While there are already over 17 million positive cases of Covid-19 globally, governments, health experts, and the scientific community face another parallel battle: finding a safe and effective vaccine against the virus.
Of the more than 200 biological products (candidate vaccines) which are being worked on around the world, 25 of them are already in the clinical trial phase, i.e. ready to be tested on humans. While this would seem to be excellent news, experts on the subject ask that we be patient and “not to get too anxious.” If any of these developments provide viable results, the vaccine won’t reach the general population before the first half of 2021.
The traditional way of developing vaccines has been left in the past. Now, a process that used to take between five and six years takes place in just a few months. While this might seem positive, the estimated time of large-scale production could take at least one year.
So, as long as we’re struggling to stem the wave of infection among the general population, we must also look for means to ensure, first of all, that an effective and safe vaccine is available. And that, when it’s ready, it will be easily accessible to governments as well, so that they can outline a vaccination strategy tailored to their needs.
“Don’t get the idea that there’s going to be a vaccine available to the general population soon. This is most likely not going to happen before the second quarter of 2021,” explains Dr. Mauricio Rodríguez Álvarez, spokesman for the commission on Covid-19 at the National Autonomous University of Mexico (UNAM).
For him, it’s undeniable that in a health emergency like the one we’re currently experiencing, a vaccine must be available to protect the general population. However, this is a task that won’t yield results overnight.
In an interview for Tec Review, Rodríguez Álvarez (who is also a professor of the Faculty of Medicine at the UNAM) asks us not to lose sight of scientific advances. If they yield good results, there could already be a vaccine by the end of 2020 or early 2021. However, its use will be limited.
“They’ll be vaccines that aren’t meant for the larger population because they probably won’t have the complete studies that will allow them to be used on all kinds of high-risk populations,” he says.
So, who should be the first to receive them?
According to information provided by the federal government’s Secretariat of Health, the initial goal is to cover 20% of each country’s population, with priority for workers in the health and social security sector, adults over 65 years of age, and adults with comorbidities, i.e. those who are overweight, obese, have hypertension, diabetes, etc.
“It’s too early to have a vaccination strategy. What we need to do right now is learn from what we’re living through in the pandemic. To identify who the most vulnerable are and who’s getting sick the most,” explains Dr. Rodrigo Romero Feregrino, president of the Mexican Vaccination Association.
As never before, efforts are being made throughout the world to come up with a vaccine to beat Covid-19.
International efforts, in addition to cooperating in laboratory and technology exchange, have been made at the foreign policy level so that when there is a working vaccine product, there will be an equitable distribution of it.
The first action that Mexico took on the subject was presenting a resolution to the General Assembly of the United Nations (UN) to promote access to medicines, vaccines, and other medical supplies for Covid-19.
The goal of this proposal was to avoid speculation on consumer prices and ensure there was a guarantee (as well a will) on the part of nations that everyone, regardless of their ability to pay, will have access to them.
And when will the vaccine arrive in Mexico?
The proposal made by President Andrés Manuel López Obrador was unanimously approved. The Ministry of Foreign Affairs (SRE) then outlined the permanent work with three multilateral efforts for the development, production, and fair distribution of the vaccine:
1. The Coalition for Epidemic Preparedness Innovations (CEPI)
2. The Global Alliance for Vaccines and Immunization (Gavi)
3. The World Health Organization (WHO)
4. This enabled the Covid-19 Vaccine Global Access (COVAX) platform to be created, which aims to distribute at least 2 billion vaccines by the end of 2021.
The doses would be distributed equally among the 77 participating countries (including Mexico) regardless of their ability to pay.
This foreign policy work, the experts agreed, is essential because “in phenomena like this one there is a risk that a part of the capitalist model will emerge in which there’s no price regulation, there’s product speculation, or the supply is conditioned, which could jeopardize the availability of vaccines,” warned Mauricio Rodríguez Álvarez, spokesman for the UNAM’s Covid-19 commission.
Mexican vaccines in the long term
In addition to international efforts, Mexico is also carrying out its own research projects (with different universities and agencies) which, while are for the long term, are efforts that should be pursued because they could culminate in vaccine production in the country.
1. At the moment, there are four projects that are being worked on:
2. The UNAM – IBT Recombinant
3. One based on the Amivex – IMSS – UNAM veterinary use platform
4. A DNA vaccine from Tecnológico de Monterrey and the Autonomous University of Baja California
5. Peptides from the Autonomous University of Querétaro – IPN
The scenarios for achieving a vaccine are among the most varied: from the developments themselves at Mexican universities, to the acquisition of these by international pharmaceutical companies, to technology transfer so that they can be produced in the country.
“Technology transfer projects can be done on the vaccines that are already more advanced or further along in development with a partner in Mexico,” added the spokesman for the UNAM’s Covid-19 commission.
