Tuesday, December 7

Giving booster shots before the world is vaccinated will not keep the UK safe from Covid | Charlotte summers


SShould Britain approve booster doses for broad swaths of the population? The Joint Committee on Vaccination and Immunization (JCVI) is making a decision this week and has already recommended that a third dose be offered to those over 11 years of age who were severely immunosuppressed at the time of their first or second injection (including people with diseases such as leukemia). . Passing a massive reinforcement program would bring Great Britain in line with countries like the United States and Israel that are already offering third doses to their vaccinated populations.

These plans are based on the concern that the protection offered by vaccines may diminish over time. In fact, the data of a widely cited study in Israel has shown that the effectiveness against severe disease of the Pfizer vaccine decreased from 91% in individuals 60 years and older who were vaccinated four months before the study, to 86% in those vaccinated six months before the study. For people aged 40 to 59, protection against serious illness was reduced from 98% to 94%.

But while these results suggest a decrease in the effectiveness of the vaccine over time, they also show that the vaccines remain highly effective against severe disease six months after two doses. In a study of more than 7 million people in the United Kingdom In 718 English general practices, antibody levels in the blood of immunosuppressed people gradually decreased after receiving the Covid-19 vaccine. Despite this, vaccines remained effective in preventing clinical disease, suggesting that antibody levels may not tell the whole story of how our immune systems respond.

Why is this? First of all, we still can’t be sure how best to measure the protection offered by Covid-19 vaccines. The markers of protection against infection with the virus that causes Covid, becoming ill with it, or becoming seriously ill (resulting in hospitalization or death), can all be different. Although antibody levels in the blood give us an indication of how that person’s immune system responded to the vaccine, they do not necessarily tell us how an individual’s immune system will respond when it encounters the virus.

The immune system is a complex attack system that behaves differently in different people. Measuring antibody levels to tell us how effective a vaccine will be in protecting someone from severe Covid can be the equivalent of evaluating the strength of an army based on its number of tanks, rather than the full power of its forces and arsenal.

With this uncertainty in mind, the World Health Organization (WHO) has called for a moratorium on Covid-19 booster injections. He noted that there is still not enough compelling science to approve the drivers. Mike Ryan, director of WHO’s health emergencies program, has likened plans to administer backups to delivering “extra life jackets to people who already have life jackets, while … letting other people drown without a single lifejacket”.

At the end of August 2021, 57% of adults in high-income countries he had received at least one dose of the Covid vaccine. In the UK, this figure exceeds 88%. However, in low-income countries, only 2% of adults had received one or more doses (in Benin, Madagascar, Turkmenistan, and Tanzania, among other countries, less than one in 100 people had received a single dose). I am an intensive care physician; Because of this, I received my first dose of Covid vaccine in early January 2021, followed by a second dose in late March. Months later, healthcare workers in other regions of the world still have to care for Covid patients, risking their lives without the vital protection of the vaccine.

Vaccine supplies are not limitless today, and ensuring that the necessary infrastructure is in place to distribute them around the world requires careful planning. Countries need to know in advance when supplies will arrive so they can plan where and how to administer doses. It is not helpful for high-income countries to donate vaccine supplies on short notice that they cannot use due to short expiration dates. There needs to be adequate global cooperation and coordination to ensure that doses are not wasted.

The fact that so many people still do not have access to vaccines because of where they live is a failure of international leadership. This uneven situation benefits no one: high levels of transmission make it more likely that new variants will emerge that bypass the protection of our current vaccines. To ensure everyone is safe, including people in high-income countries, vaccinating as many people as quickly as possible is a much better strategy than vaccinating a small group of people repeatedly.

Not doing everything possible to ensure that treatments, vaccines, tests, and oxygen are available to all who need them is a choice. Britain will choose to ignore the needs of people in poorer countries if it starts giving booster injections to wide swaths of the population. All choices have consequences, and the consequences of this choice will be felt by all of us, wherever we live. There should be no room for nationalism during a global public health crisis.


www.theguardian.com

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