How Israel and Britain took the lead in coronavirus vaccination

The UK and Israel have been ahead of most of the rest of the world in coronavirus vaccination, accelerate the vaccination of millions of people.

While newer variants of the coronavirus are cause for concern, accelerated vaccination programs are showing signs of working. The number of cases, hospitalizations and deaths decrease in both countries, allowing their governments to draw up reopening plans.

Bloomberg News spoke with Kate bingham, former head of the UK Vaccination Task Force, and Ran Balicer, Chairman of the Israeli Ministry of Health’s Covid Advisory Committee, on how these countries were able to act so quickly and what the world can do to prepare for the future challenges of the pandemic. His statements have been edited for clarity.

When it came to purchasing vaccines, they had to secure the supply without knowing which vaccines would work. How did you decide what to buy?

Bingham: Our approach has been to build a portfolio of different vaccines. This meant combining the most clinically advanced vaccines that we least knew about – mRNA and adenovirus vaccines – with the most established vaccine formats. That is, vaccines based on protein adjuvants and inactivated whole virus vaccines. Our approach has therefore been to choose the most promising among the different formats, in the hope that at least one or more of them will be successful.

In Israel, they have largely done this with a single vaccine so far. How did that happen?

Baler: Israel was fortunate enough to obtain sufficient Pfizer for a very extensive vaccination campaign. The vast majority of our populations at risk are already covered. We are starting to see the benefits of this immunization program as we see a dramatic drop in severe morbidity rates.

Some people in the European Union are skeptical of AstraZeneca’s vaccine, which the UK is relying on alongside Pfizer’s. How it works?

Bingham: When different trials are done in different places with different mutations, we might not be comparing exactly the same things, but the evidence we are seeing in Scotland is that the AstraZeneca vaccine shows greater reduction in hospitalizations than the Pfizer vaccine . But the reality is that both are effective, both are safe, and if someone is offered these vaccines, they should accept them.

How will the new variations affect strategies and how prepared are we to deal with them?

Bingham: Part of our strategy has been to make sure we can change quickly if there are serious mutations that bypass current vaccines. At the moment, this is not happening. The evidence we have indicates that the vaccines we have work against the British, South African and Brazilian variants. We have doses of Novavax that show very profound effects against these different variants.

In addition, we use two different strategies. The first is to explore the mixing and pairing of different vaccines to elicit different immune responses. Additionally, we have invested in manufacturing so that we can quickly update vaccines to deal with these potential variants if they bypass current responses.

Baler: The UK variant has been the main driver of the increase in new cases we have seen in recent months. We were able to control it thanks, at least in part, to a mass vaccination campaign which, according to our data, was very effective. All of the data we have on the effectiveness of the vaccine comes from when the new variant was the dominant strain of the virus, so this is good news.

At some point we will have strategies that combine and match different vaccines, and I also believe that Pfizer and Moderna will be able to create new bespoke vaccines that will be more appropriate for these new variants as they become available.

Do you think that at some point we will have multipurpose vaccines that work against any new variant that appears?

Baler: We couldn’t do this for the flu, but the flu mutates in a different way than the coronavirus. While I am still hopeful, I am not sure we can develop such a vaccine. We may need to update the vaccination campaign annually or seasonally depending on the variations that appear. I think this problem is not resolved yet.

To what extent does the UK or Israel have a responsibility to ensure equitable distribution of vaccines around the world?

Baler: As a small country, there is not much we can do. What we are trying to do is to disseminate the evidence of the efficacy of the vaccine and thereby help other countries to dispel the doubts about vaccines.

Bingham: It was a fundamental responsibility that we took very seriously. An important part of what we have done in the UK is to ensure that the clinical trials we have supported and conducted generate data that can be used by regulators around the world so that these vaccines can be approved as quickly as possible. possible.

This will not be the last pandemic the world will face. What can we do to respond even faster next time?

Bingham: Current vaccines, although very effective, are not particularly suitable for wide distribution around the world. We have cold chains and expensive storage, complicated logistics, we use glass. We must find formats that solve all this: scalable, stable, inexpensive, ideally without health professionals involved, that is to say without needles, without dilutions on site. This is where we need to invest.

Baler: We must also improve the monitoring mechanisms. Thanks to the tremendous efforts of the UK, which has done massive and systematic sequencing, we have the information in time for other countries to prepare for any variant. It is necessary to harmonize our monitoring mechanisms in order to reach conclusions more quickly.

We need to improve our ability to create cheaper and less complicated vaccines that we can produce quickly and distribute to all countries, regardless of their ability to have more expensive logistics.

Agencia Bloomberg