Vaccines for everyone? by Conor Giblin
After a tumultuous year, there appears to be light at the end of the tunnel with the news of Covid-19 vaccines being approved. But who will access it first? Will everyone want to be vaccinated? And will ‘anti-vaxxers’ delay the possibility of achieving herd immunity?
We spoke to Doctor Lisa Pierre, a senior clinical pharmacologist and Development Team Leader for Johnson & Johnson’s Lung Cancer Initiative (LCI), and Professor Sir Robert Lechler, former President of the Academy of Medical Sciences, to find out how these questions will create major challenges for governments, the healthcare sector, and the scientific community in 2021.
Ever since coronavirus began to force many countries into lockdown last year, pharmaceutical companies and universities around the world have been collaborating to produce a family of vaccines to save lives and enable governments to eventually relax their lockdown restrictions.
Professor Lechler explained that some Covid-19 vaccines are unusual because they are nucleic acid vaccines in the form of RNA or DNA: using “the encoding information of the virus to persuade the cells of the [vaccinated] person to make the proteins of the virus, and the immune response is triggered against those proteins.” Examples of Covid-19 vaccines containing RNA are the Moderna vaccine (currently approved in the U.S.) and the Pfizer/BioNTech vaccine (approved for use in the UK and the U.S. in December 2020). The Oxford/AstraZeneca vaccine, also approved in the UK, uses DNA.
However, it’s not only scientific innovation that has enabled the rapid development and approval of coronavirus vaccines. According to Dr Pierre, “the regulators have given it fast-track and have engaged early on […] They’ve been proactive in ensuring that approvals can happen quickly and I imagine that recruitment for clinical trials has been very quick, as people are keen to play their part and be a part of the process of finding a solution”.
The rapid development of these vaccines has given rise to a newly militant anti-vaccination movement, fuelled by concerns that scientists and regulators may have cut corners and compromised safety in the development process, along with the concept of ‘Big Pharma’—the idea that pharmaceutical companies are driven solely by profit. Despite this public narrative, Dr. Pierre explained that in fact “many of the [pharmaceutical] companies are doing it on a not-for-profit basis. It’s worth making sure that’s clear to people”. AstraZeneca has already committed to providing their vaccine to poorer regions at a low cost and claims it is not being manufactured for profit, though others like Pfizer are working for profit as normal.
The anti-vaccination movement does not consist of one demographic and there are many reasons why certain individuals or communities may be more reluctant than others to get vaccinated. A survey by the London School of Hygiene & Tropical Medicine and Public Health England found that “people from BAME backgrounds are almost three times more likely to reject a Covid-19 vaccine than those from white backgrounds”, which suggests there is a lack of trust in the British healthcare system or that public health messaging has failed to reach some communities.
During our interview, Professor Lechler also addressed the possibility of geopolitical tensions arising from “national self-interest” or, as the World Health Organisation (WHO) puts it, “vaccine nationalism”. The WHO hopes that highly developed countries will buy their own supply of vaccines, while it aims to subsidise poorer countries who may lack the funds and infrastructure to adequately distribute the vaccines.
Unfortunately, it seems that within weeks of the first vaccines being approved, this vaccine nationalism has started to emerge. The People’s Vaccine Alliance, which includes organisations such as Amnesty International and Oxfam, claims that many of the richest countries in the world have already bought enough doses to vaccinate their populations three times over. Their research concludes that in around 70 of the world’s poorest countries, only 1 in 10 people may receive the vaccine if richer countries continue to buy up the majority of available doses.
Our conversation with Dr. Pierre and Professor Lechler concluded with a brief discussion about the lessons that governments have learnt from this pandemic. Professor Lechler said a key lesson was that “we need to be ready for the next one”, as countries that had previously dealt with the SARS pandemic in the early 2000s were better equipped for dealing with Coronavirus. Dr. Pierre believes the Covid-19 pandemic has shown how much can be achieved when there is co-operation between universities and the pharmaceutical industry, which may have a positive impact on other future drug developments. Our discussion with these two experts highlighted the extreme vulnerability of our interconnected world when it comes to public health crises. There have been clear strengths and weaknesses of the global effort to end the Covid-19 pandemic, but we must remember that it is far from over. Its resolution requires global co-operation and once we see a return to some form of normality, governments must take the time to evaluate their response and learn from their failures, because the next pandemic could be just around the corner.
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