covid 19 Vaccine Rollout
Understanding longstanding barriers to vaccine uptake is necessary to ensure the success of Covid-19 vaccination efforts. This analysis examines historic vaccination patterns among adults using data from the 2016-18 National Health Interview Survey (NHIS). We examine flu vaccination rates among three risk groups: nonelderly adults (ages 19-64) at low- and high-risk of severe disease from Covid-19, and all
Stacey McMorrow, Tyler Thomas
March 12, 2021
Brief

World Economic Forum [to 13 Mar 2021]
https://agenda.weforum.org/news/
Media
Vaccine Confidence and Demand Rises Worldwide, Survey Finds
News 12 Mar 2021
:: A new Ipsos-World Economic Forum survey shows a notable increase in the number of people who want to be vaccinated against COVID-19 since December 2020
:: Italy, Spain, UK, Brazil, France, Mexico, Canada and Germany have seen the greatest uptick in vaccine intent – all rising by more than 20 points in just three months
:: Expert says trends are positive, but not at levels needed for herd immunity
:: Read the report and check out the data

Vaccines and Global Health: The Week in Review is a weekly digest  summarizing news, events, announcements, peer-reviewed articles and research in the global vaccine ethics and policy space. Content is aggregated from key governmental, NGO, international organization and industry sources, key peer-reviewed journals, and other media channels. This summary proceeds from the broad base of themes and issues monitored by the Center for Vaccine Ethics & Policy in its work: it is not intended to be exhaustive in its coverage. You are viewing the blog version of our weekly digest, typically comprised of between 30 and 40 posts below all dated with the current issue date

.– Request an Email Summary: Vaccines and Global Health : The Week in Review is published as a single email summary, scheduled for release each Saturday evening before midnight (EDT in the U.S.). If you would like to receive the email version, please send your request to david.r.curry@centerforvaccineethicsandpolicy.org.

– pdf version:  A pdf of the current issue is available here: 

– blog edition: comprised of the approx. 35+ entries posted below.

– Twitter:  Readers can also follow developments on twitter: @vaxethicspolicy.
.
– Links:  We endeavor to test each link as we incorporate it into any post, but recognize that some links may become “stale” as publications and websites reorganize content over time. We apologize in advance for any links that may not be operative. We believe the contextual information in a given post should allow retrieval, but please contact us as above for assistance if necessary.

Support this knowledge-sharing service: Your financial support helps us cover our costs and to address a current shortfall in our annual operating budget. Click here to donate and thank you in advance for your contribution.

.
David R. Curry, MS
Executive Director
Center for Vaccine Ethics and Policy

Milestones :: Perspectives :: Research

Rotavirus vaccines made available for use in humanitarian crises
Health partners welcome landmark pricing agreement through Humanitarian Mechanism, urging more manufacturers to follow suit
4 March 2021 News release Geneva/London/New York
Médecins Sans Frontières (MSF), Save the Children, UNICEF and the World Health Organization (WHO) welcome the opportunity to make rotavirus vaccine available to more children living in humanitarian crises thanks to a landmark pricing agreement with the manufacturer, GSK.

Children living in refugee camps, displaced communities or in other emergency situations now have a better chance of being protected against severe diarrhoeal disease with these lower price rotavirus vaccines. Diarrhoea is one of the leading causes of death among children under five.

The agreement makes use of the multi-partner Humanitarian Mechanism, launched in 2017. Rotavirus vaccine is the second vaccine  to be accessed through the scheme, which depends on manufacturers making their vaccines available at their lowest price for use in emergencies – across countries of all income levels. The first to be made available was the pneumococcal vaccine.

“We welcome this engagement from manufacturers and hope it will be a step towards making more vaccines available in the future at affordable prices,” said Dr Kate O’Brien, Director of Immunization, Vaccines and Biologicals at WHO. “It is unacceptable that some of the most at-risk children are not vaccinated against devastating diseases like rotavirus because of lack of availability or high costs.”…
The Humanitarian Mechanism facilitates access to vaccines for humanitarian organizations working in countries affected by emergencies, where access and prices have otherwise been a bottleneck…

Since 2017, nearly one million doses of pneumococcal vaccine have been approved for use by civil society organizations through the Mechanism in 12 countries: Algeria, Central African Republic, Chad, Democratic Republic of the Congo, Ethiopia, Greece, Kenya, Lebanon, Niger, Nigeria, South Sudan and Syria. The pneumococcal vaccine protects against childhood pneumonia, also a leading cause of childhood deaths during emergencies.

