4 We focused on characteristics that distinguish individual vaccine candidates from one another. ) to highlight the key characteristics of 26 leading vaccine candidates, based on the target product profiles for COVID-19 vaccines set by WHO. To guide our review, we developed a dashboard ( figure 2 In this Health Policy paper, we review potential challenges to success in each of these dimensions and discuss policy implications. WHO publishes a list of stringent regulatory authorities. *Stringent regulatory bodies can approve vaccines or authorise their use in emergencies (eg, emergency use authorisation during public health crises, such as pandemics) WHO can grant emergency use listing (comparable to emergency use authorisation by a stringent body) or prequalification (comparable to approval by a stringent body). These four dimensions of the global vaccination challenge are closely related, and the development and production steps have important implications for pricing, allocation, and public confidence.įour dimensions of an effective global immunisation strategy against COVID-19 Yet having licensed vaccines is not enough to achieve global control of COVID-19: they also need to be produced at scale, priced affordably, allocated globally so that they are available where needed, and widely deployed in local communities ( figure 1 Several COVID-19 vaccines have now been authorised or approved for human use, with many more in the late stages of clinical development. 1 Although the spread of the virus can be mitigated through physical distancing, face coverings, and testing and tracing-and potentially with therapeutics-the risk of outbreaks and disruption to economic and social life will probably remain until effective vaccines are administered to large portions of the global population to prevent hospitalisation and severe disease, and preferably achieve herd immunity to halt transmission of the virus. The COVID-19 pandemic has caused substantial excess mortality and plunged national economies into deep recessions. Vaccine acceptance was highest in Vietnam (98%), India (91%), China (91%), Denmark (87%), and South Korea (87%), and lowest in Serbia (38%), Croatia (41%), France (44%), Lebanon (44%), and Paraguay (51%). We also present original data from a 32-country survey (n=26 758) on potential acceptance of COVID-19 vaccines, conducted from October to December, 2020. Although specific datapoints are subject to change as the pandemic response progresses, the dashboard will continue to provide a useful lens through which to analyse the key issues affecting the use of COVID-19 vaccines. We use a traffic-light system to signal the potential contributions of each candidate to achieving global vaccine immunity, highlighting important trade-offs that policy makers need to consider when developing and implementing vaccination programmes. To guide our review, we developed a dashboard to highlight key characteristics of 26 leading vaccine candidates, including efficacy levels, dosing regimens, storage requirements, prices, production capacities in 2021, and stocks reserved for low-income and middle-income countries. Yet having licensed vaccines is not enough to achieve global control of COVID-19: they also need to be produced at scale, priced affordably, allocated globally so that they are available where needed, and widely deployed in local communities. Regulators in numerous countries have authorised or approved COVID-19 vaccines for human use, with more expected to be licensed in 2021. The COVID-19 pandemic is unlikely to end until there is global roll-out of vaccines that protect against severe disease and preferably drive herd immunity.
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