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AVAC's weekly COVID News Brief provides a curated perspective on what COVID news is worth your time.
"The waiver of intellectual property rights to allow as many countries as possible to produce the vaccines is the way to go. Pharmaceutical companies that have monopoly over the COVID-19 vaccines might not be receptive to calls to waive intellectual property rights. However, the need to save humanity in the face of the fast growing and mutating COVID-19 virus should override the urge to make profits."
— Editorial in The Standard ([link removed])


** Latest Global Stats
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May 7, 2021
Global Documented Cases
156,176,138 Global Reported Deaths
3,258,680 People Fully Vaccinated
297,637,980
Source: Coronavirus Research Center – Johns Hopkins University & Medicine ([link removed])


** Table of Contents
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* If You Are in a Hurry (#hurry)
* India’s Growing Crisis (#india)
* Vaccine Equity and Access (#equity)
* Vaccine Research (#research)
* Vaccine Approvals (#approvals)
* Rwanda Plans mRNA Vax Plant (#rwanda)


* Pandemic Fog (#fog)
* HIV and Vaccines (#andvax)
* “Most Vaccinated Country” Sees Uptick in Cases (#most)
* New Treatment Trial (#trial)


Vaccine equity remains a major issue in the global response to COVID-19. Less than four percent of the world populations has been fully vaccinated. As vaccination programs in the US slow in many communities as almost everyone who wants to be vaccinated has been, in many countries the healthcare workers and the most vulnerable still have no access to vaccines.

In a surprise move, this week US President Joe Biden’s government announced that it would support the call from India and South Africa for the TRIPS waver on COVID vaccines and treatments. Trade Ambassador Katherine Tai tweeted ([link removed]) : “These extraordinary times and circumstances call for extraordinary measures. The US supports the waiver of IP protections on COVID-19 vaccines to help end the pandemic and we’ll actively participate in @WTO ([link removed]) negotiations to make that happen.” The US support doesn’t mean the waver will happen and if it does it won’t lead to immediate global access for COVID vaccines, but it is an important step in putting people over profits.

The waiver for IP protections will address one piece of the puzzle contributing to the bottlenecks to COVID-19 vaccine access but there is still more work to be done around the other pieces. Check out this new infographic ([link removed]) from AVAC looking at breaking the bottlenecks to create equitable access.




** If You Are in a Hurry
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* Read STAT ([link removed]) on what the surprise US endorsement of the TRIPS waver means, and what it doesn’t
* The check-out Reuters ([link removed]) TRIPS waver explainer. Spoiler: negotiations are complicated and likely to take a long time.
* And read an editorial from Kenya’s The Standard ([link removed]) outlining why the waver is needed.
* Read how the Blackfeet tribe in the US shared excess vaccine doses with tribe members across the border in Canada in AP ([link removed]) .
* Read about “mix and match” vaccine doses on NPR ([link removed]) .
* Listen to a story about pandemic fog and stress on NPR ([link removed]) .
* Read about two (preprint) studies about PLHIV and the AstraZeneca vaccine in aidsmap ([link removed]) .




** India’s Growing Crisis
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NDTV ([link removed]) (India) reports, “The coronavirus wave that plunged India into the world's biggest health crisis has the potential to worsen in the coming weeks, with some research models projecting that the death toll could more than double from current levels. A team at the Indian Institute of Science in Bangalore used a mathematical model to predict about 404,000 deaths will occur by June 11 if current trends continue. A model from the Institute for Health Metrics and Evaluation at the University of Washington forecast 1,018,879 deaths by the end of July. While coronavirus cases can be hard to predict, particularly in a sprawling nation like India, the forecasts reflect the urgent need for India to step up public health measures like testing and social distancing.”

Newsweek ([link removed]) (US) reports, “Oxygen demand in India is seven times higher than in April as the country still struggles to combat COVID-19 cases… On Wednesday, pressure in an oxygen line dropped at the Chengalpet Government Medical College hospital in Tamil Nadu that resulted in the deaths of 11 COVID-19 patients, the Times of India reported. Authorities at the hospital said last week that they had repaired the oxygen pipelines but oxygen consumption has doubled since they worked on it.

