Right now, there are about 160 clinical trials looking for what the world needs more than ever: a vaccine that prevents infection with the new coronavirus.
Of these medical tests of a COVID-19 vaccine, three are in the stage known as phase 3, which is when the vaccine is tested on a large number of people, to see what immunity it offers, and whether it is safe and does not produce care side effects.
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Science is advancing and experts, such as Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases of the United States, assure that a vaccine will surely be available in the next 12 months.
Given what will be one of the great news of the century, two questions arise: will there be enough doses? And who will get the vaccine first?
Answers to both questions are already being debated by officials from the Centers for Disease Control and Prevention (CDC).
According to a preliminary plan by the federal agency, the approved vaccines would first be offered to vital health professionals and national security personnel. LI call on other essential workers and those groups considered high risk: older adults and people with pre-existing medical conditions such as diabetes or heart disease.
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But officials They are also considering a controversial option: putting blacks and Latinos (of all races) at the top of the list, as they have been disproportionately affected by the COVID-19 pandemic.
However, some public health experts say that prioritizing one race or ethnic group over another would harm public perception of the vaccine, and would generate discomfort rather than benefits.
According to Claire Hannan, executive director of the Association of Immunization Managers, an entity that is part of the committee that studies the issue with the CDC, putting race and ethnicity in this decision would have a negative effect: that people trust the vaccine less.
The medical pressure is enormous and politics has entered disproportionately in this debate.
The Department of Health and Social Services (HHS) created an alliance of federal agencies called Operation Warp Speed (OWS), whose goal is to deliver 300 million doses of a safe and effective vaccine for COVID-19 by January 2021. Congress has already allocated $ 10 billion to achieve this goal.
To accelerate distribution when the vaccine becomes a reality, some that are already advanced and have shown sufficient efficacy will enter the market even before the Drug Administration has completed the approval process.
However, who has the final decision about who gets the vaccine first? A possible model is a kind of lottery explained in an article published in JAMA Networks, in which local health departments along with hospitals, are the ones that determine which state residents need a medication or a vaccine first.
This strategy has already been used for the first patients who received remdesivir, the first drug that was shown to be effective against COVID-19.
To assign this drug, doctors from Pittsburgh, Pennsylvania, decided that the lottery would give preference to health workers and emergency doctors. Doctors also sought to favor people from economically disadvantaged areas, which tend to be mostly from black and Hispanic communities (of all races).
On July 21, the National Academy of Medicine announced the creation of a panel to determine a system to define who would be vaccinated first.
No one doubts that healthcare workers caring for patients with COVID should be the first to be immunized. The critical debate is who’s next in line for vaccination.
The controversy reaches ethical levels. Global bioethics experts say the concept of equity should be applied globally.
Because countries like the United States, Germany or France have money to buy and distribute the vaccine. But the reality is different in developing countries.
For this reason, public health experts have criticized the decision of the Trump administration to withdraw the funds that the country grants to the World Health Organization (WHO), because the WHO is the entity that just negotiates that the new medicines or vaccines arrive to all corners of the planet and to the most displaced and vulnerable societies.
The WHO has stated that 4 billion doses will be needed to vaccinate priority populations.
Robert Redfield, CDC director, said distribution should be equitable, fair and transparent.
The development and distribution of a vaccine against COVID-19 is the key that will open the door to normality. But the process, which involves purchases, negotiations, among other complex steps, will be neither quick nor easy.
The new coronavirus has reached all corners of the planet, the vaccine must follow the same route.