Smart vaccination should be our strategy | By Shahzeb Khan


Smart vaccination should be our strategy

PURSUANT to my last article in Pakistan Observer titled Omicron: COVID-19’s Great Leap Forward, instant piece is on meeting the logistical challenge of vaccinating the world fast enough to effectively control the virus.

Vaccines are most important tool for fighting the pandemic.Since they arrived in late 2020, rollout has been way too slow, especially in lower-income countries.

Additionally, two big setbacks have befallen the global vaccination campaign; waning immunity in vaccinated people and arrival of variants that can evade immunity, creating the need for additional doses.

We are now in a particularly critical situation due to the Omicron surge bringing record-high hospitalizations and fatalities.

The current drop in Omicron’s spread, no doubt because of the changing season, is giving us some breathing space, but vaccination still has to race against Omicron.

This poses a serious challenge.Some recommend just letting Omicron, given its lowered virulence, spread and deliver herd immunity to end the pandemic, but as explained in my aforementioned piece, Omicron is still a dangerous virus and high coronavirus prevalence makes creation of mutant strains more likely.

We need to ramp up our vaccine efforts to prevent the global health catastrophe from getting worse.

Scientists are racing to create further developments in vaccination.Some promising ideas include nasal vaccines, “universal vaccines” meant to target any coronavirus variant, and Corbevax, which is open-source and easy to copy.

But right now, we have to work with what we already have.An effective strategy, crafted so that vaccines keep up with the coronavirus, is needed.

What we need to do more than anything else is to vaccinate first the people most likely to catch COVID-19.

To do this, vaccines must be primarily administered in the areas where the virus is spreading the most or is most likely to spread.

Such a strategy is relatively easy.Here’s why.COVID-19 spreads faster in high-income societies and urban areas.

Thus, after appearing in Wuhan, the coronavirus spread through developed countries, travel hubs and the world’s major cities first.Omicron did the same after it first appeared in South Africa.

These are the same environments where most of the world’s COVID-19 vaccination has taken place, because networks of human interactions enable not just the spread of communicable diseases but the supply of medicine as well.

In a way, there is fairness in how big countries like India and the United States chose to vaccinate their own people first.

They have had the highest COVID-19 case counts – and not just because they are best at detecting COVID.

Taking cognizance of this factor, we can tune it further.Closely aligning vaccine supply chain networks with the virus’s transmission networks is the most effective way to ensure maximum number of people get immunized before being exposed to the virus(this being the whole point of vaccination).

Since vaccines have some ability to prevent Omicron transmission, this strategy will also play a part in blocking COVID-19 in its tracks.

To achieve the strategy proposed here, monitoring is needed to accurately quantify the rate of COVID-19 spread in every area.

Right now, we are mostly delivering COVID-19 vaccines by telling people to come to clinics to receive their shots, putting the onus on them.

That should change.Vaccinators should come to the people by operating in places where people usually gather or pass through, like markets, schools, airports, train stations, festivals, rallies and workplaces.

At present, our two aims are getting vaccines to people not vaccinated before and giving booster shots to people who are already vaccinated.

Both these activities must race against the fast spreading Omicron, and we should consider giving priority to the second activity, since already-vaccinated populations are where Omicron variant is spreading through.

By late 2021, when richest areas and biggest cities were mostly done being vaccinated, vaccinators spread their effort out to more dispersed populations.

But when Omicron appeared in November, vaccine distributors should have shifted course to delivering booster shots back in the commercial hubs and metropolises.

It was those very places where Omicron was seeded all around the world.

Ultimately, what we need most to beat the pandemic are vaccines that effectively block transmission.

The nasal-spray COVID vaccines currently under development are a promising prospect, as they are being designed to focus immunity build-up along the upper airways, where coronavirus enters and exits.

Each shot, therefore, protects more than just the person who gets it.Nasal-spray vaccines could finally end the pandemic, but for now, our effort must be focused on administering vaccines in hubs of COVID-19 transmission and thus keeping the pandemic on a leash till more effective solutions come to market.Smart lockdowns are, by now, a familiar concept.

The “Smart Vaccination Strategy” proposed here is based on similar principle and will achieve best results.

—The writer is Director at Pakistan’s People-Led Disaster Management.


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