REGIONAL – Vaccination for richer countries first, a plus for tourism — UWI professor in Jamaica

Source: Jamaica Observer- At least one public health expert has said that rather than being upset that many high-income countries have bilateral arrangements with the manufacturers of vaccines for SARS-CoV-2 — the virus that causes COVID-19 — making them the first recipients in line, tourism-dependent territories like Jamaica should see it as a positive.

Professor of public health, epidemiology and HIV/AIDS at The University of the West Indies (UWI) Dr Peter Figueroa’s statements come even as the United Kingdom on Tuesday became the first western Government to begin vaccinating against the virus using Pfizer-BioNtech — one of the two approved vaccines — with the United States set to follow suit.

He made the observation while responding to queries during a virtual COVID-19 and immunity conference, hosted by The UWI and the University Hospital of the West Indies, as to whether the existence of COVAX — formally known as The COVID-19 Vaccines Global Access Facility, which is a global collaboration for speeding up the development, manufacture and equitable distribution of new vaccines — meant that all countries would receive the approved vaccines at the same time.

Under the arrangement, countries that sign on to COVAX are expected to get access to a broad portfolio of new vaccine candidates to combat the virus.

“The reality is that a significant amount of the early vaccine is going to go to high-income countries. In addition, the cold chain requirements are such that, especially the BioNtech vaccine, it really needs a -70 degrees freezer to store it, so that even if you made arrangements to deliver it to major cities in developing countries, it could not be used extensively.

But there is a benefit to all of us if many thousands of persons are vaccinated in developed countries, it means that it is easier for us to receive the tourists coming from North America, if the majority are vaccinated,” Professor Figueroa pointed out.

“So I am not upset about the fact that there may be a little more distribution, initially, in high-income countries, provided that the COVAX facility works effectively and gets it on an equitable basis to the low- and middle-income countries rapidly,” he added.

Jamaica’s Tourism Minister Edmund Bartlett last month said that the impact of COVID-19 on the tourism sector, over the past eight months, “has been very severe”, but that “we have been doing a good job in controlling the things we can control”.

“The projections have been looking good, so we have to continue putting our best foot forward and continue to maintain best practices,” he said at the time.

Dr Figueroa is, in the meantime, emphasising that “there are a lot of important issues left to be addressed”, as it relates to the vaccine getting to Jamaica’s shores.

“The most important thing, in my view, for us to address is to promote vaccine confidence among health workers and the population. People must have confidence in the vaccine if they are going to take it,” he said.

He also noted that the “challenges we have with communication” will have to be resolved, even while acknowledging the differing levels of acceptance amongst individuals globally.

“There is a lot of misinformation and rumours, and we have to recognise that the vaccines are not a silver bullet. Johns Hopkins University did a survey, globally, in July…the acceptability of COVID[-19] vaccines varied between countries; from as low as 26 per cent of the population said they would take it [and] up to 95 per cent in Ecuador, so it varies tremendously within the Americas,” he said, adding that in July, Jamaica was at 35 per cent acceptability.

The public health expert emphasised, too, that a small survey among Caribbean immunisation staff showed that 79 per cent were of the view that there needs to be “a vaccine introduction communication plan”.

Based on that study, 74 per cent were concerned about vaccine safety, 58 per cent about the cold chain, 42 per cent about storage, and 42 per cent about vaccine efficacy and herd immunity.

“So these are real issues that we have to address. There are issues of storage, cold-chain logistics, training staff and the vaccine characteristics are going to vary.

There are additional costs, not just for the vaccine but for delivering them, and it’s a period of economic downturn; and if we are not careful there will be significant opportunity cost if our other essential health services are not sustained. You have to know the characteristics of the vaccines, the formulation.

Take the Pfizer-BioNtech vaccine, up until now you have the vaccine in a vial, but you may have to take normal saline separately in order to dilute the vaccine. So that introduces another element, whereas with the Moderna [the other approved vaccine], everything is in one vial. So you also have to think [about] whether you have to mix or not, you may have to keep everything at the same temperature. Once you open the vaccine you may have to discard it within six hours. Each country has to think about which vaccine best suits its conditions,” Professor Figueroa explained.

Meanwhile, he said the vaccine is not a cure-all, but a necessary part of the mix of solutions.

“We are going to have to live with COVID[-19] for the foreseeable future, and certainly through 2021. The vaccines are not a silver bullet, we still need to have in place non-pharmaceutical measures…saliva tests are already available in the United States and we hope they become more widely available. We need to train dogs to smell persons with COVID[-19], this is already being done elsewhere,” Professor Figueroa said.

He also said there are apps which can be used to help identify hot spots and individuals exposed to the virus.

“We continue to learn more about COVID, but we have to prepare ourselves for more change as the situation is very dynamic, and I suggest that you take the vaccine when you get the chance, I certainly am going to do so,” he stated.