MedPage Today ([link removed]) (US) reports, “As COVID-19 cases overwhelm hospitals in India, a new coronavirus variant has emerged. Dubbed the ‘double mutant’ variant and announced ([link removed]) barely one month ago, already researchers are trying to figure out whether it could be causing the surge in cases—and what that could mean for the rest of the world…. Could the new variant be to blame for the current surge? Or is it a confluence of factors related to people letting their guard down—a lack of masking, large gatherings of people mixing and travelling together, and people somehow thinking that India was already immune? No one really knows, but a similar situation has already occurred elsewhere in the world [in Brazil].”



** Vaccine Equity and Access
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STAT ([link removed]) (US) reports, “The US’s stunning endorsement ([link removed]) of a proposal to waive COVID-19 vaccine patents has won plaudits for President Biden and roiled the global pharmaceutical industry. But, at least in the short term, it’s likely to be more of a symbolic milestone than a turning point in the pandemic…. Experts suggested the earliest the world could expect to see additional capacity flowing from the waiver—if it’s approved at the World Trade Organization—would be in 2022.” Global News ([link removed]) (Canada) reports “The European Union is willing to discuss a proposal to waive intellectual property rights for COVID-19 vaccines, European Commission President Ursula von der Leyen said on Thursday, as drugmakers fought their
ground as their share prices tumbled…. WHO chief Tedros Adhanom Ghebreyesus reached for capital letters in a tweet calling Biden’s move a ‘MONUMENTAL MOMENT IN THE FIGHT AGAINST #COVID19,’ and said it reflected ‘the wisdom and moral leadership of the United States.’”

SA News ([link removed]) (South Africa) reports, “President Cyril Ramaphosa says a proposal by South Africa at the World Trade Organisation to waiver specific Trade-Related Aspects of Intellectual Property Rights (TRIPS) obligations related to the manufacturing of COVID-19 vaccines is now supported by over 100 countries…. This comes after the President, in his capacity at the Chairperson of the African Union (AU), made the call during a webinar on the Africa COVID-19 Vaccine Financing and Development Strategy, in a move that would enable countries in Africa and in other developing countries to access active pharmaceutical ingredients and benefit from technology transfer, including the know-how to manufacture vaccines in Africa at a cheaper cost.”

Reuters ([link removed]) (UK) explains how the TRIPS waiver will be negotiated. “Not only are the negotiations expected to be lengthy, they are also likely to result in a waiver that is significantly narrower in scope and shorter in duration than the one initially proposed by India and South Africa, trade experts said. 164 WTO member countries must reach consent on such decisions, with any one member able to veto them, so there could be a lot of red pencils out. Negotiations are likely to be held in a mixture of virtual and in-person meetings.”

In an editorial in The Standard ([link removed]) (Kenya) argues, “The waiver of intellectual property rights to allow as many countries as possible to produce the vaccines is the way to go. Pharmaceutical companies that have monopoly over the COVID-19 vaccines might not be receptive to calls to waive intellectual property rights. However, the need to save humanity in the face of the fast growing and mutating COVID-19 virus should override the urge to make profits. Concerns raised regarding the possibility that Biden's call could undermine and compromise safety of vaccines cannot be swept under the carpet, but such concerns can be addressed through strict regulatory agencies to ensure mass produced vaccines by third parties are not only safe, but their efficacy is above reproach.”

AP ([link removed]) (US) reports “The Blackfeet tribe in northern Montana provided about 1,000 surplus vaccines last month to its First Nations relatives and others from across the border, in an illustration of the disparity in speed at which the United States and Canada are distributing doses. While more than 30 percent of adults in the US are fully vaccinated, in Canada that figure is about 3 percent.”

The Daily Maverick/Bhekisisa ([link removed]) (South Africa) looks at why South Africa, a country with vaccine manufacturing capability is not manufacturing COVID vaccines. “With a dire, global shortage of COVID-19 jabs, countries with local vaccine manufacturers have consistently been able to procure jabs faster and quicker than those nations that have no such facilities. South Africa, on the other hand, has struggled to get hold of enough COVID shots fast enough. And while the Durban-headquartered drug manufacturer, Aspen ([link removed]) , is producing Johnson & Johnson’s (J&J’s) COVID-19 jab from its Gqeberha plant, it’s not from start to finish, but rather involves a process called ‘fill and finish’ where an imported vaccine is put into vials and packaged for distribution.”

