Unequal distribution of COVID‐19 vaccine: A looming crisis

Sawal, Imaduddin; Ahmad, Shoaib; Tariq, Waleed; Tahir, Muhammad Junaid; Essar, Mohammad Yasir; Ahmed, Aziza

doi:10.1002/jmv.27031

Cited by 24 publications

(32 citation statements)

References 8 publications

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“… 7 In LMICs, infection and fatality rates are higher, and mass vaccination has been challenged. 13 The situation is even worse in lower resource settings, like Bangladesh, where mass vaccination is a major concern due to the unequal distribution of the vaccine 14 and vaccine hesitancy. 15 AMR specialists have warned that misuse or overuse of antibiotics during the COVID-19 pandemic can vary, including seeking antibiotics without clinical confirmation of co-infection, 8 , 16 suboptimal adherence, 17 , 18 and self-medication 19 , 20 .…”

Section: Introductionmentioning

confidence: 99%

Antibiotics in the Community During the COVID-19 Pandemic: A Qualitative Study to Understand Users’ Perspectives of Antibiotic Seeking and Consumption Behaviors in Bangladesh

Kalam¹,

Shano²,

Afrose³

et al. 2022

PPA

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Introduction The COVID-19 pandemic is thought to have led to increased “inappropriate” or “unjustified” seeking and consumption of antibiotics by individuals in the community. However, little reference has been made to antibiotic seeking and using behaviors from the perspectives of users in Bangladesh during this health crisis. Purpose This study seeks to document how antibiotic medicines are sought and used during a complex health crisis, and, within different contexts, what are the nuanced reasons why patients may utilize these medicines sub-optimally. Methods We used an exploratory, qualitative design. Forty semi-structured telephone interviews were conducted with people diagnosed with COVID-19 (n=20), who had symptoms suggestive of COVID-19 (n=20), and who had received care at home in two cities between May and June 2021 in Bangladesh. In this study, an inductive thematic analysis was performed. Results The analysis highlighted the interlinked relationships of antibiotic seeking and consumption behaviors with the diversity of information disseminated during a health crisis. Antibiotic-seeking behaviors are related to previous experience of use, perceived severity of illness, perceived vulnerability, risk of infection, management of an “unknown” illness and anxiety, distrust of expert advice, and intrinsic agency on antimicrobial resistance (AMR). Suboptimal adherence, such as modifying treatment regimes and using medication prescribed for others, were found to be part of care strategies used when proven therapeutics were unavailable to treat COVID-19. Early cessation of therapy was found to be a rational practice to avoid side effects and unknown risks. Conclusion Based on the results, we highly recommend the take up of a pandemic specific antimicrobial stewardship (AMS) program in the community. To deliver better outcomes of AMS, incorporating users’ perspectives could be a critical strategy. Therefore, a co-produced AMS intervention that is appropriate for a specific cultural context is an essential requirement to reduce the overuse of antibiotics during the COVID-19 pandemic and beyond.

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Section: Introductionmentioning

confidence: 99%

Antibiotics in the Community During the COVID-19 Pandemic: A Qualitative Study to Understand Users’ Perspectives of Antibiotic Seeking and Consumption Behaviors in Bangladesh

Kalam¹,

Shano²,

Afrose³

et al. 2022

PPA

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“…42 Advocates for the COVID-19 products TRIPS waiver argue that significant public monies have contributed to the development of these patents thus waiving IPR will support vaccine development and manufacturing, and that some countries are already undermining existing TRIPS flexibilities through restrictive free trade agreements. 42 53 55 61 Proponents against governments' enacting patent waivers claim that they contribute to inefficiencies by diverting raw materials and supplies away from effective manufacturers. 47 Compulsory licences are not considered by these proponents as being a practical tool to rapidly expand access to vaccines, instead they support voluntary licensure, for instance, AstraZeneca's arrangements with Indian and Brazilian manufacturers.…”

Section: Resultsmentioning

confidence: 99%

“…Most articles indicated collective action as being key to contribute to equitable access 1 5 6 13 24–50. Global collective agreements should be driven by multilateral agencies that have the global mandate to convene interest groups, advocate for collective response measures, as well as the investment, procurement and distribution of pandemic vaccines 51.…”