Once secured through the Mechanism, the vaccines are offered to humanitarian organizations working in camps and other emergency settings, who can make applications to access the vaccine at these lower prices.

“The Humanitarian Mechanism has already expanded the number of children who can receive lifesaving vaccines, but to reach its full potential and save more lives, MSF calls on manufacturers to commit additional vaccines and to allow governments hosting children in humanitarian emergencies to access the vaccines too,” said Miriam Alia, Vaccination and Outbreak Response Referent at MSF. “Children everywhere, no matter where they live, should have access to lifesaving vaccinations.”…

Milestones :: Perspectives :: Research

COVID Vaccines – UN Security Council; UNESCO

Security Council Calls for Increased Global Cooperation to Facilitate COVID-19 Vaccine Access in Conflict Areas, Unanimously Adopting Resolution 2565 (2021)
26 February 2021
SC/14454
The Security Council today announced the adoption of a resolution calling for strengthened international cooperation to facilitate equitable and affordable access to COVID-19 vaccines in armed conflict and post-conflict situations, and during complex humanitarian emergencies.

Acting through its special silence procedure enacted during the pandemic, the Council unanimously adopted resolution 2565 (2021), recognizing the role of extensive immunization against COVID-19 as a global public good for health.  It stressed the need to develop international partnerships, particularly to scale-up manufacturing and distribution capabilities, in recognition of differing national contexts.

By other terms, it reiterated its demand for a general and immediate cessation of hostilities in all situations on its agenda, demanding as well that all parties to armed conflicts engage immediately in a durable, extensive, and sustained humanitarian pause to facilitate the equitable, safe and unhindered delivery and distribution of COVID-19 vaccinations in areas of armed conflict.

Reaffirming that these calls do not apply to military operations against Islamic State in Iraq and the Levant (ISIL/Da’esh), Al-Qaida and Al-Nusra Front, or their associates, the Council demanded that all parties to armed conflicts fully comply with their obligations under international law.

Further, the Council requested the Secretary-General to provide a full assessment of the impediments to vaccine accessibility and the COVID-19 response, including vaccination programmes, in situations of armed conflict and complex humanitarian emergencies — and as necessary, make recommendations to the Council.  It expressed its intention to review situations brought to its attention by the Secretary-General where hostilities and armed group activities are impeding COVID19 vaccination and to consider what further measures may be necessary to ensure such impediments are removed, and hostilities paused to enable vaccination.

It emphasized the urgent need for “solidarity, equity and efficacy”, inviting donation of vaccine doses from developed economies and all those in a position to do so to low- and middle-income countries and other countries in need, particularly through the COVAX Facility — a global mechanism for pooled procurement and equitable distribution of COVID-19 vaccines.

[Security Council resolutions are currently adopted through a written procedure vote under temporary, extraordinary and provisional measures implemented in response to the COVID-19 pandemic, as set out in a letter (document S/2020/253) by its President for March 2020 (China).]

::::::

UNESCO calls for COVID-19 vaccines to be considered a global public good
24/02/2021
UNESCO’s International Bioethics Committee (IBC) and the World Commission on the Ethics of Scientific Knowledge and Technology (COMEST) have called for a change of course in current COVID-19 vaccination strategies, urging that vaccines be treated as a global public good to ensure they are made equitably available in all countries, and not only to those who bid the highest for these vaccines. Both committees have a long track record in providing ethical guidance on sensitive issues*.

The statement was presented during an online event on 24 February, which gathered UNESCO’s ethics bodies together with Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, and Professor Jeffrey Sachs from Columbia University.

The IBC-COMEST Statement stresses three key messages:
Firstly, pharmaceutical industries have a responsibility to share the intellectual property acquired with government support to enable manufacturers in all countries to provide access to vaccines for all, which should be considered a global public good. The IBC and COMEST also stress the responsibility of the pharmaceutical industry to invest in factories capable of producing vaccines of the highest possible efficacy and facilitating rapid distribution where needed.

Secondly, the IBC and COMEST say that the vaccine’s benefit to the greatest number of people cannot be considered the sole ethical criterion. Equality, equity, protection from vulnerability, reciprocity and the best interests of children must also be taken into account. Furthermore, decisions on fair distribution and prioritization should be based on the advice of a multidisciplinary group of experts in bioethics, law, economics, and sociology, together with scientists.

