Health and Healthcare Systems

Vaccines can win the race against COVID-19 variants. Here's how

Vaccines are delivered to Tanzania as part of COVAX programme.

Vaccines are delivered to Tanzania as part of the COVAX programme. Image: UNICEF/Msirikale.

Paul Stoffels
M.D., Vice Chairman of the Executive Committee and Chief Scientific Officer, Johnson & Johnson
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Vaccination

  • COVID-19 variants threaten to undermine global vaccine programmes unless we accelerate the pace of delivery.
  • Just over 1% of people in low-income countries have received at least one dose of a COVID-19 vaccine.
  • In order to control the spread of COVID-19, we need a global effort to ensure no one is left behind in immunization campaigns.

A new wave of COVID-19 is engulfing many countries around the world primarily due to the increasingly prevalent and more transmissible Delta variant of the new coronavirus. With only a few regional exceptions, Delta is mounting a successful global attack.

In Indonesia and other Asian countries, health systems are overwhelmed and running out of oxygen. Across Africa – from Tunisia in the north to South Africa – the virus is surging; recently, recorded deaths on the continent jumped 40% in one week alone. In Europe, plans to lift or relax lockdowns are being delayed or modified. And in countries like the US and the UK, a number of key COVID-19 metrics have started to increase after months of decline.

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The Delta variant (first discovered in India), and other variants of concern including Beta (South Africa) and Gamma (Brazil), are confirming the critical need to vaccinate billions of people around the world – fast. In the race between variants and vaccines, we are falling behind. Failure to pick up the pace now will enable this virus to multiply and mutate to the point where future variants could outsmart our vaccines.

In the quest to vaccinate every citizen of the world against COVID-19, speed and strategy are key. It’s essential to think smartly about the impressive armamentarium of vaccines at our disposal and ensure we don’t squander any of these lifesaving assets. No single vaccine can conquer COVID-19 – we need many.

Each vaccine should be deployed to the frontlines, targeted to where they can make the greatest impact so that no population is left behind. Above all, we need to follow through on vaccine delivery all the way from the supply depot to the last mile, turning every available vaccine dose into a vaccination in someone’s arm.

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At Johnson & Johnson, it was precisely this kind of pandemic scenario that informed our selection of a single-dose vaccine that could be easily transported without the need for ultra-cold refrigeration. Of course, no vaccine developer could have predicted how the original Wuhan strain of coronavirus would evolve, and whether their vaccines would hold up against emerging variants.

Recent research published in the New England Journal of Medicine, along with a large real-world study of health workers in South Africa, suggests that the vaccine generates strong immune responses against Delta and other variants of concern. We now await results on protective efficacy from our large-scale clinical studies.

While getting vaccine science right is never easy, vaccine deployment on a global scale – in the middle of a pandemic – presents other challenges. Underscoring this, only slightly more than 1% of people in low-income countries have received at least one dose of a COVID-19 vaccine. This has to change, not just for reasons of global equity, but because if we don’t get COVID-19 under control everywhere, we will not be able to end this pandemic anywhere.

How do we crack the challenge of global deployment?

  • Intensify international cooperation and cross-sector partnerships between industry, governments, health systems and civil society. Turning COVID-19 vaccines into vaccinations involves executing countless legal agreements, establishing no-fault compensation coverage for vaccine recipients, streamlining regulatory processes, overseeing technology transfers with production partners, setting up pharmacovigilance systems, and coordinating closely with many global partners. This complex, multistep process, which normally takes years to complete, must be compressed into weeks.
  • The global community needs to get behind COVAX, the unprecedented initiative working to ensure that the world’s pandemic response includes concrete plans to enable access for lower-income countries, and vulnerable populations including those in conflict and crisis environments. Governments with surplus vaccines should immediately ramp up their dose sharing via COVAX. Stockpiling vaccine supplies will only prolong the pandemic. An example to emulate is the United States government, which recently embarked on the largest vaccine donation programme undertaken by any country in history. It involves the deployment of three COVID-19 vaccines from different manufacturers, and we’re proud to be part of it. So far, nearly 30 million doses of our vaccine have been donated to more than 30 countries across four continents – many through COVAX. This is just a start: millions more doses to many more countries will follow.
  • Maintain the free flow of the global vaccine supply chain. Many of today’s vaccines (not just for COVID-19) take shape in a multistep process involving suppliers and manufacturers located across multiple countries and continents. From the raw materials (like bio-bags to make biologics), to large batches of vaccine drug substance, to the finished vials, we are working with world-class manufacturers from the US to Europe, India and South Africa to supply our vaccine to the global community. It is important for governments to resist protectionist policies such as export controls and restrictions, which ultimately only serve to delay vaccine shipments and other lifesaving medicines reaching their own citizens. We must work together to ensure equitable supply.
  • Build on decades of innovation and science. When the coronavirus crisis started, Johnson & Johnson leveraged more than a decade of research and development investments in our vaccine platform technology. We leveraged this platform to develop our COVID-19 vaccine in just one year. We stand by our proprietary technology and believe in leveraging it for the global good. Expanding and accelerating voluntary technology transfers between vaccine developers and manufacturers, as we have done in India, South Africa and elsewhere, is the way forward. Short term actions that undermine the value of intellectual property will only discourage the innovation we need to combat the next pandemic.

Ultimately, what we do now in the race against the variants will help to define not just how quickly the global community conquers COVID-19, but whether we are adequately prepared for the next pandemic. The principles of multilateral partnership, global equity, and unfettered rapid response must be at the heart of any pandemic preparedness blueprint for the future.

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