Global Health Week panel considers state of coronavirus vaccination

April 20, 2021
Screenshot of four people talking during a Zoom panel discussion
Thomas Quinn, (clockwise from top left), Heidi Larson, Emmanuel Agogo and Peter Hotez talk about the worldwide campaign to get people vaccinated against the coronavirus.

So far, the global vaccination campaign against the coronavirus is going well, but there are still several obstacles that could upend the process, according to panelists during Friday’s session of MUSC Global Health Week.

Global Health Week is an annual event sponsored by the MUSC Center for Global Health that considers health issues of worldwide significance. Normally occurring in person on the Charleston campus of the Medical University of South Carolina, it was canceled last year because of the pandemic and returned this year in virtual format.

Panelists included Heidi Larson, Ph.D., founding director of the Vaccine Confidence Project; Peter Hotez, M.D., Ph.D., dean of the National School of Tropical Medicine at Baylor College of Medicine; and Emmanuel Agogo, M.B.B.S., Nigeria country representative for Resolve to Save Lives. The panel was led by Thomas Quinn, M.D., director of the Johns Hopkins Center for Global Health, who spoke at the 2019 MUSC Global Heath Week about the evolution of the global HIV/AIDS epidemic.

Agogo noted that only 2% of vaccines have made their way to Africa. His nightmare scenario, he said, is that once well-off countries achieve herd immunity within their borders, they will grow comfortable and “interest in ensuring there’s a global good, the global equity that we talk about in terms of vaccinations, is gone.”

Access to vaccines and vaccine manufacturing capacity must be democratized across the globe, he said, so that lower- and middle-income countries aren’t left out of vaccination efforts or future efforts to develop booster shots. 

Hotez noted that the World Health Organization’s COVID-19 Vaccines Global Access program, known as COVAX, is an innovation that is working. In fact, he hopes that it becomes institutionalized so it can help with future pandemics.

“There was no way you were going to provide Lamborghinis and McLarens for the world.”
Peter Hotez, M.D., Ph.D.

Instead, the failure he pointed to was one of science policy leadership. So many leaders looked to the newest, most cutting-edge technologies to develop vaccines without giving a thought to how those vaccines would be distributed on the ground, especially considering the ultra-cold freezer requirements for the Pfizer vaccine.

He compared the mRNA technology behind the Pfizer and Moderna vaccines to luxury car brands.

“There was no way you were going to provide Lamborghinis and McLarens for the world,” he said.

His group, however, has been using its prior 10 years of research to focus on creating a vaccine using the “Toyota and Hyundai” technology of the vaccine world – recombinant proteins, already used in the Hepatitis B vaccine – that are simple to make, low cost and easy to scale up.

The vaccine is currently being tested in India, with good results, he said. But even though he had a 10-year head start on different types of coronavirus vaccines, his trial is behind some of the others because he had to spend time raising money to develop this vaccine.

“I still don’t have any engagement from the federal government, from BARDA,” he explained, referring to the Biomedical Advanced Research and Development Authority. “We could easily make another 3 billion doses. And again, they’re not very interesting vaccines: simple receptor binding domain expressed in yeast. But I think we have to take a look at that,” he said.

The group also discussed vaccine hesitancy, especially in light of the pause placed on the Johnson and Johnson vaccine while federal health officials investigate six cases of women who experienced a rare form of blood clot after receiving the vaccine.

“I truly, truly, deeply hope that a ‘pause’ is genuinely a pause. Every extra day that there's ambiguity is a day to be filled with mis- and disinformation and more anxiety,” Larson said.

She said she’d like to see information about the risk and how to manage the risk be communicated clearly. When the Astra Zeneca vaccine was paused in Europe, she saw in polling a “precipitous” day-by-day drop in public confidence.

She said polling about vaccine confidence has become akin to political polling in that there are volatile swings in public opinion based on daily events. However, some surveys that ask about overall vaccine confidence might be masking the fact that people have strong preferences for a particular vaccine and low confidence in another.

Local leadership needs to step up to attest to the vaccines, particularly in places where national leaders are instilling doubt and undermining, she said.

“We heard in Brazil that it could turn you into a crocodile. And you think, ‘This is a crazy idea, you know? Who would ever believe that?’ But just the suggestion of it has really tipped some confidence in certain places. So I think with situations where national leadership is not building confidence in scientific interventions, local, local, local is needed. And in a way, in the absence of national leadership in a number of countries, local leadership has come up, and that's actually been a good thing,” she said.

The anti-vax movement has globalized and become political, Hotez said. Scientists tend not to want to get involved in politics, he added. Further, for a long time, there was the thought that ignoring the anti-vax movement would keep it contained to fringe groups, but instead, the anti-science movement has grown, he said.

On the bright side, the panelists noted that already, more than 815 million people worldwide have received at least one dose of a vaccine.