Thirdly, the IBC and COMEST consider that vaccination strategies should be based on a non-compulsory, non-punitive model, grounded in information and education, including dialogue with people who may be hesitant about vaccination or hostile to it. Refusing to be vaccinated should not affect the individual’s fundamental rights, specifically his or her right to access healthcare or employment.

Other issues the statement covers include: international cooperation across all different sectors working on COVID-19 to share the benefits of research; the sustainability issues that favour the emergence of zoonotic diseases; trust in science and healthcare authorities; the indispensable need for dialogue between science, ethics, politics and civil society.

Milestones :: Perspectives :: Research

World Bank Bond Expands Support to COVID-19 Resilience Through the United Nations Children’s Fund (UNICEF)
Washington, DC, March 4, 2021—The World Bank (International Bank for Reconstruction and Development or IBRD) has issued a US$100 million 5-year bond which both supports IBRD’s ongoing sustainable development and COVID-19 activities and adds a new feature to support similar efforts by the United Nations Children’s Fund (UNICEF). As countries confront the economic challenges of the pandemic, which has affected millions of children worldwide, the issuance will channel an amount equivalent to half of the total proceeds, US$50 million, to UNICEF. This frontloading of financing to UNICEF will support its pandemic response programs for children around the world over the 5-year period.

“This World Bank bond serves as an example of how the private sector can share financial risks to achieve positive development impact,” said David Malpass, World Bank Group President. He added, “We are grateful to our investors for joining this effort and demonstrating how investors can participate in the global response to COVID-19, through this unique opportunity to scale up resources available to UNICEF to expand its programs. The bond also spotlights impact investor support for World Bank Sustainable Development Bonds and the potential for finding new ways to collaborate for impact.”

“The COVID-19 pandemic has exacerbated deep inequalities within and across countries worldwide,” said Henrietta Fore, UNICEF Executive Director. “Keeping children at the heart of recovery efforts and focusing on innovative partnerships will enable us to reimagine children’s futures and secure more equitable societies.”

“Making real headway in alleviating social challenges requires new ways of doing things. We’re excited to innovate in the financial space and our institutional and private clients have shown overwhelming support for investments that can further their social missions,” said Jim O’Donnell, Head of Citi Global Wealth.

Milestones :: Perspectives :: Research

Coalition of International NGOs Call for Equitable Access for Vaccines and Treatment during COVID-19 Pandemic
Mar 4, 2021
…On February 11, 2021, the World Federation of Public Health Associations hosted a historic meeting to initiate a coalition amongst leaders from international NGOs who share a common interest in equitable access for vaccines and treatment during COVID-19.

The organizations agreed to work together to build and sustain equity in global public health through increased advocacy for social protection and social development in vulnerable communities. Moreover, leaders expressed the need for an environmentally conscious and safe way to develop, distribute, and deliver vaccines, as this will also help reduce inequity following the pandemic by ensuring we do not exacerbate adverse climate effects. The Coalition is committed to engaging with other organizations, governments, and key stakeholders to achieve a coordinated response to the pandemic. The organizations will dedicate themselves to continue compiling resources, sharing evidence-based best practices, and using their collective voice to advocate for those who are disproportionately harmed by the pandemic, including chronically ill patients, individuals lacking access to health care services and medication, and marginalized communities.

Therefore, together we call on the World Health Assembly, the G20, every government, and all organizations that engage in public health, social policy, and advocacy to make the ethical choice now for the health and the economic well-being of all populations globally, especially the most vulnerable — leaving no one behind.

We call on all of these actors to work together to:
:: Guarantee more and equitable access to vaccines
:: Increase the health care, public health, and social protection workforce
:: Challenge uncoordinated social, economic, and health system dynamics to maximize vaccine production, distribution, and uptake
:: Address the national and international spending priorities during the pandemic
:: Guarantee an environmentally and economically sustainable and equitable production and distribution of the vaccines
:: Engage all groups in society, including youth and young professionals, key stakeholders, and health professionals in the decision-making process and implementation
:: Engage with civil societies, patient organizations, and the broader public across diverse communities to address communication, including risk communication, tackling misinformation and combatting hesitancy, on every level.

