This week there is still no viable global plan that will see equitable vaccine distribution and globally just over five percent of the world population is fully vaccinated.

Jon Cohen and Kai Kupferschmidt write in Science (US) that “Today, some rich countries are vaccinating children as young as 12 years old, who are at extremely low risk of developing severe COVID-19, while poorer countries don’t even have enough shots for health care workers. Nearly 85 percent of the COVID-19 vaccine doses administered to date have gone to people in high-income and upper middle—income countries. The countries with the lowest gross domestic product per capita only have 0.3 percent.... The moral argument aside, there’s a very practical reason to try to distribute vaccines more equitably: No part of the world can feel safe if the pandemic rages on elsewhere, posing the risk of reintroduction and spawning potentially more dangerous viral mutants.” They look at four strategies for vaccine equity with timelines ranging from weeks to months to years. In the shortest term, rich countries donating more vaccines to COVAX. “At the World Health Assembly, Tedros made a bold call for all manufacturers to offer any new product to COVAX before putting it on the market, or to commit 50 percent of their doses to the facility.” Ramping up manufacturing capacity could also help over the coming months. “All told, 14 billion doses could leave factories before the year is over, according to a document written in advance of a March summit about stepping up the production pace.” Longer term solutions include “sharing knowledge” on how to make vaccines with more companies, perhaps through patent waivers and building more vaccine plants worldwide. To quote IAVI’s Feinberg: “The challenge that’s being taken on here is unprecedented: You want to vaccinate everyone on the planet. That has never been done before. You might say: If we do this in 3 years that’s an accomplishment that is unprecedented in the history of the human race. But if you actually think about the tragedy that COVID is imposing, that seems like a really long, long time.”
 

If You Are in a Hurry

• Listen to FiveThrityEight’s PODCAST-19 on vaccine patents.
• Read a NEJM Perspective on ways to get more people vaccinated in the US.
• Read The Economist on what’s behind the resurgence of interest in the virus’s orgins.
• Read a new report from Human Rights Watch on the impact of the pandemic on child labor.
• Read about what parts of the virus beyond the spike vaccine researchers are targeting in The Atlantic.
• Read Public Citizen’s report on what it would take to vaccinate the world in one year.

 

Lessons for Vax Rollout from South Africa          

 
In a Bhekisisa (South Africa) op-ed, Glenda Gray, Linda-Gail Bekker and others write about lessons learned from the Sisonke trial that provided vaccines to healthcare workers. They write that “Usually, the gap between designing a study and scaling it up to reach people on the ground takes years. Sisonke did it in a matter of 17 days—and rewrote history.”
 

France Shares Vaccines with Rwanda

 
The East African (Kenya) reports, “French President Emmanuel Macron has donated 100,000 doses of AstraZeneca vaccines to Rwanda as both countries move to amend ties. The donation was delivered on Thursday as President Macron arrived in Rwanda on a two-day state visit…. Rwanda needs at least 13 million doses of COVID-19 vaccine to inoculate its target 60 percent of the population, about 7.5 million people, by June 2022. So far, only 4 percent have received the first dose of the vaccine.”
 

More on Vaccine Patents and Access    

 
FiveThirtyEight’s PODCAST-19 (US) looks at patent issues. “Some of us today kind of are wondering, are we entering another period of time where we’ve got the same sort of issue: a global pandemic [HIV in the 1990s], and pharmaceutical companies that don’t seem to be willing to share their technology, their know-how, their ability for other countries and other companies to be able to rapidly scale up production of these vaccines and other medical products…. Patents may not seem like the most exciting issue, but they are so, so important to how we got to this moment, when people need vaccines but there aren’t enough to go around. If the patent system were different, so would our approach to fighting COVID-19.”
 
Public Citizen (US) released a report this week that looks at “What would it take to produce enough coronavirus vaccine for the world in one year?... Using computational process modelling, we show how the global community could set up regional hubs capable of producing eight billion mRNA vaccine doses by May 2022. This would be enough to cover 80 percent of the population—what some experts believe is necessary for achieving herd immunity—in low- and middle-income countries. Critically, given the adaptability of mRNA technology, it also would set up the infrastructure required to quickly address variants and future public health threats.”
 