In an interview with Financial Times ([link removed]) (UK), “Melinda Gates has called on wealthy nations to stop ‘hoarding’ coronavirus vaccines, saying it was disappointing how little was being done to prevent the pandemic from ravaging the developing world. The US philanthropist told the Financial Times that developed countries should vaccinate their populations only ‘up to a point’ before they donate supplies to those in greater need.”

Africa News ([link removed]) (France) reports, “With Africa-bound COVID-19 vaccine doses from the Serum Institute of India delayed for the foreseeable future, slow vaccine rollouts and new variants making inroads, the risk of a new wave of infections in Africa remains high. Delays and shortages of vaccine supplies are driving African countries to slip further behind the rest of the world in the COVID-19 vaccine roll out and the continent now accounts for only 1 percent of the vaccines administered worldwide, down from 2 percent a few weeks ago…. New variants also place the continent at risk of a third wave. The B.1.617 variant that was first found in India has been reported in at least one African country. The B1.351 strain, first found in South Africa, is spreading in 23 African countries and the B1.1.7 strain, first found in the United Kingdom, has been found in 20 countries. With new variants circulating,
low vaccination levels, population fatigue in adhering to preventive measures, and easing of restrictions, the conditions are present for a resurgence.”



** Vaccine Research
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Research continues into potential new COVID vaccines and to see how current vaccines standup against variants and in real world settings.

The Guardian ([link removed]) (UK) reports, “The first ‘tweaked’ vaccine against the worrying coronavirus variants that emerged in South Africa and Brazil has successfully neutralised them in laboratory trials, the US company Moderna has said. The results of the small trial suggest that boosters against the variants will be feasible and could be rolled out this year to counter the threat from variants that have appeared around the world and are feared in some cases to be more transmissible or partially vaccine-resistant.”

NPR ([link removed]) (US) reports that some experts are looking at the possibility of “mix and match” vaccines. One UK expert says, “shortages of a vaccine or concerns about side effects may induce health officials to adopt a mix-and-match strategy. Health agencies in France and Germany are already encouraging people who've gotten the AstraZeneca vaccine to consider getting one of the mRNA vaccines ([link removed]) for their second shot.”

Reuters ([link removed]) (UK) reports, “Novavax Inc's COVID-19 vaccine had efficacy of 51 period against infections caused by the South African variant among people who were HIV negative, and 43 percent in a group that included people who were HIV positive, according to a new analysis published on Wednesday. The variant, known as B.1.351, carries mutations that threaten the efficacy of COVID-19 vaccines, several studies have shown. Most vaccine makers, including Novavax, are testing versions of their vaccines to protect against emerging variants. The Novavax post-hoc analysis was published in the New England Journal of Medicine along with full data from the company's trial in South Africa, which included nearly 2,700 volunteers who had not been previously infected with the coronavirus. The South African
([link removed]) quotes co-author Shabir Madhi: “The data make a compelling case for use of the Novavax COVID-19 vaccine in settings where the B.1.351 variant dominates ([link removed]) – which is most of southern Africa—to reduce the risk of mild disease and also to maximise the opportunity for protection against severe COVID. Further work is required for Novavax and all other COVID-19 vaccines, particularly in people living with HIV.”

Contagion Live ([link removed]) (US) reports “Two-dose administration of Pfizer-BioNTech COVID-19 vaccine ([link removed]) BNT162b2 is associated with greater than 90 percent prevention of asymptomatic, symptomatic and severe COVID-19 infection, according to new real-world findings out of Israel. The three-month study outcomes from the nation with the greatest rate of vaccinated adults showed persons aged ≥16 years old given the two-dose mRNA vaccine have similarly benefitted in substantial risk reduction from hospitalization (97.5 percent) and death (96.7 percent) related to the pandemic virus.” The study authors say, “Taken together, these findings suggest that high vaccine uptake can meaningfully stem the pandemic and offers hope for eventual control of the SARS-CoV-2 outbreak as vaccination programmes ramp up across the rest of the
world.”



