Mosialos: We now need better coronavirus vaccines

"We need better vaccines now"

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Given the fatigue of citizens in many countries with continuous vaccinations, we now need better vaccines. "Unless we are lucky and the virus weakens a lot, so that it is no longer a major public health problem," said Elias Mosialos, a professor of health policy at the School of Economics and Political Science (LSE) and Imperial College London, in a Facebook post. .

As he states, “in order to stop the pandemic, we will need vaccines and drugs that will prevent the spread of the virus. The updated vaccines we will have in the fall will not do that. Therefore, the effort of the pharmaceutical companies but also of the global regulatory authorities should have long been focused on the direction of the production of more integrated vaccines ".

As for the new vaccines under development, he points out that "what we do know is that the updated vaccines are designed to treat Omicron strains that are no longer prevalent. The dilemma therefore is whether we should use them in the autumn months or continue to use existing vaccines. In other words, will the 'expansion' of immunoprotection have a significant difference and effect with our exposure to a new vaccine that treats an older Omicron strain and not the original Wuhan strain. Nevertheless, the challenges will remain. "

He also adds, "At the moment we do not yet know what happens to cellular immunity, ie how many have developed cellular immunity and for how long. It is really interesting that the regulatory authorities at global and regional level have not requested the submission and analysis of relevant data. Also, even if we renew the vaccines at regular intervals, we will probably be one step behind the evolution of the virus, as we are now. "We will have vaccines for older Omicron executives, but not for the more recent ones."

"Up until the advent of Delta, vaccines were relatively effective both in preventing infection for a significant proportion of those vaccinated (not all) and in reducing the likelihood of spread," he said. They were very effective in reducing the chance of serious illness. But the data with Omicron and especially sub-variants 4 and 5 have changed. Vaccines are no longer effective in preventing mild infection and also do not seem to be effective in reducing the chance of spreading. But vaccines are still very effective in reducing the chance of serious illness.

We know that the second booster dose for those over 60 and the vulnerable is recommended by vaccination committees in many countries, although there are differences. In the US the recommendation applies to those over 50, while in the UK to those over 75 living in nursing homes. The European Medicines Agency and the ECDC also point out that we do not yet have clear data on efficacy in order to propose a second booster dose for those under 79. Until recently, our country had the same guidelines as EU countries (Germany and France). . Nevertheless, only 17% of over 60 in our country have taken the second booster dose, although the platform has been open for 2,5 months. What would therefore be more important, from the point of view of health policy, would be to intensify efforts to increase the percentage of those vaccinated in the categories where there is safer data on the benefits offered by the 2nd booster dose. That is, to increase the percentage of vaccinated over 60 years from 17% to much higher rates. This is the public health policy that identifies the main problem and aims to address it. And it does not dwell on individual issues, especially when there is no documentation to extend policies to new categories of citizens.

At the same time, in the implemented health policy, the responsibility is not transferred to the citizens, in the context of "we do not know if there will be benefits but the citizens can individually decide what to do with this dose of the vaccine". The policy of Pontius Pilate is doubtful whether it will have results while, I repeat, the main problem has not been addressed. We have an even higher number of unvaccinated people over 60 compared to other countries in Western Europe and I again point out only 17% of those vaccinated with a second booster dose ".

Source: RES-EAP