Incentives for Vaccination in the US

 
While most of the world’s population still has no access to vaccines, the US is awash in vaccines that are increasingly hard to give away. The US CDC reports that half of US adults are vaccinated, but getting many of those who are unvaccinated to take the vaccine is increasingly difficult. A NEJM (US) Perspective asks if the increasing number of incentives for vaccination “represent a desirable path forward?” The authors argue that incentives will not be enough to achieve the desired vaccination rates and offer three alternatives, including vaccine mandates in certain workplaces, access to “activities that involve close person-to-person contact” limited to vaccinated people and finally, “raising health and life insurance premiums for people who forgo vaccination. This approach could redistribute the higher expected health care costs in a way that is fair to people who have already been vaccinated.”
 

Many in US Still Lack Vaccine Access and Information

 
Even as vaccine super centers are closing and vaccine demand is lessening in many parts of the US, there are still people in some communities who lack access to vaccines and vaccine information. KFF (US) reports on a new initiative “Unvaccinated Latinos want to get the vaccine but face obstacles such as not having access to paid leave, being asked by vaccine providers for sensitive information that increases barriers to getting more Americans vaccinated, or hard to access vaccination sites. ‘We need to reaffirm that COVID-19 vaccines are free and available to ALL, regardless of immigration status or access to health insurance and we also urge that sites are put in places where Latinos are: schools, workplaces, and community centers across the country,’” said UnidosUS President and CEO Janet Murguía.” KFF’s latest data on vaccinations in the US shows “recent trends suggest a narrowing of racial gaps in vaccinations at the national level, particularly for Hispanic people, who have recently received a larger share of vaccinations compared to their share of the total population (23 percent vs. 17 percent).”
 

Vaccines and Variants

 
MedPage Today (US) reports, “Both the Pfizer and AstraZeneca COVID-19 vaccines showed effectiveness against symptomatic disease from B.1.617.2, the so-called Indian variant, British researchers found…. ‘These findings suggest a modest reduction in vaccine effectiveness,’ the authors wrote. ‘Nevertheless, a clear effect of both vaccines was noted with high levels of effectiveness after two doses.’"
 
The Nation (Kenya) reports, “Three Covid-19 variants of concern have been detected in the country, says a top research organisation that has been conducting genome sequencing of the virus.” One expert warned, “The variants are also affecting younger people more than the [wild type virus] and since they tend to interact more, the likelihood of it spreading faster is also high. ‘Emerging variants are likely to be more transmissible, more pathogenic, and more likely to escape natural immunity or vaccine immunity,’ he said.”
 

The Search Heats Up (Again) for the Virus’s Origins        

 
MedPage Today (US) reports, “Leaders of the White House's COVID-19 task force refused to completely discount a popularly held theory that the coronavirus originated in a lab in Wuhan, China. During a press briefing on Tuesday, NIAID Director Anthony Fauci, MD, said 'we don't know 100 percent' where the novel coronavirus causing COVID-19 came from. 'We feel strongly, all of us, that we should continue with the investigation and go to the next phase of the investigation that the [World Health Organization] has done,' said Fauci, the chief medical advisor to President Biden.”
 
The Washington Post (US) reports “in recent months the idea that it emerged from the Wuhan Institute of Virology (WIV)—once dismissed as a ridiculous conspiracy theory—has gained new credence…. But a lack of transparency by China and renewed attention to the activities of the Wuhan lab have led some scientists to say they were too quick to discount a possible link at first.”
 
The Economist (UK) reports, “There is as yet no evidence in the public domain that a laboratory leak actually took place; just evidence that the possibility is real. Mr Biden’s request suggests anything the secret world can currently add to that is pretty weak stuff. His statement says that, at present, two “elements” within the intelligence community lean towards the zoonotic explanation, one prefers the laboratory origin, and no one has high confidence in any of these assessments. Without help from China, a harder look will not necessarily change this. The attempt to take that look, though, means that the sort of transparency and co-operation talked about at the World Health Assembly, and that China has not provided, is unlikely to blossom any time soon.”
 

