Ómicron threatens to widen gap in global vaccination

The omicron variant threatens to widen an already huge gap in access to covid vaccines as scientists are bracing for the possibility that repurposed vaccines are needed and rich countries once again rush to get them first.

The omicron variant emerges just as vaccine supplies destined for low-income countries begin to rebound. At the start of the pandemic, wealthy governments hoarded most of the initial doses, leaving vast regions of the planet behind.

Now the goal is to avoid another episode of inequity. The UK is already moving swiftly to secure omicron-adapted messenger RNA vaccines and other possible variants if these are developed as part of new agreements with Pfizer Inc. and Moderna Inc. The recent discovery of the variant in the United States could trigger a similar move.

“That is the great concern: that what happened in the last year and a half be repeated“, said Ellen ‘t Hoen, director of Medicines Law & Policy, a research group based in the Netherlands. “If it is not this variant, it will be another.”

Even if vaccines maintain their potency, health groups pushing to protect vulnerable regions are under increasing pressure. About 100 nations have not met a World Health Organization target (WHO) to vaccinate 40% of their populations, and more than half are at risk of not reaching it by the end of 2021.

Scientists worry that vaccine disparities and the continued spread of the virus will lead to more dangerous variants that pose a risk to both rich and poor nations.

“Inequality stems from scarcity, and when there is scarcity, those who have resources will use them to meet their own needs first.“, he pointed Richard Hatchett, head of the Coalition for Epidemic Preparedness Innovations (CEPI, for its acronym in English). “So the question would be: if this turns out to be a really dangerous variant, will countries rush to get supplies?”

CEPI is discussing the possible deployment of modified vaccines with other partners in Covax, the global vaccine distribution program, he said. Covax is in a more advantageous position than it was at the beginning of the crisis, when it was still in the making, and a vaccine shortage shouldn’t last that long this time, but concern “it is real”, He indicated.

“If the data suggest that we really need to introduce a vaccine against the omicron variant, we will act as quickly as possible to secure the doses to reduce the inequity that could arise“, said.

So far, there is little evidence that the newly discovered variant affects the protection provided by current vaccines, and is likely to prevent severe disease, the chief scientist of the WHO.

However, Moderna’s CEO, Stephane Bancel, shook markets earlier this week when he said that the surprising number of mutations in the omicron variant suggests that new vaccines would be needed to prevent contagion. Many questions remain.

They don’t wait

But vaccine manufacturers are not waiting for the answers. They have already started work to adapt their vaccines. Pfizer and BioNTech SE noted that they will be ready with an omicron-targeted vaccine in 100 days, if needed. Pfizer expects data two to three weeks from now on how firm its vaccine is.

Omicron could trigger a new search for limited supplies, and enough doses for a global rollout won’t be produced until the end of next year, according to Airfinity Ltd. At best, 6 billion doses could be produced by October 2022, estimates the London-based data firm. But wealthy governments will try to corner the market, said Shabir Madhi, a vaccinologist at the University of the Witwatersrand who led trials for the AstraZeneca and Novavax vaccines in South Africa.

“We can observe the behavior of rich countries in the past ”, said. “It would be very surprising if they developed some kind of social conscience.”

That could lead to further delays in the effort to bridge the vaccine gap, according to Thomas bollyky, director of the global health program at the Council on Foreign Relations.

“Will spark a source of demand for vaccine manufacturing that was expected to change at some point to meet global needs“, said Bollyky. “If we were to develop a modified vaccine to address this new variant, there is the possibility that some of that capacity would go into producing those vaccines, presumably initially for high-income countries.”.

It’s a scenario that could repeat itself as the coronavirus continues to evolve. Some researchers anticipate that vaccine updates may be necessary if vaccines slowly become obsolete over time due to variants.

Faced with that threat, the groups behind Covax, backed by the WHO, are calling for a series of measures aimed at increasing vaccination rates. Donations from wealthy governments have come very slowly and only one country, Switzerland, has responded to Covax’s calls.

More than 90 million donated doses have been delivered to Africa through Covax and the African Vaccine Acquisition Trust, and millions more through direct agreements between countries and manufacturers. However, most of those vaccines have arrived unannounced and with a short shelf life, making it difficult for health systems, already under pressure, to use them, health groups said earlier this week.