EBOLA in Uganda, polio (or polio) in Pakistan, monkeypox practically everywhere, especially in Europe and the Americas. While much of the world was – and still is – grappling with the Covid-19 pandemic, from Gavi (Global Alliance for Vaccines and Immunization) comes the appeal not to forget other emergencies. Especially for the poorest countries, those who continue to lag behind, even on the immunization front. Gavi’s appeal is actually an attempt to revive the recommendations that emerged from the meeting of the group of experts on vaccination of the World Health Organization (Sage) which met a few days ago to discuss the priorities in subject of vaccinations with ongoing emergencies.
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Against Covid-19, expand coverage in the countries that have lagged behind
The Covid-19 emergency could not be overshadowed in the Sage discussions. So, again, the recommendation was to proceed expeditiously with the vaccinations, taking advantage of the arrival of the new formulations directed against the latest variants of the coronavirus but without further delays to wait for these vaccines, indeed favoring the original ones for the completion of the primary cycle. . Especially in the countries that have fallen behind. In fact, in the face of very high levels of coverage for Covid-19 in rich countries – many of which are now engaged in the distribution of the second or even third booster dose – the percentages in low-income countries remain very low, despite the efforts and commitments of international programs. for the fair distribution of vaccines such as Covax, participated by Gavi and the World Health Organization, among others. In these countries, Gavi remembers, not even a quarter of the population is vaccinated with a dose, and less than a fifth can be said to be completely immunized. Proceeding quickly remains the priority against Covid-19.
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Smallpox of monkeys
The vaccination strategies recommended against monkeypox – a disease that in 2022 spread internationally even in countries where it was not historically present, to the point of being declared a global health emergency by the WHO – are different. In this case, given the different modes of transmission of the virus and the dynamics of the current epidemic, the recommendations are to vaccinate populations at risk for prophylactic purposes – such as men who have sex with men, people with multiple sexual partners and laboratory handling virus – and to administer the vaccine post-exposure for close contacts. But alongside vaccination strategies, it is also necessary to collect data on the disease, on its epidemiology, especially in countries that have historically already been affected and with low numbers in this epidemic.
Polio and measles
Although polio was eradicated in Europe in 2002, the threat of future outbreaks continues to exist, both from wild polio cases in Pakistan and traces of vaccine-derived poliovirus in New York and London. For this reason, the appeal is to continue with the routine vaccination efforts and especially in the event of epidemics, favoring young children and adult populations where any immunization gaps are highlighted. The appeal is to keep response plans active and ready to any outbreaks of both wild polio and vaccine-derived viruses, hoping for the arrival of new oral formulations. A similar discourse was also made against measles, where the decline in coverage associated with the pandemic (not only in poor countries, recalled by Gavi) has led to the return of epidemics and an increase in cases. In Zimbabwe alone, there have been at least 700 deaths among children. Measles remains an extremely contagious disease, and that level of global coverage of around 70% is still far from the 95% recommended to protect against the disease.
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Ebola
However, there are also other ongoing emergencies for which vaccines do not yet exist, such as the Ebola epidemic that is hitting Uganda. In fact, if there are vaccines against the Zaire strain of the ebolavirus, products indicated against the Sudan strain, the one responsible for the ongoing epidemic and for which there are only studies for six vaccine candidates, have not yet arrived. One of these could be tested in a similar way to what happened in the past in the experiment against the Zaire strain, that is, using the ring vaccination, in which the vaccine is administered to contacts of known cases.