Disinformation Campaigns

 
Rumors, myths and disinformation continue to be a major concern that is slowing the response to the pandemic. The Guardian (UK) reports, “French and German YouTubers, bloggers and influencers have been offered money by a supposedly UK-based PR agency with apparent Russian connections to falsely tell their followers the Pfizer/BioNTech vaccine is responsible for hundreds of deaths. USA Today (US) says, “France's government offered strong praise Wednesday to YouTubers and other social media influencers who resisted a mysterious effort to recruit them for a smear campaign to spread disinformation to their millions of young followers about the Pfizer COVID-19 vaccine. A government spokesperson said, 'I want to salute the great responsibility of these young YouTubers or influencers who not only didn’t fall for this and didn’t, through cupidity, allow themselves to be manipulated but also denounced it publicly. I really want to salute that.'”
 

COVID and Children

 
A new report from Human Rights Watch (US) says “The unprecedented economic impact of the COVID-19 pandemic, together with school closures and inadequate government assistance, is pushing children into exploitative and dangerous child labor… Researchers examined the rise in child labor and poverty during the COVID-19 pandemic, and the pandemic’s impact on children’s rights. Children described working long, grueling hours for little pay after their parents lost jobs or income due to the COVID-19 pandemic and associated lockdowns. Many described hazardous working conditions, and some reported violence, harassment, and pay theft.”
 
The New York Times (US) reports, “Children who get sick from the rare but serious COVID-related inflammatory syndrome may surmount their most significant symptoms within six months, but they may still have muscle weakness and emotional difficulties at that time, a new small study suggests.”
 

Thailand’s mRNA Vaccine

 
Nature (UK) reports, “Thailand is about to launch human trials of its first mRNA COVID-19 vaccine. If it is successful, the country could emerge as an important supplier of mRNA vaccines in Asia, making it a small but significant player in the dash to adopt the new technology.”
 

Evolving Mask Mandates

 
Nature (UK) reports that as the US and other countries relax mask mandates, “Mask use will continue for this pandemic, and it’s likely to become a common response to future outbreaks. So, researchers are trying to get a handle on what the science says about how to encourage people to wear them. As the COVID-19 pandemic enters a new phase, scientists around the world are accessing the accumulated data and asking what makes some policies more effective than others, and probing when and how they need to change.”
 

Looking Beyond the Spike

 
The Atlantic (US) reports, “Eventually, our first generation of spike-centric vaccines will likely become obsolete. To get ahead of that inevitability, several companies are already looking to develop new vaccine formulations packed with additional bits of the coronavirus, ushering in an end to our monogamous affair with spike. The potential perks of this tactic run the gamut: More vaccine ingredients could help the body identify more targets to attack, and loop in untapped reservoirs of immune cells that have no interest in spike. Multifaceted shots also up the ante for the virus, which can alter only so many aspects of its anatomy at once.”
 

Finding Corelates of Protection

 
Nature (UK) reports, “After people have been vaccinated against COVID-19, the levels of infection-blocking antibodies in their blood are a strong indicator of how much protection they’ve gained against the disease, according to a modelling study. The research showed that the presence of even small quantities of these potent ‘neutralizing antibodies’ indicates that a vaccine is effective at protecting against COVID-19…. If researchers have a well-defined correlate of protection, they can predict from early trial data how effective a vaccine will be, says James Triccas, a medical microbiologist at the University of Sydney in Australia and a co-author of the study. This ‘alleviates the need to do larger, more expensive and time-consuming phase III trials’.”
 
The New York Times (US) reports, “Immunity to the coronavirus lasts at least a year, possibly a lifetime, improving over time especially after vaccination, according to two new studies. The findings may help put to rest lingering fears that protection against the virus will be short-lived. Together, the studies suggest that most people who have recovered from COVID-19 and who were later immunized will not need boosters. Vaccinated people who were never infected most likely will need the shots, however, as will a minority who were infected but did not produce a robust immune response.”
 

A Pill for Protection?

 
AFP (France) reports, “Several companies are working on so-called oral antivirals, which would mimic what the drug Tamiflu does for influenza. Prevention is better than cure—but when it comes to COVID-19, what happens when people can’t get the vaccine, don’t want it, or they’re immune suppressed and it fails to stop infection? The hunt is on for a coronavirus treatment that can be taken as a pill soon after a confirmed positive, halting the disease in its tracks so that cases that might have been severe end up being nothing more than a bad cold.”