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Second-generation vaccines offer a chance to correct flaws in early vaccination campaigns

Alarming headlines about the Delta variant’s inexorable rise and reports of even more concerning coronavirus mutations obscure the good tidings: countries with successful vaccination campaigns are seeing remarkable reductions in hospitalisations and deaths. Iceland, for example, saw Covid cases rise to record highs this summer; with over 90% of the country’s eligible population at least partially vaccinated, however, hospitalisations remained low and deaths near zero.

Despite such success stories, two fatal flaws continue to hinder the international vaccine drive: wealthy governments’ vaccine hoarding and policymakers’ failure to address vaccine hesitancy. These two phenomena are responsible for the fact that several billion people around the world remain uninoculated and unprotected against Covid-19. The forthcoming second generation of coronavirus vaccines, however, offers policymakers and public health bodies a unique opportunity to course correct.

First-generation vaccine supply swallowed up by those with deep purses

The thorniest problem plaguing the global Covid-19 vaccine rollout is undoubtedly vaccine inequity. A stark inoculation gap has already opened up: high- and upper-middle-income countries have administered 82% of all vaccines to date, while the world’s 30 poorest nations have inoculated a mere 2% of their populations.

What’s more, there’s little hope for a windfall of first-generation vaccines for poorer countries any time soon. By the end of 2021, the G7 countries are expected to have stockpiled almost one billion vaccine doses, and many developed countries have inked multi-year deals with leading vaccine manufacturers such as Pfizer and Moderna, meaning that they’ve effectively gobbled up future supply as well. While the World Health Organisation (WHO) has called for a moratorium on booster jabs until 10% of people in all countries have been vaccinated, few wealthy countries seem inclined to oblige. Israel has already begun administering third doses to anyone above the age of 12, while major European countries are beginning booster campaigns as well.

Vaccine inequity is further compounded by other factors: the COVAX scheme, intended to improve equitable distribution, has delivered less than 10% of the doses promised, while the cold chain required to supply leading first-generation jabs poses major logistical challenges for developing countries.

Vaccine hesitancy and disinformation: an intractable problem?

This initial phase of the vaccination rollout has also been marred by a failure to address the disinformation and distrust which has caused many to become skittish of the lifesaving jabs. As a result, even countries with ample supplies of Covid-19 vaccines have been forced to go to drastic lengths to increase uptake. In the United States, civic groups have gone door-to-door in areas with low vaccination coverage, while incentives ranging from free beer to multimillion dollar lotteries have not been enough to stop American vaccination rates from plateauing.

France has managed to kick its vaccination campaign into high gear—but only after President Emmanuel Macron took a gamble on introducing widespread health passes, requiring people to show proof of vaccination or a recent negative test for everything from eating in a restaurant to travelling on a train. The gambit flattened France’s summer curve, prompted more than 10 million French people to get their jabs, and according to epidemiologists may have saved tens of thousands of lives.

What neither Paris nor Washington—nor most other governments around the world—have managed to do is to find arguments which resonate with the vaccine hesitant. While there is a core group of people are staunchly antivaccine, many more remain on the fence; the rollout of second-generation vaccines offers policymakers a fresh chance to convince these people that the jabs on offer are both safe, with minimal and manageable side effects, and essential to ending the Covid pandemic.

Promising second-generation vaccines could change the game

Second-generation vaccines—engineered in the light of advanced understanding of the coronavirus—are edging ever closer to approval. As such, the world’s top brass will soon have a second shot at communicating about the importance of this preventative measure, as well as a chance to improve access in the lower-income countries penalised for not securing expensive vaccine contracts.

The vaccine candidate known as AKS-452, from Massachusetts-based Akston Biosciences, is one promising example of a jab which could address vaccine inequity and vaccine hesitancy alike. Following promising Phase I trial data which found that AKS-452 was safe, well-tolerated, and achieved a 100% seroconversion rate even after a single 90 µg dose, the vaccine candidate is now undergoing Phase II trials in the University Medical Center Groningen (UMCG) in the Netherlands.

The Akston vaccine has a number of characteristics which could make it eminently suitable for worldwide use. For one thing, AKS-452 remains shelf-stable for six months at 25°C—and can even be stored for a month at 37°C, making it a perfect fit for regions without the cold chain necessary to distribute more finicky vaccines. Akston’s vaccine could also be produced easily and affordably using standard low-cost techniques which could yield more than one billion doses a year from a single production line. The fact that it’s produced using more conventional techniques could also win over people sceptical of the mRNA vaccines which have formed the backbone of wealthy countries’ vaccination efforts so far.

There are a number of other promising vaccines entering trials, as well—suggesting that a full complement of second-generation vaccines is imminent. After a first vaccine formulation disappointed with only 48% efficiency in human trials, CureVac is more sanguine about its second vaccine candidate, an mRNA vaccine known as CV2CoV which showed promise in preclinical macaque monkey trials mid-August. Particularly encouragingly, the vaccine candidate sparked antibodies against the Beta, Delta and Lambda variants—a factor which would make it a boon not only for countries dealing with surges of those mutations, but for individuals whose hesitancy stems from concerns that first-generation vaccines do not protect them against the latest variants.

Transparent and informed second-generation vaccination campaigns, which prioritise the vulnerable no matter where they live and lean into the concerns of the vaccine hesitant could ensure that the pandemic is no longer able to wreak havoc on public health and the economy.

This article does not necessarily reflect the opinions of the editors or the management of EconoTimes

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