Article by Lalita Panicker, Consulting Editor, Views and Editor, Insight, Hindustan Times, New Delhi
President Joe Biden’s administration said this week it plans to spend more than $5 billion to stoke development of better coronavirus vaccines and treatments to curb future pandemics. www.science.org/content/article/news-glance-new-us-coronavirus-research-lab-gears-carbon-cost-repurposed-accelerator?
Like Operation Warp Speed, its predecessor during the administration of former President Donald Trump, the new program, Project NextGen, will rely on public-private partnerships, The Washington Post reported. Its top goals include devising upgraded monoclonal antibodies to replace once-potent varieties whose effectiveness against the latest SARS-CoV-2 variants has waned. Another goal is to produce nasal vaccines that prompt immune responses within the body’s mucosal linings, potentially eliciting a stronger defence than shots in the arm. The program will also aim to create vaccines against multiple types of coronaviruses.
A University of Oxford developed and Serum Institute of India (SII) manufactured and scaled up “high efficacy” malaria vaccine has been licensed for use in Ghana by Africa’s Food and Drugs Authority, the university announced here on Thursday. www.ptinews.com/news/international/-oxford-university-serum-institute-of-india-tie-up-delivers-high-efficacy-malaria-vaccine/550200.html
The R21/Matrix-M vaccine, leveraging Novavax’s adjuvant technology, has been approved for use in children aged 5 to 36 months – the age group at the highest risk of death from malaria. It marks the first regulatory clearance for the R21/Matrix-M malaria vaccine for use in any country.
“This marks a culmination of 30 years of malaria vaccine research at Oxford with the design and provision of a high efficacy vaccine that can be supplied at adequate scale to the countries who need it most,” said Professor Adrian Hill, chief investigator of the program and Director of the Oxford University’s Jenner Institute at the Nuffield Department of Medicine. https://www.bbc.co.uk/newsround/65264062
Ghana is the first country in the world to approve a malaria vaccine from Oxford University. The vaccine has been shown in early studies to be highly effective against the disease.
Ghana has approved the vaccine based on final trial data on the vaccine’s safety and effectiveness which hasn’t yet been made public.
The World Health Organization is also considering approving the vaccine.
The vaccine has been described as a “world-changer” by the scientists who developed it.
Malaria kills about 620,000 people each year, and it is particularly dangerous for children aged five and under. Current methods to reduce malaria include mosquito nets at night, protective clothing and
insect repellent – which are all ways to stop being bitten by mosquitos.
But scientists believe a vaccine that stops a malaria infection would reduce cases hugely worldwide.
Scientists from the University of Oxford, the same university that created one of the vaccines that helped to prevent coronavirus, revealed some data of their R21 vaccine in September 2022. The data showed that it was able to prevent up to 80% of infections in a small trial of 450 children.
In 2021, the WHO recommended another malaria vaccine created by pharmaceutical company GlaxoSmithKline (GSK), which has committed to produce up to 15 million doses of Mosquirix every year through 2028.
But this is under the roughly 100 million doses a year of the four-dose vaccine the WHO says is needed long-term to cover around 25 million children.
The Oxford vaccine in contrast has made a deal with the Serum Institute of India, the world’s largest manufacturer of vaccines, to produce up to 200 million doses annually.
Widespread use of the vaccine will depend on an ongoing clinical trial in Burkina Faso, Kenya, Mali and Tanzania involving 4,800 children.
Although this data has not been made public yet it has been shared with some government bodies in Africa and scientists.
Ghana’s Food and Drugs Authority, which has seen the data, has approved the vaccine’s use in children aged between five months to three years old.
Other African countries are also studying the data, along with the WHO.
Adar Poonawalla, CEO of the Serum Institute, said that Ghana being the first country to approve the vaccine, represents a “significant milestone in our efforts to combat malaria around the world”.
The second Health Working Group (HWG) meeting under India’s G20 presidency began in Goa from April 17, 2023. The three-day meeting will conclude on April 19. www.thehindu.com/news/national/other-states/g20-goa-to-host-second-health-working-group-meeting-from-today/article66746322.ece
According to India’s Ministry of Health and Family Welfare, more than 180 delegates from 19 G20 member countries, 10 invited states and 22 international organizations will be participating in the meeting. The second HWG meeting will have thematic discussions on three priorities identified under the G20 Health Track.