In order to strengthen production capacity in Mexico, the Biological Products and Reagent Laboratories of Mexico (Birmex) (a mostly state-owned company reporting to the federal Ministry of Health) could be the place where vaccines are developed once the technology can be transferred.
Such actions would be of paramount importance because at this point in scientific research it is unknown whether once the vaccine is ready one or more doses will be required, hence the importance of taking on all possibilities for developing and producing the biological products.
Before the end of 2020, Mexico will join the Covid-19 vaccine study that was developed by the French pharmaceutical company Sanofi-Pasteur. This biological product is already in the third phase of its development. With Mexico’s participation, it will ensure that if it’s viable, the country will know of its effectiveness firsthand.
“There are several vaccine projects that are in phase 1, phase 2, or phase 3. This would be the first confirmation of a phase 3 vaccine project. There are 35 thousand volunteers globally, including in Mexico,” confirmed Foreign Affairs Minister Marcelo Ebrard.
He added that “it’s not the same participating in the study as waiting for it to occur. So, first of all, you have the advantage of knowledge. Second is that it gives you the possibility of having all the information regarding the vaccine and not just what they give you. Third, it gives you access to the vaccine right away, from the beginning. It gives you access because you’re in the study, which is very important for us.”
On the way toward finding a vaccine against Covid-19, Mexico hopes to also participate in other studies. According to the Minister, there’s a chance of participating in candidates being developed in the United States, China, and Germany. Mexico’s participation in other tests could be confirmed in the next 15 days.
$10 billion dollars for vaccination
According to calculations by the Coalition for Epidemic Preparedness Innovations (CEPI), meeting the goal of immunizing 20% of the world’s most vulnerable population will require a budget of $10 billion dollars. This could account for the purchase of 2 billion doses.
At the moment, there’s a list of nine projects (out of the 25 that are already in clinical trial phase). Although budget estimates are still being worked on, it’s projected that each dose of vaccine could cost between $7 and $10 dollars.
Because of the country’s economic conditions, however, the cost of the vaccine for Mexico could be $5 dollars.
“In the Mexican government, we don’t talk about budget constraints. It’s a health investment. Vaccines and everything necessary will be done to cover it from beginning to end, such as the monitoring and purchase of whatever is needed,” said federal Minister of Health Jorge Alcocer.
Of the 25 vaccines that are already in clinical trial phase, 10 of them are the most advanced. Here are the projects that are the furthest along:
Wuhan Institute of Biological Products
Beijing Institute of Biological Products
Oxford University, AstraZeneca
Moderna / NIAID
“We have to be patient because this isn’t going to be fast, and we’re not going to have it tomorrow. All steps have to be completed to ensure that the vaccine is effective and safe, and from there we have to look at options because the manufacture of billions of vaccines, as well as all regulatory processes, takes time,” insisted Rodrigo Romero Feregrino, president of the Mexican Vaccinology Association (AMV).
Beyond the vaccine
The challenge with Covid-19 isn’t simply finding a vaccine, but once it’s available, also having the general population willing to get it.
Compared to other countries, there are no anti-vaccine groups identified in Mexico. However, immunization rates in the country have gone down for two main reasons. The first is because there hasn’t been sufficient supply. The second is that people, because of misinformation, have chosen not to get them.
“We must inform the general population that we currently need to be getting other vaccines. When it comes to Covid-19, the general population should be immunized. It’s not going to be like it was 10 years ago during the influenza pandemic of 2009. When we had the vaccine, people didn’t want to get it,” Rodrigo Romero said.
In Mexico City, for example, vaccination coverage was 50% of the general population in 2018. To contain an epidemic, ideally 95% should be vaccinated.
So, if there’s a vaccine for certain diseases, why aren’t people getting vaccinated?
Romero Feregrino explained that one of the reasons is misinformation. For example, many people believe that if they get the flu vaccine, they’ll get sick. A false positive
According to the survey Vaccines: Ideas in Mexico, conducted by AMV last April, 93.9% of respondents are against anti-vaccine groups. In contrast, 61% consider biological products to be risky. In addition, 43.7% said they didn’t have sufficient information about vaccines and their safety.
“We hope that we learn from this situation. It’s happening now with Covid-19, but it can happen with measles, which is much more contagious. The less coverage we have, the more susceptible the general population is. There’s greater risk of us having a bigger outbreak from measles than the one we’re experiencing in Mexico City,” the expert warned.
As of July 30th, the federal Department of Epidemiology reported 195 cases of measles in the country. 146 were reported in Mexico City. During all of 2019, only 20 cases were reported in Mexico.
The vaccine is free, and there’s a supply at health centers. But some families have chosen not to immunize their children. To avoid misinformation and people not getting vaccinated, the entire research and manufacturing process should be completely transparent. This is so that there will be trust on the part of the general population.
“I’ll end with one thought. Right now, let’s hope the Covid-19 vaccine arrives soon. But let’s not stop taking the vaccines we already have available,” he urged.