** Vaccine Approvals
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UPI ([link removed]) (US) reports Pfizer “plans to ask federal regulators for full approval of the shot by the end of this month—and could have an emergency approval to offer it to teens in days. The authorization for use in adolescents age 12 to 15 is expected in the coming days as states look to start vaccinating children across the country ahead of the summer and 2021-22 academic school year.”

The Washington Post ([link removed]) (US) reports, “Canada on Wednesday authorized the use of the Pfizer-BioNTech vaccine for children ages 12 to 15, a step hailed by officials as a “significant milestone” in the country’s fight against the coronavirus…. “While younger people are less likely to experience serious cases of COVID-19, having access to a safe and effective vaccine will help control the disease’s spread to their families and friends, some of whom may be at a higher risk of complications,” [Supriya Sharma, chief medical adviser for Health Canada] said. “It will also support the return to a more normal life for our children, who have had such a hard time over the past year.”



** Rwanda Plans mRNA Vax Plant
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Bloomberg ([link removed]) (US) reports “Rwandan President Paul Kagame said his country is in talks to establish the first mRNA vaccine plant in Africa as the continent battles the coronavirus pandemic…. Africa has few manufacturing facilities of any kind and most that do exist can only package and distribute the inoculations—so called fill-finish facilities—rather than make the ingredients needed for the shots.”



** Pandemic Fog
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If living through the pandemic has you tired and stressed, you are not alone. NPR ([link removed]) (US) reports on the mental fog and exhaustion many people are reporting during the pandemic. “A recent survey ([link removed]) by the American Psychological Association found that 3 in 4 Americans said that the pandemic is a significant source of stress. Millions of people have lost loved ones, have become ill themselves and/or have lost income as a result of the pandemic. The threat of COVID-19 alone has been stressful for most people, as has all of the upheaval that the pandemic has brought….”



** HIV and Vaccines
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aidsmap ([link removed]) (UK) reports, “Two studies of immune responses to the Oxford/AstraZeneca COVID-19 vaccine show that the vaccine produced similar immune responses in people with or without HIV. People with HIV did not experience more side effects from the vaccine. The findings have been made available as pre-prints, which means that they have not been peer-reviewed yet.” Authors of a study from the UK, “say that the findings show that people with HIV should be supported to receive the vaccine and do not need a different vaccination regimen from the rest of the population. However, they warn that further data are needed in people with CD4 counts below 350 or detectable viral load." In a South African study, “The researchers say that while the vaccine produced strong antibody responses against SARS-CoV-2 in people with high CD4 counts, the results may not be generalisable to people
with CD4 counts below 500. They also highlight the need for further studies of vaccine efficacy in people with HIV in Africa.”



** “Most Vaccinated Country” Sees Uptick in Cases
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BBC ([link removed]) (UK) reports, “The Seychelles, which has fully vaccinated over 60 percent of its population against COVID-19, is bringing back restrictions amid a rise in cases. The archipelago of nearly 100,000 people recorded close to 500 new cases in the three days to 1 May and has about 1,000 active cases. A third of the active cases involved people who had had two vaccine doses, the country's news agency said. The Washington Post ([link removed]) (US) reports, “Though the number of new cases is relatively low—peaking at an average of just over 100 new cases a day—they are a big deal in a country with a population of less than 100,000. On a per capita basis, the Seychelles outbreak is worse than India’s raging surge…. The Seychelles situation is being watched all over the world for what it says about the effectiveness of vaccines. ‘It is providing a critical
case to consider the effectiveness of some vaccines and what range we have to reach to meet herd immunity,’ said Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations.”



** New Treatment Trial
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The Star ([link removed]) (Kenya) reports, “Kenya has joined the largest trial in Africa to test two existing drugs for COVID-19 treatment. The trial will test nitazoxanide—an antiparasitic drug used to stop diarrhea—and ciclesonide, which is inhaled by asthma patients to prevent difficulties in breathing. Researchers said laboratory tests show the two drugs have some antiviral activity against the coronavirus…. The two drugs being tested are already registered for other diseases and are therefore known to be safe and medics are familiar with them.”

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