Section: Resultsmentioning

confidence: 99%

Global access to COVID-19 vaccines: a scoping review of factors that may influence equitable access for low and middle-income countries

et al. 2021

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ObjectiveTo identify the factors contributing to equitable access to COVID-19 vaccines for low and middle-income countries (LMIC).MethodsWe conducted a scoping review following the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews and a five-stage framework for scoping studies. We performed systematic searches for published peer-reviewed literature in five databases: Medline, Embase, Web of Science, Global Index Medicus and COVID-19 Evidence Epistemonikos (August 2020, updated May 2021).ResultsSystematic selection according to predefined criteria resulted in the final inclusion of 45 peer-reviewed articles, with no limitations on study design or publication type. We derived four key factors that potentially influence equitable access to COVID-19 vaccines in LMICs: (1) collectively agreed global mechanisms or frameworks; (2) bilateral purchasing, contracting, and vaccine prices; (3) vaccine manufacturing that is supported by sharing know-how; and (4) countries’ strength in implementing vaccination programmes.ConclusionsThis scoping review highlights the ongoing challenges for the international community in ensuring equitable access to COVID-19 vaccines for LMICs. The literature suggests that vaccine manufacturing can influence the supply of vaccines, as can the role of patent holders who can influence global governance through their role in the distribution of COVID-19 vaccines. Our findings indicate that including the principles of equitable access throughout vaccine research and development, procurement, scale-up and distribution processes can support equitable access for LMICs. Advances made with mRNA vaccines may have additional benefits in relation to expanding the manufacturing of other vaccine. Finally, the exploration and scale-up of such capacities of LMICs are likely to prove to be a valuable investment, even after the pandemic.

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“…However, the duration of natural immunity is unknown and infection of a large proportion of the population may not suffice to achieve collective immunity, in particular when facing emerging variants. This is of concern because of unequal vaccine distribution across the world [4] and significant level of vaccine hesitancy in Europe and the United States [5]. Therefore, it is important to determine if individuals with a history of PCR-confirmed SARS-CoV-2 infection are protected against symptomatic reinfection and viral shedding and if so, how long this protection lasts.…”

Section: Introductionmentioning

confidence: 99%

The REinfection in COVID-19 Estimation of Risk (RECOVER) study: Reinfection and serology dynamics in a cohort of Canadian healthcare workers

Racine

Boivin

Longtin

et al. 2022

Preprint

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Background : Understanding the immune response to natural infection by SARS-CoV-2 is key to pandemic management, especially in the current context of emerging variants. Uncertainty remains regarding the efficacy and duration of natural immunity against reinfection. Method : We conducted an observational prospective cohort study in Canadian healthcare workers (HCWs) with a history of PCR-confirmed SARS-CoV-2 infection to : (i) measure the average incidence rate of reinfection and (ii), describe the serological immune response to the primary infection. Results : We detected 5 cases of reinfection over 14 months of follow-up, for a reinfection incidence rate of 3.3 per 100 person-years. Median duration of seropositivity was 420 days in symptomatics at primary infection compared to 213 days in asymptomatics (p<0.0001). Other variables associated with prolonged seropositivity for IgG against the spike protein included age 55 and above, obesity, and non-Caucasian ethnicity. Summary : Among healthcare workers, the incidence of reinfection with SARS-CoV-2 following a primary infection remained rare, although our analysis predates the circulation of the Omicron variant.

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Unequal distribution of COVID‐19 vaccine: A looming crisis

Cited by 24 publications

References 8 publications

Antibiotics in the Community During the COVID-19 Pandemic: A Qualitative Study to Understand Users’ Perspectives of Antibiotic Seeking and Consumption Behaviors in Bangladesh

Antibiotics in the Community During the COVID-19 Pandemic: A Qualitative Study to Understand Users’ Perspectives of Antibiotic Seeking and Consumption Behaviors in Bangladesh

Global access to COVID-19 vaccines: a scoping review of factors that may influence equitable access for low and middle-income countries

The REinfection in COVID-19 Estimation of Risk (RECOVER) study: Reinfection and serology dynamics in a cohort of Canadian healthcare workers

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