Overall, we believe that this growing Coalition has immense potential to strengthen our individual and collective responses to inequity, which like the virus itself, works beyond national borders both during the pandemic and in the years of recovery to follow. We are keen to begin this important work, and we look forward to contributing to and sharing our joint initiatives across our extensive networks…

Signed by:
FDI World Dental Federation
Healthcare Without Harm
International Alliance of Patients’ Organizations
International Council of Nurses
International Federation on Ageing
International Federation of Environmental Health
International Federation of Medical Students’ Associations
International Federation of Social Workers
International Hospital Federation
International Pharmaceutical Federation
International Pharmaceutical Students’ Federation
International Physicians for the Prevention of Nuclear War
International Veterinary Students’ Association
The European Forum for Primary Care
The Global Ageing Network
Union for International Cancer Control
WHO Collaborating Centre on Family Medicine and Primary Health Care – Ghent University
World Association for Disaster and Emergency Medicine
World Federation of Public Health Associations
World Heart Federation
World Organization of Family Doctors
World Patients Alliance
World Physiotherapy

Milestones :: Perspectives :: Research

COVAX: Vaccine Supply/Allocation

The COVAX Facility – FIRST ROUND OF ALLOCATION: ASTRA ZENECA/OXFORD VACCINE (manufactured by AstraZeneca & licensed and manufactured by Serum Institute of India)
Feb-May 2021 – last updated 2 March 2021
Introduction
Following from the publication of an interim distribution forecast, and based on current knowledge of supply availability, this first round of allocations provides information on provision of doses of the AstraZeneca(AZ)/Oxford vaccine to COVAX Facility participants, through May 2021.

This first round allocation outlines delivery of 237 million* doses of the AZ/Oxford vaccine – manufactured by AstraZeneca (AZ) & licensed and manufactured by Serum Institute of India (SII/AZ) – to 142 Facility participants.
[*This total does NOT include 5% of supply set aside for Humanitarian & Contingencies Buffer, not yet approved by Gavi Board]

This list will be updated by the end of the week to provide indicative timelines for the supply of these doses, split into Feb-March and April-May. These timelines are dependent on a variety of factors including national regulatory requirements, availability of supply, and fulfilment of other criteria such as validated national deployment and vaccination plans (NDVPs) from AMC participants, indemnification & liability agreements, and export and import authorisations.

Participants not listed have either exercised their rights to opt-out of this vaccine, wish to transfer allocated doses to AMC participants, are AMC-eligible but have not joined the AMC, have voluntarily delayed receipt of doses and communicated this intent ahead of allocation, or have not met financial requirements.

In addition to this first round of allocations, an exceptional distribution of 1.2 million doses of the Pfizer-BioNTech vaccine, anticipated for delivery in Q1 2021, was announced in early February. These doses are reflected in the table below, to provide a global overview of allocations to-date but are not part of this round of allocation.

Further allocation rounds for vaccines in the COVAX portfolio will be announced in due course.

Overview of the process
This first round of allocation took place as per the Fair allocation mechanism for COVID-19 vaccines through the COVAX Facility, which was developed by WHO in consultation with its Member States. This allocation framework for fair and equitable access to COVID-19 health products sets forth the criteria and approach to allocation of vaccines through the COVAX Facility.

The operationalization of the Framework, in accordance with the principles and provisions set forth in the document above, is performed by the Joint Allocation Taskforce (JAT), composed of staff from Gavi, the Vaccine Alliance and WHO, and the Independent Allocation Vaccine Group (IAVG). The main purpose of the IAVG is to make validation assessments of proposals for Vaccine Allocation Decisions (“VAD proposals”), which outline the volumes

of Vaccines that should be allocated to each country/economy participating under COVAX within a given time frame. The IAVG will consider VAD proposals prepared and submitted by the JAT.The IAVG met twice over 22 and 23 February 2021 to discuss this first round of allocation. All 12 IAVG members were present during both meetings, and therefore full quorum was achieved. The deliberations resulted in consensus and no divergent views were recorded on the proposed allocation.As is normal procedure, the IAVG allocation report was then validated by the WHO Deputy Director-General, and the decision was communicated tothe Office of the COVAX Facility, administered by Gavi.

TABLE: Allocations by Facility participant
Note: Table will be updated later this week to provide further information on anticipated supply timelines, split into February-March and April-May 2021.
[138 countries listed at title link above including an allocation for “non-UN Member States” of 1,125,600 doses of AZ]

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Independent Allocation of Vaccines Group (IAVG)
[WHO webpage – accessed 6 Mar 2021]
One of the principal objectives of COVAX is to promote the fair and equitable allocation of COVID-19 vaccines that are procured or distributed through COVAX (the “Vaccines”) to countries and economies participating in COVAX. To achieve such objective, the mechanism through which Vaccines are allocated must be transparent and independent.

