The outbreak of deadliest corona virus (COVID-19) or (SARS-CoV-2) from Wuhan province of China in 2019 was the beginning of the most challenging pandemic of this century and considering its high mortality and rapid spread, an effective vaccine is urgently needed to control this pandemic. Precautionary measures were taken and nationwide lockdowns were imposed but the world continues to face an existential threat. As a result, the academia, industry, and government sectors are working tightly together to develop and test a variety of vaccines at an unprecedented pace.
A glance at the spread of infection and death toll shows that Asian countries, such as India, Turkey, Iran, and Indonesia have the highest numbers of confirmed coronavirus cases. Among the earliest countries to report COVID-19 cases after the outbreak in mainland China were Japan, South Korea, Thailand and Vietnam, but these states has successfully controlled the pandemic as compared to Europe and North America. As of mid-March 2021, the US leads the death toll table with 542,360 deaths in total others include India, Iran, Indonesia, Turkey, and Iraq with more than 300,000 deaths combined. However, the death tolls in a number of countries are claimed to be significantly higher than those given in official figures.
With the global efforts, we have been able to develop vaccines to beat the deadly virus within a very short period relatively. As of 18 February 2021, at least seven different vaccines across three platforms have been rolled out in countries. Vulnerable populations in all countries are the highest priority for vaccination. At the same time, more than 200 additional vaccine candidates are in development, of which more than 60 are in clinical development.
COVID-19 Vaccines Global Access, abbreviated as COVAX, is a global initiative aimed at equitable access to COVID-19 vaccines led by UNICEF, Gavi, the Vaccine Alliance, the World Health Organization, the Coalition for Epidemic Preparedness Innovations, and others. For the COVID-19 vaccine development, the World Health Organization proposed attributes and criteria for considerations for the evaluation and prioritization of COVID-19 candidate vaccines. COVAX is part of the ACT Accelerator, which WHO launched with partners in 2020. is one of the three pillars of the Access to COVID-19 Tools Accelerator, an initiative begun in April 2020 by the World Health Organization (WHO), the European Commission, and the government of France as a response to the COVID-19 pandemic. COVAX aims to coordinate international resources to enable the equitable access of COVID-19 diagnostics, treatments, and COVID-19 vaccines. By 15 July 2020, 165 countries – representing 60% of the human population – had joined COVAX.
With the expedited development of vaccine, another major hurdle faced by the global population is the mass-immunization process because it is difficult to vaccinate the global population overnight. Furthermore, the international regime also established the ACT-Accelerator to contain the COVID-19 pandemic faster and more efficiently by ensuring that successful diagnostics, vaccines and treatments are shared equitably across all countries. It will speed up development and production and manage vaccine distribution fairly, because otherwise, there will be hoarding in some places and life-threatening shortages in others.
Similarly, the Country Readiness and Delivery (CRD) work stream is part of COVAX, the vaccines pillar of the Access to COVID-19 Tools Accelerator. Through the CRD work stream, WHO, UNICEF, the GAVI Secretariat, and partners are working together at the global and regional levels to develop and disseminate adaptable global resources (e.g., guidance, trainings, tools, and advocacy materials) to support COVID-19 vaccines introduction.
WHO advises that once a vaccine(s) is shown to be safe and effective, and authorized for use, all countries receive doses in proportion to their population size, albeit initially in reduced quantities. This will enable every country to start by immunizing the highest priority populations.
In the second phase, vaccines would continue to be deployed to all countries so that additional populations can be covered according to national priorities.
In a snapshot, fair allocation of vaccines will occur in the following way:
- An initial proportional allocation of doses to countries until all countries reach enough quantities to cover 20% of their population
- A follow-up phase to expand coverage to other populations. If severe supply constraints persist, a weighted allocation approach would be adopted, taking account of a country’s COVID threat and vulnerability.
With a fast-moving pandemic, no one is safe, unless everyone is safe