Failure Recognition: A required change in the global vaccination strategy


Many health organizations involved in global vaccination efforts aim to immunize 90 percent of the vulnerable population in all countries – a move that violates WHO’s 70 percent target.
The change in strategy will make a significant turn in response to the global pandemic. This comes at a time when the Omicron sub-variant BA.2 is spreading worldwide, and Congress is debating how much money to spend on the Biden administration’s global vaccination campaign.
“I do not think 70 percent of the thinking is as much about acknowledging failure as it is about acknowledging failure,” said Gail Smith, CEO of ONE Campaign and former Covid-19 Global Response Coordinator. . “A target of 70 percent is still intelligent. But the practical reality is that there will not be enough vaccines, plus the resources needed to deliver them at up to 70 percent at the same rate that we have been able to in more affluent countries.

Prioritizing vulnerable populations – health workers, the elderly, and comorbidities – could undermine global efforts to avoid options if it would reduce the total number of people vaccinated, some experts said. But in the face of the goal of 70 percent vaccination by mid-2022 is virtually doomed, some healthcare groups working on global vaccination efforts are focusing on allowing countries to set targets according to their capabilities and advising them to target the population first.
“At the very least, we believe that every country should vaccinate its high-risk population; there is no doubt about that,” said Seth Berkeley, chief executive of the Gavi Vaccine Alliance. “Now there are new recommendations, for example, to give amplifiers to high-risk populations 4-6 months after they received the initial series. The thing we need to do is take responsibility for what countries need in the coming period.”

Meanwhile, World Health Organization officials are still adamant that the world must meet its original 70 percent target, even if it means prioritizing vulnerable populations in the short term. Officials said returning to the initial goal would deprive developing countries of a chance to protect their people from future waves.
“Achieving vaccination of 70 percent of the population in each country is essential to pandemic control – priority will be given to health care workers, the elderly, and other at-risk groups,” WHO Director-General Tedros Adhano Gebreius told reporters. Conference on Wednesday. “I’m surprised that people in the global healthcare community think that a 70 percent goal is no longer relevant. “If the rich in the world enjoy the benefits of high vaccine coverage, why not the world’s poorest?”

So far, the Biden administration – a leading country where about 80 percent of people have at least one dose of the vaccine – and COVAX have not said whether they would prioritize vaccinations around the world. The U.S. Agency for International Development – the agency that oversees the global Covid-19 vaccination – declined to comment.
But at a conference this week, Raj Panjabi, the superior general of the National Security Council on global health security and bio-defense, gave some insight into the administration’s thinking, saying the world can still maintain its 70 percent goal while focusing on vaccinating the vulnerable.

“Countries have the opportunity to think about expanding their national vaccination plans to not only get 70 percent of their population vaccinated but to vaccinate at-risk populations fully,” Punjabi said.
In recent weeks, reports from the Global Health Society indicate that re-focusing vulnerable populations will ensure that those most at risk receive the first vaccines because vaccines are less effective against newer variants such as Omicron.
“We need to get back to basics,” Smith said. “Remember, when the vaccination campaign started here, the goal was to vaccinate the most vulnerable.”
The COVID Global Accountability Platform, led by Duke University and COVID Collaborative, the report highlights a 90 percent target this week. Rockefeller Foundation – co-sponsored research with the Bill & Melinda Gates Foundation – Supports new goals. The strategic change is one of four steps Duke has recommended for global public health organizations to move from “emergency crisis management to a sustainable control strategy.”

Krishna Udaakumar, the report’s lead author, said the findings might have been misinterpreted, prompting researchers to change them. He said the goal of the information was not to abolish the 70 percent benchmark – just to set a more effective, immediate target and allow countries to set their standards beyond that.
The original report said that global health organizations should “shift the immediate goal of global vaccination from the target population of 70 percent, which prioritizes full vaccination (including boosters) to high-risk populations and achieving rapid health and other essential goals.” Reached 90 percent of those most at risk. “
Then, a few days later – after WHO publicly criticized the resignation from its original purpose – the report was resumed to emphasize the global recognition of 70 percent of primary vaccination, with immediate priority given to complete vaccination (including boosters). At-risk populations and health and other necessary workers to quickly reach 90% of those most at risk.

Still, Udakumar said it is important to set more immediate, realistic goals – although those goals can be challenging, depending on funding, hesitation, and supply chain issues in countries with weak health systems.
“If we were to live in an ideal world with the resources available, we would have to try to vaccinate as multiple people as possible,” he said. “Everything we describe here is an effective way to phase out access in a way that saves lives the fastest.
The push to change the immediate goal of global vaccination is spoiling the feathers in the global healthcare world, including WHO, which says focusing on vaccination and empowering at-risk groups should respect the goals set for all populations.

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Olivia Wilson
By Olivia Wilson


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