Pandemic plan, where are we with anti-Covid prophylaxis? Long-term strategies to block the way to the dreaded return of new ones in a big way variants of the Sars-Cov2 virus were the focus of a round table organized by Novavax in the context of World Congress on Public Health organized in Rome. We are moving towards an annual combined flu and Covid vaccination for all concerned, in the autumn, with a booster in the spring recommended for frail individuals.
- Predictions and coexistence
- Seasonal trend
- Degrees of protection
- Combined vaccines
- Heterologous immunization
- Omicron variants
- Security indexes
- Current situation
- future scenarios
1. Forecasts and coexistence. In recent years, Covid-19 has brought out how i respiratory viruses are to be expected only partially. Looking at what has happened in the last three years, considering the typical behavior of respiratory pathogens, experts try to trace future vaccination strategies that will allow us to live with Sars-Cov2just like we do with flu viruses.
2.Seasonality. Will an annual anti-Covid vaccination be necessary? To date, the coronavirus epidemic occurs cyclically in waves without a recurring character as occurs in influenza viruses. “We expect, however – he declared Pierluigi Lopalco, professor of public health at the University of Salento – that sooner or later the seasonal trend will end up establishing itself, and then it will be useful to foresee an autumn vaccination, such as the flu vaccination, for the entire population. In any case we must continue to monitor the progress of the circulation of variants and be ready to change strategy in case the virus shows peaks”.
3.Protection. How long does the coverage last? Until when are the immune defenses able to reject infections? The epidemiologist Pierluigi Lopalco reports that, according to updated studies, the immunity conferred by infection or from vaccination decreases over time, and it was possible to measure it. Especially for frail people, protection against serious illness can only be obtained with recent immunisation. For them, experts suggest, one may also be needed second vaccination, before summerso intuitively in frail subjects two administrations would be recommended, one in autumn and one in spring.
4. Combined vaccines. Many experts find it useful to be able to combine the vaccine against Covid and the one against the flu. “The population has shown itself in favor of receiving both vaccines in a single session, when given the opportunity. Research around combination vaccines, spurred by the pandemic, is crucial to offer new alternatives that can provide protection against two global public health threats,” he said. Francesco Vitale, professor of hygiene and preventive medicine, director of clinical epidemiology at the Policlinico Hospital of Palermo.
5. Heterologous immunization. Access to diverse vaccines is essential to protect public health and to ensure safety security against variants as part of an overall strategy. In fact, the research shows the advantages of heterologous vaccination, which Professor Vitale explains in this way: “The tendency to always vaccinate with the same vaccine is now outdated, studies have shown that even with heterologous vaccination (that is, using products from pharmaceutical companies different, depending on the case, as occurs with flu prophylaxis, ed) a high is obtained degree of protection from disease”.
6.Omicron variants. It is important to note that protein subunit vaccines remain an important option. “They are manageable vaccines, also because they are easy to manage and the doctor can keep them in the office in the refrigerator. They are safe and effective: they stimulate immunity even if the person has been vaccinated with another type of vaccine,” he stressed Paul Bonanniprofessor of Hygiene at the University of Florence e scientific coordinator of the Calendar for Life. “In addition, we have seen that the recombinant vaccine, even if monovalent, demonstrates good cross-reactivity against the Omicron variants”.
7.Security indexes. “The development of safe and effective vaccines – he says Giuseppe Bunone of Novavax – allowed us to slow down the global pandemic and contain the spread of the Covid-19 infection. Defining the most effective vaccination strategy and being able to count on a diversified portfolio of vaccines is of fundamental importance, in particular to protect people with comorbidities, and those at risk”.
8. Current situation. Organized every three years, the World Congress on Public Health brings together experts from around the world and scientific partnerships such as the Association of the School of Public Health in the European Region and the Italian Society of Hygiene, Preventive Medicine and Public Health (Sites). Second WHO and Unicef data, in 2021 there were vaccination coverage 5% lower than in the pre-pandemic period, and declines in pediatric vaccinations. Vaccination coverage for polio and measlesat 24 months, remain below the 95% threshold recommended to limit the circulation of pathogens.
9.Future scenarios. Attention must remain high in planning strategies to recover the vaccinations left pending during the emergency. Recent data have shown that around 100 new vaccines are under development in Europe alone – many of these aim to mitigate the burden of respiratory tract infections, cases of antibiotic resistance and zoonotic infections.