Immunization disparities (Yudong Sun

Vaccines were firstly performed in 1796. Currently, immunization plays important roles in each country’s health system to combat infectious diseases, due to its abilities to stimulate immune memory and provide immunity. However, contrary to its unlimited potential, quantities of vaccines are limited. Taking current COVID-19 Vaccines for example, many countries’ health systems were impacted greatly and challenged their abilities to develop or acquire COVID-19 vaccines and allocation during COVID-19 pandemic.

Different actions in developing Covid-19 vaccines

United States

Under section 564 of the Federal Food, Drug, and Cosmetic Act (FD&C Act), when the Secretary of HHS declares that an emergency use authorization is appropriate, FDA may grant unapproved medical products or unapproved uses of approved medical products Emergency Use Authorization. However, this process still requires rigorous review of safety and efficacy data. Currently, there are three vaccines authorized for emergence use: ● Pfizer-BioNTech COVID-19 Vaccine ● Moderna COVID-19 Vaccine ● Janssen COVID-19 Vaccine All authorized vaccines have acceptable rates of adverse events.

European Union

The European medicine agency apply conditional marketing authorization for medicines with less safety and efficacy data than normal, where the benefit of immediate availability of the medicine outweighs the risk inherent in the fact that additional data are still required. Also, this act allows the vaccine developers to submit additional data after the marketing authorization. Currently, there are four vaccines granted EMA: ● Comirnaty ● Moderna COVID-19 Vaccine ● Vaxzevria ● Janssen COVID-19 Vaccine

All authorized vaccines have acceptable rates of adverse events.

Most African Countries

Instead of developing vaccines, most african countries have joined COVAX Facility. This is an international health program intended to improve access to new or currently using COVID-19 vaccines for many lower-income countries. Those vaccines come from donations by higher-income countries or personnel. Currently, COVAX has shipped 32 million COVID-19 vaccines to 60 participants.

Immunization rollout of COVID-19 vaccines

European Union

United States

Phase 1A: Healthcare personnel and residents of long-term care facilities.

Phase 1B: Frontline essential workers and People aged 75 years and older.

Phase 1C: People aged 65—74 years; People aged 16—64 years with underlying medical conditions; Other essential workers

Germany

1. Those over 80 years old. 2. Care workers who work in elderly people's homes or regularly look after the elderly or the mentally ill. 3. Health care workers with a high risk of exposure to COVID-19, especially those working in intensive care units, emergency rooms, and first responders. 4. Health care workers who primarily treat patients with a higher risk of dying from COVID-19.

France

1. Residents of Ehpads 2. Highest risk groups – phase 2 will concern all over 75s, and anyone in the 65-74 age group who has a chronic illness that makes them vulnerable to COVID, such as heart and lung conditions. 3. Vulnerable people and health workers 4. High-risk employment 5. All other adults

However, in most African countries like Nigeria, there is lack of the government guidance on vaccine rollout. No clear COVID-19 vaccine rollout plan is available. Though there are rollout plan provided by COVAX and WHO, it is all the same and is not suitable for every lower-income countries. Solution and Effort: Currently, WHO has started accelerated the approval process for Vaccines entering COVAX program and begins sending inverstigators to different low-income countries to collect information and design rollout plan based on local conditions. In my opinion, the immunization disparities are not limited to COVID-19 vaccines. This disparity also applies to MMR vaccines, DTaP, etc. Those areas also need constant effort from WHO and cooperation from other international organizations.

References:

1. France prepares 5-stage plan for Covid-19 vaccination campaign. The Local France. Published December 1, 2020. Accessed March 28, 2021. https://www.thelocal.fr/20201130/france-prepares-5-stage-plan-for-covid-19-vaccination-campaign/ 2. Welle (www.dw.com) D. COVID: German regulations on who gets vaccine first | DW | 18.12.2020. DW.COM. Accessed March 28, 2021. https://www.dw.com/en/covidgerman-regulations-on-who-gets-vaccine-first/a-55987647 3. Research C for BE and. Emergency Use Authorization for Vaccines Explained. FDA. Published online December 14, 2020. Accessed March 27, 2021. https://www.fda.gov/vaccines-blood-biologics/vaccines/emergency-use-authorization-vaccines-explained