COVID-19 Vaccines: Unfinished Business – Previous Sessions
Even as we don’t know what the next pandemic threat will be, that threat already exists and is circulating in nature as we speak...
Dennis Carroll, PhD
The fifth and final day of the 2022 Vaccine Symposium discussed what we’ve learned so far from the COVID-19 pandemic, and what we need to be prepared for the future—from more effective bio surveillance to the development of novel vaccine delivery approaches.
“Even as we don’t know what the next pandemic threat will be, that threat already exists and is circulating in nature as we speak. … We need to be much more thoughtful about going to the virus before it comes to us,” said Dennis Carroll, PhD, Chair of Leadership Board, Global Virome Project and Special Advisor on Global Health Security for University Research Co.
The crucial topic of surveillance dominated much of the day’s discussion, with panelists calling for strategies from monitoring geographic hotpots where human behaviors increase the likelihood of virus spillover into humans, to deploying cost-effective surveillance technologies such as wastewater testing.
Panelists also championed new approaches to vaccines, including developing variant-proof products, streamlining regulatory processes without compromising safety, and investing in delivery technologies beyond syringes in order to avoid supply chain shortages. In addition, panelists supported investment in affordable and accessible anti-viral drugs, as well as ultra-fast diagnostic technologies that keep pace with viral spread.
As the 2022 Vaccine Symposium drew to a close, Sir John Irving Bell, GBE, FRS, FMedSci, FREng, Regius Professor of Medicine at Oxford University shared a final thought: “What the world needs from Covid is a legacy that will be hugely beneficial for public health for decades to come.”
...We really need people to be immunized against misinformation.
Natália Pasternak Taschner, PhD
Day Four of the 2022 Vaccine Symposium convened experts and officials from Africa, Brazil, Israel, the United States, the United Kingdom, and Greece to discuss trust in science, the impact of communication on vaccine hesitancy and acceptance, strategies for countering anti-vaccination campaigns, and more.
“Trust in science is very fragile … and trust needs booster shots if we really need people to be immunized against misinformation,” said Natália Pasternak Taschner, PhD, Fundaçao Getulio Vargas, São Paulo, Brazil, and Research Scholar at Columbia University.
The panel compared experiences from around the globe: In Africa, vaccine coverage challenges have included supply problems, the fragmentation of vaccine platforms, and doubt among the population. In Brazil, which once had a strong history of vaccine uptake, the 2018 election of their first “anti-vax” president sparked a downward trend in vaccination rates across the board, from COVID-19 to polio. The early and effective vaccination campaign in Israel found that education, transparency, teamwork, and accessibility were essential tools, as well as understanding that different population segments required different outreach approaches.
Speaking more broadly, the panelists proposed that science and health messaging embrace complexity rather than oversimply communication, and explored issues of trust and doubt in regulatory systems.
The afternoon ended with two interviews. The Hon. Kyriakos Mitsotakis, Prime Minister of the Hellenic Republic, shared his country’s experiences with vaccine rollout, from communicating with young people to promoting boosters. Dame Kate Bingham, Managing Partner of SV Health Investors, discussed successful messaging strategies in the UK and the need for supporting a range of vaccine formats.
It’s not as if developing COVID-19 vaccines was easy, and that’s why we did it. We did it because it was necessary.
Krishna Udayakumar, MD, MBA
Day Three of the 2022 Vaccine Symposium took on some of the toughest questions surrounding global vaccine production and distribution. What role does vaccine equity play in preventing new variants? Is vaccine nationalism a path to equity? How do factors such as tech transfer, talent transfer, and IP restrictions impact widespread vaccine manufacturing? There were few simple answers.
“It’s not as if developing COVID-19 vaccines was easy, and that’s why we did it. We did it because it was necessary,” said Krishna Udayakumar, MD, MBA, Associate Professor of Global Health and Medicine at Duke University.
The day’s speakers outlined the mosaic requirements of vaccine manufacturing—from a trained work force and dependable supply chain to patents and quality control. Such complexity is tough to ramp up only in times of need, prompting some panelists to suggest that countries approach “national health security” in the same way as “national security.”Addressing equity, the panel noted the strong correlation between manufacturing site locations and earlier access to vaccines, and voiced support for local and regional manufacturing. Regarding funding, the panel asked if governmental, non-profit players can compete with for-profit entities.
Another concern was the lack of preparedness for future pathogens. The panel observed that with COVID-19 we were lucky that multiple vaccine platforms worked, but the next pathogen may be different. Looking ahead, panelists called for building on technologies that address not just a single pathogen, but a suite of emerging pathogens.
Trust is one thing you cannot surge during an emergency. If it’s not there before it’s going to take time to build.
Tom Frieden, MD, MPH
Day Two of the 2022 Vaccine Symposium convened leading public health experts from the U.S. and Africa, who discussed past, present, and future challenges to immunization coverage rates. They shared insights on vaccine misinformation, the role of safety science in vaccine acceptance, and messaging strategies for increasing confidence in public health initiatives.
“Trust is one thing you cannot surge during an emergency. If it’s not there before it’s going to take time to build,” said Tom Frieden, MD, MPH, President and CEO of Resolve to Save Lives.
The day’s presenters shared several principals of optimizing communication, including understanding the politics of public health decisions, working with trusted messengers (often healthcare workers, social networks, and religious leaders), and taking a comprehensive and preventive approach to disinformation. After reviewing previous U.S. vaccine rollouts—such as polio and H1N1—the discussion covered the unique hurdles to COVID-19 vaccine acceptance, including its speed of development, the presence of multiple vaccine products, and today’s climate of misinformation.
Sharing insights from Africa, the speakers discussed the need to accelerate the rate of vaccination across the continent, where only 15 percent of its 1.3 billion population has so far been vaccinated. They called for proper coordination (e.g., streamlining supply), logistics (e.g., supporting “last mile delivery”), and community engagement (e.g., combatting vaccine hesitancy with education).
The final discussion covered vaccine hesitancy among health care workers, the challenges of public health communication in the context of the war in Ukraine and other such instability, and the importance of focusing vaccine campaigns locally.
Unfortunately, vaccines have rolled out along the fault lines of inequity … as power, not need, dictated who had access.
Carissa F. Etienne, MBBS, MSc
Day One of the 2022 Vaccine Symposium convened leading infectious disease experts from around the world, who praised the rapid development and distribution of COVID-19 vaccines as a remarkable human achievement, but also cited numerous shortcomings, from failures to equitably administer doses to a lack of preparedness for future pandemics.
“We have witnessed the largest vaccination campaign of our lifetime, as countries everywhere race to protect their populations with COVID vaccines,” said Carissa F. Etienne, MBBS, MSc, Director of the Pan American Health Organization. “Unfortunately, vaccines have rolled out along the fault lines of inequity … as power, not need, dictated who had access.”
As we enter the third year of the COVID-19 pandemic we’re in a better position but nowhere near the end, said the day’s presenters, who raised critical issues in need of exploration. The topics discussed included the importance of solving distribution inequity problems in low-income countries and increasing global manufacturing capacity, exploring vaccine platforms beyond mRNA as variant complexity increases, understanding the durability of protection following both vaccination and natural infection, and planning booster schedules in light of waning efficacy and new variants.
Sharing regional insights from around the globe, the presenters discussed poor vaccination coverage among children and the elderly in China, the staffing and infrastructure issues impeding vaccine administration in Latin America and the Caribbean, the high transmission rate despite successful vaccine rollout in the United Kingdom, and the urban-rural divide in vaccine equity in the United States.