The first priority is Health Emergencies Prevention, Preparedness and Response with a focus on One Health and AMR (antimicrobial resistance). The second is Strengthening Cooperation in the Pharmaceutical Sector with a focus on access and availability to safe, effective, quality and affordable medical countermeasures (vaccines,
therapeutics and diagnostics). The third priority includes Digital Health Innovations and Solutions to Aid Universal Health Coverage and Improve Healthcare Service Delivery.
The Health Track of the G20 India Presidency will comprise four Health Working Group (HWG) meetings and one Health Ministerial Meeting (HMM). India plans to host four side events along with HWG meetings to enrich, supplement and support G20 discussions. A side event on Digital Health will be held on the side-lines of the second meeting of HWG at Goa on April 18-19.
India assumed the presidency of the G20 on December 1, 2022, marking a significant milestone. India is currently part of the G20 Troika comprising Indonesia, India and Brazil marking the first time that the Troika is made up of three developing and emerging economies.
As chair of the G20 Presidency, India aims to continue and consolidate health priorities and key takeaways from previous presidencies while highlighting critical areas that require strengthening. India also aims to achieve convergence in discussions across various multilateral fora engaged in health cooperation and work towards integrated action, an official statement added.
The Technical Advisory Group on COVID-19 Vaccine Composition (TAG-CO-VAC), in its most recent meeting held March 16-17, discussed two key objectives: Review the evidence on the performance of updated COVID-19 vaccines that incorporate
descendent lineages of Omicron as a booster dose; and establish timelines for COVID-19 vaccine composition recommendations in 2023. www.downtoearth.org.in/news/health/consider-updating-covid-19-vaccine-composition-to-include-omicron-who-to-authorities-88788
The report, published by the World Health Organization (WHO) April 14, noted that while index virus-based vaccines continue to provide protection against severe disease and death, their effectiveness in protecting against symptomatic infection has been waning.
Keeping this in mind, the report made recommendations to update existing vaccines to try and bridge the “antigenic distance” in the backdrop of “uncertainties of further viral evolution”. The suggestion seemed mild because the body simply “advised vaccine manufacturers and regulatory authorities to consider an update of vaccine antigen composition by including Omicron, as the most antigenically distinct SARS-CoV-2 variant thus far, for administration as a booster dose.”
While the report acknowledged that variant-specific boosters targeting the BA.1 and BA.4 / BA.5 variants confer better protection than using the original vaccine, it also shed light on the immune imprinting phenomenon, where “immune memory recall biases the immune response towards previously encountered antigen”.
However, limited data based on epidemiological studies plagues our understanding of the clinical impact of immune imprinting. The global health body remains steadfast in its view that “achieving
broader cross-reactive vaccine-induced immune responses remains prudent in the context of continued SARS-CoV-2 evolution.”
In conclusion, the report outlined the aims of the upcoming meetings of TAG-CO-VAC; whether the index virus should be a part of future vaccination updates.
Tailoring vaccines to keep up with the evolving SARS-CoV-2 is a practice that began last July, when sub-lineages of Omicron had begun causing waves across different geographies. It is the easiest to do so for mRNA-based vaccines.
Essentially, the existing antigen is replaced with a new antigen, for which two critical ingredients are needed: Genetic sequence of the spike protein from a new variant of concern and a DNA template to build the mRNA, Down To Earth (DTE) had earlier reported.
Experts estimated that it will take 52 days for manufacturers to carry out preclinical tests and another 100 days for human trials. Updating viral vector and protein-based vaccines is a more tedious and long-drawn process.
The only other precedent we have for updating vaccines regularly based on what strain is circulating is with flu. But that comparison is not entirely fair, since we understand the flu virus much better than SARS-CoV-2.
“The value in developing new variant vaccines is always mitigated against the time taken to find a new variant, figure out if it’s an important one, [and then] develop, modify the vaccine, check it’s worked and approve,” Paul Hunter, professor of medicine at the University of East Anglia, was quoted as saying in an article for journal The BMJ.
Three risk groups have been identified based on risk of severe disease and death, complimented with our understanding of vaccine performance, cost-effectiveness, programmatic factors and community acceptance; high, medium and low, according to the latest set of recommendations made by the Strategic Advisory Group of Experts on Immunization (SAGE) March 28, 2023. For the high priority group — older adults; younger adults with significant comorbidities (diabetes, heart disease); people with immunocompromising conditions (those living with HIV, transplant recipients), including children aged six months and older; pregnant persons; and frontline health workers — SAGE recommended an additional booster shot 6-12 months after the last dose.
For the medium priority group — healthy adults below 60 years of age and children and adolescents with comorbidities — SAGE recommended primary vaccination and one booster dose.