In this context, WHO, Gavi and CEPI (collectively, the “COVAX Partners”) support the establishment by WHO of an Independent Allocation of Vaccines Group (“IAVG”) pursuant to the WHO Regulations for Study and Scientific Groups, Collaborating Institutions and Other Mechanisms of Collaboration, and in accordance with these Terms of Reference. The IAVG is expected to play a pivotal role in the allocation of Vaccines under COVAX and to foster the independence of, and provide transparency into, the Vaccine-allocation decision-making under COVAX.

The main purpose of the IAVG is to make validation assessments of proposals for Vaccine Allocation Decisions (“VAD proposals”), which outline the volumes of Vaccines that should be allocated to each country/economy participating under COVAX within a given time frame. The IAVG will consider VAD proposals prepared and submitted by the Joint Allocation Taskforce (“JAT”), composed of WHO and Gavi staff.

The IAVG will have the following functions:
:: To review the VAD proposals submitted by the JAT and to request clarifications from the JAT when necessary;
:: To discuss with the JAT any adjustments to the VAD proposals considered necessary on the basis of IAVG’s critical assessment;
:: To make validation assessments of the VAD proposals, ensuring they are technically informed and based on the latest available data and evidence;
:: For each VAD proposal that is validated by the IAVG (hereinafter a “VAD”), to document and justify the validation of such VAD, including any adjustments made to the original VAD proposal submitted to the IAVG by the JAT;
:: To deliver the VADs to the WHO Deputy-Director General for further implementation by the JAT.

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Independent Allocation of Vaccines Group (IAVG) Members – as of January 2021
Members
Professor Anna Mia Ekström
Dr Arlene King
Christopher Maher
Dr Narendra Kumar Arora
Dr Bruce G. Gellin
Dr Dafrossa Cyrily Lyimo
Professor Tjandra Aditama
Doctor Alejandro Cravioto
Maria Guevara
Dr Manica Balasegaram
Dr Poh Lian Lim
Dr Masahiko Hachiya

Terms of Reference: https://www.who.int/groups/iavg/terms-of-reference

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Documents and reports
22 February 2021
Report of the Independent Allocation of Vaccines Group on the allocation of COVAX Facility secured vaccines: 22 February 2021
Overview
This report covers the first Allocation of Astra Zeneca vaccines produced at the following two sites for which WHO issued an Emergency Use Listing on 15 February 2021:
:: Serum Institute of India Pvt Ltd – COVID-19 Vaccine (ChAdOx1-S [recombinant]) – COVISHIELD™ – “SII AZ”
:: AstraZeneca/SKBio – COVID-19 Vaccine (ChAdOx1-S [recombinant]) – “AZ” …

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Annexes
Report of the Joint Allocation Taskforce (JAT) on the distribution of COVAX Facility secured vaccines
COVAX FACILITY DISTRIBUTION of Astra Zeneca vaccines produced at two different sites: SK BIO in Republic of Korea and Serum Institute of India Pvt Ltd
Date of report 19 February 2021
Summary
:: The current distribution round is enclosing allocation of Astra Zeneca vaccines produced by two different manufacturers at the following two sites for which WHO issued an Emergency Use Listing on 15 February 2021:
>> Serum Institute of India Pvt Ltd – COVID-19 Vaccine (ChAdOx1-S [recombinant]) –
COVISHIELD™ – “SII AZ”
>>AstraZeneca/SKBio – COVID-19 Vaccine (ChAdOx1-S [recombinant]) – “AZ”

:: To date, 1,200,420 M doses of vaccine (Pfizer) have been allocated in a separate and distinct process (more details here) which was performed on 29 January 2021. These are referred to as “First Wave” doses. This was due to specificities pertaining to the Pfizer/ BioNTech deal as well as learning objectives. These doses are not included in this allocation round, however coverage reached in the participants that received these early doses are reflected in the allocation. To date no doses have been shipped to the 18 First Wave participants.

:: Supply needs for a COVAX Buffer are also factored in this allocation – with 5% of total available supply set aside. Further information is available in the Supply section below.

:: Considering the supply and demand characteristics, the overall number of doses to be distributed is 237,468,000 to 142 participants for the period January to May 2021 for AZ and SII AZ

:: Given the supply available (and the 2-dose regime) and the population of all the participants in this round, the average proportion of population covered in this round across countries is 5.52% (not weighted for population size)…