Devex CheckUp: COVID-19 booster shot: Need or greed?

Presented by Bay Global Health Alliance 

Just over 25% of the world’s population has received a COVID-19 vaccine dose, though only 1% of people in low-income countries have. But rising case numbers in nations with high vaccine coverage are leading several countries to offer or consider a third dose. Some experts say booster shots will inevitably be needed as the threat of potentially more transmissible variants looms and immunity declines. But the question is whether and when booster shots should be given, since billions have yet to receive a single jab.

• Israel this week started offering booster shots to adults with weak immune systems as it battles a surge of cases fueled by the more aggressive delta variant. The United Arab Emirates and Bahrain have already been offering booster shots, and the U.K. Joint Committee on Vaccination and Immunisation has advised the government to offer a third dose to vulnerable groups starting in September.

• Some countries making this decision used Chinese vaccines but are now seeing high infection rates among health workers. In Indonesia, where 10 doctors died last month despite being fully vaccinated with Sinovac, the plan is to give health workers a booster of the Moderna vaccine. In Thailand, a different vaccine will be given as a third dose to health workers.

• But World Health Organization officials say the evidence does not yet show that fully vaccinated individuals should receive a third dose. Dr. Soumya Swaminathan, WHO chief scientist, said science — not companies — should dictate the need for one.

• Swaminathan said a booster may be needed one or two years down the line. But Pfizer has already announced plans to seek regulatory approval for a booster dose in Europe and the United States, and the company met with U.S. officials to discuss data on declining immunity in fully vaccinated individuals.

• That research isn’t public, but Dr. Anthony Fauci, director at the U.S. National Institute of Allergy and Infectious Diseases, said it’s just one piece of a very large puzzle of data that’s being reviewed to determine how long vaccine immunity lasts.

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A mind-boggling decision

Bangladesh registered nearly 14,000 new COVID-19 cases Monday — almost double the number recorded at the peak of a second wave of infections in April. While reported cases have slightly gone down in the past two days, there are concerns that it will increase as the country approaches a religious holiday next week, and experts have called on authorities to impose more stringent restrictions to avoid disaster. But as of today, the government has already lifted its lockdown for the celebration.

Another 100 years?

On July 18, 1921, a newborn child in Paris was the first person to receive the Bacille Calmette-Guérin vaccine for tuberculosis. A century later, BCG remains the only licensed vaccine for the disease. But while it has provided protection to infants, experts say the vaccine doesn’t work as well for older people at risk of developing pulmonary TB. Before COVID-19, TB was the leading cause of death from a single infectious agent, killing 1.4 million people in 2019.

But some new research is showing promising results, Sara Jerving reports. One study suggests that two doses of the M72/AS01E vaccine candidate can halve the development of TB in adults with latent infection. This is the first vaccine since BCG to prevent disease in people previously exposed to TB, and it’s now moving to phase III trials.

A separate study looking at the efficacy of a new treatment for highly resistant TB also showed a significant success rate. Study results announced Thursday showed that this treatment can still be successful while reducing side effects of one of the drugs.

A conversation with Heather Barr

With the announcement of the withdrawal of U.S. forces from Afghanistan, we wondered about the repercussions on health programs, particularly those affecting women and children.

Amruta spoke to Heather Barr, interim co-director of the women's rights division at Human Rights Watch, about health care for women hit by aid cuts and what the international community should do to keep the pressure on donor governments. This conversation has been edited for length and clarity.

On donor responsibility: What I’m hearing from donors is a lot of caginess — they say, “We made this pledge at the 2020 Afghanistan Conference, but it’s a political commitment” — which is indicative [of] “we'll have to see what the situation on the ground is like.”

If security becomes an issue, then they might scale back essential programs. But this will be detrimental to women and girls, and the donor community can't wash their hands of the issue. We, the international community, shouldn't tolerate depriving women of health care because it's inconvenient to deliver it or because there are constraints.

On what to expect: As the Taliban asserts control, we have seen that they have started putting restrictions — such as women can’t seek health care without a “mahram” [male guardian] and access to reproductive health is curtailed. But there are some models we can follow, such as UNICEF’s deal with the Taliban to keep schools open. Everybody who works in Afghanistan is going to have to be adaptable in the near future.

What we’re reading

Authorities increase surveillance amid a Zika outbreak in the Indian state of Kerala. [The Telegraph]

Medical oxygen demand outstrips local supply as Indonesia deals with record COVID-19 cases. [Reuters]

At least 92 people are dead after a fire at a COVID-19 ward in Iraq, the second hospital fire there in three months. [BBC]