As the COVID-19 pandemic continues to impact communities worldwide, several vaccines have been authorized for emergency use in various countries, with many more in the final stage of clinical trials. The successful deployment of a COVID-19 vaccine has the potential to eradicate the global coronavirus pandemic, but the task is challenging. COVAX, co-led by Gavi, the Coalition for Epidemic Preparedness Innovations, and the World Health Organization (WHO), was established to accelerate the development and manufacture of COVID-19 vaccines and to guarantee fair and equitable access for every country. However, for governments, making decisions on COVID-19 vaccine options and deployment poses complex challenges. Success will depend on how key essential components of the vaccine introduction process are planned, implemented, monitored, and evaluated.
Dr. Anton Luchytsky, Principal Technical Advisor, Infectious Diseases at Management Sciences for Health supporting USAID MTaPS on COVID-19 response and vaccine introduction in low- and middle-income countries (LMICs), talks about challenges and capabilities MTaPS has to assist countries in this process.
Q: You have considerable experience in vaccine introduction, including planning and implementing a large-scale diphtheria campaign in Ukraine and Belarus and providing direction for Gavi’s Accelerated Vaccine Introduction Initiative in several countries. What are some strategies for supporting COVID-19 vaccine introduction in countries and what are the unique challenges?
AL: The WHO has developed a detailed guidance on COVID-19 vaccine introduction that can help plan all key aspects from coordination and regulatory preparedness to costing, delivery strategies, supply chain, and vaccine safety monitoring. However, one of the biggest challenges LMICs face is the lack of access to quality-assured vaccines that have been thoroughly reviewed by functional regulatory agencies. This supply scarcity does not only constrain countries’ ability to put a vaccination plan in motion but also highlights the need to carefully use any emergency use authorizations in resource-limited settings.
In addition, there are several unique challenges to COVID-19. Evidence about the infection, immunity, and vaccine safety and efficacy is constantly evolving. It is important that vaccination managers are knowledgeable about the latest science to make good implementation decisions. Since the approved Pfizer/BioNTech and Moderna vaccines use a new mRNA technology never licensed in humans, safety surveillance accompanying their deployment will be critical. Some vaccines, such as the Pfizer/BioNTech vaccine, must be stored at very cold temperatures, which requires specialized equipment and adjustment of the current inventory management, distribution, and requisition systems. Regulatory support to speed up the introduction of new products at the country level will also be important. While supplies are still limited, people in all countries should have equitable access to the vaccines. Donors may help cover the initial cost in some settings, but countries will need strategies to mobilize resources to scale up and sustain implementation. MTaPS has the capability to address many of these challenges.