Race for new COVID-19 treatments as vaccine efficacy wanes in six months
•WHO announces new recommendation for treatment of COVID-19, calls for equitable access to casirivimab, imdevimab
•It is too early to mandate COVID-19 vaccination in Nigeria because there are no enough doses to go round, says Agwale
Scientists are in a race against time to develop better treatments for COVID-19 as several studies have confirmed that efficacy of vaccines wanes after six months and that people may need to be getting boosters every year.
Consequently, the World Health Organisation (WHO), yesterday, announced the addition of another therapeutic to the world’s arsenal against COVID-19, but urged producing companies and governments to address the high price and limited production of the Regeneron antibody combination and ensure safe and appropriate handling of the medicine.
WHO, in a statement, said given the high cost and low availability of the combination therapy, UNITAID is negotiating with Roche Pharmaceutical, which is currently manufacturing the drug for lower prices and equitable distribution across all regions, especially in low- and middle-income countries.
It is also in discussions with Roche Pharmaceuticals for a donation and distribution of the drug through United Nations Children Fund (UNICEF), following allocation criteria set by WHO.
UNITAID is a global health initiative that works with partners to bring about innovations to prevent, diagnose and treat major diseases in low- and middle-income countries, with emphasis on tuberculosis, malaria, and HIV/AIDS and its deadly co-infections.
In parallel, WHO said it has launched a call to manufacturers who may wish to submit their products for pre-qualification, which would allow for a ramping up of production and therefore greater availability of the treatment and expanded access. ACT-A partners are also working with WHO on an equitable access framework for recommended COVID-19 therapeutics.
The Access to COVID-19 Tools (ACT) Accelerator, is a groundbreaking global collaboration to accelerate development, production, and equitable access to COVID-19 tests, treatments, and vaccines.
WHO also called for the sharing of technology to allow for the manufacturing of biosimilar versions, so all patients who may need this treatment have access to it.
Reacting to the waning effects of COVID-19 vaccines after six months and the global clampdown on unvaccinated people as well as need for better treatments, a vaccinologist and virologist and Chief Executive Officer (CEO) of Innovative Biotech, Keffi, Nasarawa State and Innovative Biotech, United States of America (USA), Dr. Simon Agwale, told The Guardian: “In the race to end the pandemic, the more safe, effective vaccines we have available, the sooner we’ll be able to end it. In the last phase of clinical trial (that is phase III), all authorised vaccines were found to be effective in the early months after vaccination.
However, recent studies indicated that the antibodies produced by most of these vaccines starts to wane six months after vaccination. We still yet don’t know how long the immunity will last, but the good news is that early data found that those who did contract COVID-19 after receiving the vaccines did not develop a severe form of the disease.”
Agwale, who is also leader of the COVID-19 vaccine task team of the African Vaccine Manufacturing Initiative (AVMI), said most developing countries, including some African countries are making efforts to build local production capabilities to boost vaccine supplies and hopefully overcome vaccine hesitancy. He said Nigeria needed to adopt the same strategy because there are no enough COVID-19 vaccines in the country to mandate them. “I think with proper scientific explanation of the different COVID-19 vaccine technologies that are currently available, we may not need to mandate the vaccines before Nigerians will embrace them. Moreover, it is too early to mandate COVID-19 vaccination in the country because there are no enough doses to go round,” he said.
On the implication of worldwide clampdown on the unvaccinated, a consultant pharmacist and medical director, Merit Healthcare Limited, Dr. Lolu Ojo, told The Guardian: “I will not support the clampdown on or harassment of the unvaccinated. That will be going against their right to take decision for themselves. However, I could understand why some countries will take some form of action against the unvaccinated. It is the effect on the community; the unvaccinated remains the reservoir of the virus that can infect others as they interact with them. What I will suggest is a continuous advocacy that will get the unvaccinated to fall in line and it may be right for Government to insist on vaccination as a condition to access services provided.”
On the considerations that Nigeria does not have enough vaccines, Ojo said there is a paradox here: vaccine hesitancy amid vaccine shortages. “For us in Africa, it is time for us to stop depending on benevolence of other countries to keep our population healthy. We have both human and material resources to fend for ourselves jut as other (even less endowed) countries are doing. On vaccine equity, I think it will come very soon. The whole world, not just a part of it, must be protected for all of us to be considered safe,” he said.
On reports that COVID-19 vaccine immunity is waning, Ojo said: “There is nothing absolute in science. We will continue to improve we gather experience and knowledge about the disease and its management. Similarly, we will continue to get more information on the vaccine as we deepen our knowledge and exposure. If the immunity wanes after few months, then, there may be need for a booster dose and I think some countries are already administering the 3rd or 4th doses.
“I think we need to continue to trust science on this subject.”
On reports that developed nations like United Kingdom (UK) and United States (US) have said that people that were vaccinated in Africa (Nigeria) will be considered as unvaccinated, Ojo said: “This will COVID-19 apartheid. They have all the means to know whether we got the doses or not. So, why would they deny us the benefit associated with vaccination including free movement?
“This is no longer in the realm of science; it is pure politics. Our Governments in Africa should know what to do.”
National Chairman, Clinical Pharmacists Association of Nigeria (CPAN), Dr. Joseph Madu, said the implications of the world wide clampdown on the unvaccinated and possibilities in Nigeria is that such an act will only negatively add to the suffering of the people and may not provide the desired results.
“We should not just copy and paste what is happening in other countries without first considering our own peculiarities. Vaccines like every other medical treatment should not be forced on people but be given with the client or patient’s consent. Any attempt to force treatment or vaccination on people can lead to undesirable consequences, he told The Guardian.
Madu said what is required in Nigeria is more public education and enlightenment such as by those close to the community. He explained: “I mean using people like community pharmacists for public education and vaccination administration as well as provision of reliable healthcare infrastructure and services. For instance, no medication including vaccines is ‘one size fits all’.
“The drug may be contraindicated in some persons and therefore they cannot take a particular brand of vaccine etc. In a country with good health system, such persons in whom the vaccine is contraindicated will be easily identified and given medical certificates to show they are not to take the vaccines. All this must be considered holistically before any clampdown.”
The clinical pharmacist said vaccines should be made hugely available and enough time given for people to go and get vaccinated first, otherwise any clampdown will be an effort in futility.
Madu said: “It is said that there are enough vaccines in Nigeria to go round, but I doubt that if one consider our huge population, cold chains and other storage facilities.
“I will like to personally say that I am not convinced that we have enough vaccines in Nigeria for targeted population. It will not be good for any government in Nigeria to talk about preventing workers or citizens from accessing certain public facilities without providing enough vaccines and building trust of the people.”
He said there is also the need to enlighten the public the more; there are more than enough conspiracy theories out there to discourage people from taking the vaccine. “Fears such as ‘will the Pharma manufacturers accept responsibility for any long-term effects discovered from the vaccines use’, must also be allayed,” Madu said.
He said although there are such reports but available information shows the immunity does not just wane. Madu said it might be true that antibody levels may wane post vaccination, but vaccine immunity does not just disappear after six months.
Madu said the implications is that many Nigerians may find it difficult to travel to such countries and those who have been vaccinated may have to be vaccinated again if they find themselves in such countries.