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How will a COVID-19 vaccine be delivered?
Picture Source: EPR
17 June 2020 | IVAC Webinar Series
Picture credit: Elderly Health
Speakers
Naor Bar-Zeev, PhDIVAC Deputy Director
Lois Privor-Dumm, IMBASr. Advisor, Policy, Advocacy, &
Communications
Director of Adult Vaccines
Maria Deloria-Knoll, PhDDirector of Epidemiology
Our Speakers
Vaccination Strategy Targets
Health
Care
Workers
Older
adults
Population
immunity
Essential
WorkersHigh Risk
Vaccination Strategy Trade-offs
Number of People Vaccinated
Cost,
Complexity,
Effort
70M 770M 2-3 Billion >6 BillionCumulative dose requirement
(single dose, one time)
Given only 100 million doses are available for the world, how would you allocate them? (choose one)
1. Equally divided per population size of the country
2. Countries with the worst burden currently (e.g. death rate)
3. Driven by purchasing power – more doses to the highest bidder
4. Priority (more doses) to countries that invested in the vaccine’s
development
5. Based on capacity to deliver the vaccine (i.e., can’t receive more
doses than have the infrastructure to distribute)
6. It’s a private market anyway, companies will decide
Poll:
Global Allocation –multiple vaccines likely needed
Technology Candidates/Phase
Attributes
Current Scale Single
Dose
Licensed
PlatformOther considerations
Protein subunit Ph 1/2 High ✓ Adjuvanted
DNA Ph1 MediumRegulatory – device & biologic
review (with electroporation)
Nonreplicating vector Ph 1, 2b/3 High
✓ Preexisting immunity to vector -
effectiveness?
Replicating viral vector Preclinical High✓ ✓
Inactivated Preclinical, Ph 1, 2 Medium to High✓ Adjuvanted
Live attenuated Preclinical High✓ ✓
RNA Ph 1, 2Low to
Medium
New technology, storage temps
Uncertain
10
Sources: WHO Draft Landscape COVID-19 Vaccine Candidates, Jun9 ;Lurie et al. NEJM. 2020.
What do you think will be your country’s primary challenge for COVID-19 vaccination?
1. Insufficient cold chain capacity
2. Ability to get the vaccine to all parts of the country (particularly
rural areas)
3. Infrastructure/plan to reach most vulnerable populations
4. Acceptance by public
5. Competing priorities/ insufficient resources for new programs
6. Inadequate safety surveillance
7. Other (put comments in chat box)
11
Poll:
+Italy
Countr
y T
ypolo
gie
s (
Arc
hety
pes)
Privor-Dumm et al. Vaccine. 2020.
Adult immunization program
archetypes in 34 countries
Malaysia
Public Acceptance: what will it be a year from now?
14
Source: AP-NORC Poll conducted May 14-18, 2020 with 1,056 AdultsAdditional Considerations are described by DeRoo et al. https://jamanetwork.com/journals/jama/fullarticle/2766370
Do you plan to get vaccinated with a Coronavirus vaccine?
Not
demanding
the vaccine
40
67
56
25
37
49
35
21
27
32
37
31
23
1216
40
2320
< 6 0 6 0 + W H I T E B L A C K H I S P A N I C
A G E R A C E / E T H N I C I T Y O V E R A L L
Yes Unsure No
Current global response model: pillars/silos with little integration
GAVI, Briefing on the COVAX Facility. June 11 2020
Participating
countries
Manufacturers
COVAX FacilityOffer to
manufacturers
Secure supply
for countries
Access to
appropriate product
Make commitments
to purchase doses
Make price and
supply commitments
GAVI, Briefing on the COVAX Facility. June 11 2020
Current global response model: pillars/silos with little integration
GAVI, Briefing on the COVAX Facility. June 11 2020
Delivery
strategy
Product profile
Demand Program
priorities
Ethics &
politics
Supply &
financing
Integrating framework of considerations
19
Delivery
strategy
Product profile
DemandProgram
priorities
Ethics &
politics
Supply &
financing
Global and
country
coordination
Strategy to consider public perspectives
Design new Platforms,
Plan for known bottlenecks,
Track
Communicateallocation
Reliable supply of
affordable & appropriate
products
Needs to store, deliver, administer and dispose
Potential Framework: Integrating experience and new perspectives
Global actors should ask:
• What are the local conditions needed to make it work?
• What are the differing priorities of countries?
• How do we integrate all perspectives while meeting global health & economic goals?
Country actors should ask:
• What do we need to do to make it work here?
• Are we bringing in diverse voices to meet our strategic priorities?
• How are we working with the global community?
21
Participating
countriesThe Facility
Thank you!
Q&A
22
Let’s continue the discussion:
Naor Bar-Zeev: [email protected]
Lois Privor-Dumm: [email protected]
Maria Deloria Knoll: [email protected]