Dr G.Zagury – 19/11/2020
I/ WE ARE FORTUNATE TO HAVE A VACCINE SOLUTION AVAILABLE: A POWERFUL TOOL IN THE CONTROL STRATEGY
We are fortunate (especially because Coronavirus is genetically stable),that a new generation vaccine (m RNA,…) could be urgently developed: in less than 10 months,the teams were able to provide this technological feat,whereas conventionally the development of a vaccine requires about ten years …
By analogy to the Ebola vaccine, which was also developed via genetic engineering (a new technology never applied to humans with VSV vector virus), by a Canadian team, we can be reasonably optimistic: in 2015, in West Africa (Guinea,…) this therapeutic tool had completely changed the game by eradicating this epidemic, whose lethality was 50%.
It should also be noted that these new technologies (mRNA new therapeutic family…), allow us to be equally optimistic for our future vaccines (existing flu-type pathologies – whose effectiveness is between 40 and 60% – or to come…)
II/ ALREADY 3 EFFECTIVE VACCINES AVAILABLE AT THE END OF THE YEAR (ACCORDING TO AMM) WITH LIKELY EFFICACY RATES – 90%
Quantitative aspect: More than 200 vaccine candidates have been in development since the beginning of 2020, and already 12 of them are in the final phase of approval around the world: Phase III of large-scale human experimentation
Quality aspect: as shown in the table below there are 2 types of vaccine (new technology / more conventional technology having already been used in humans), which come in 5 major categories of technologies :
Each vaccine will therefore have its own identity (“interest”) in terms of:
- Efficiency (clinical benefit): % of protection, duration of protection, humoral/cellular immunity…
- Against the indication (extreme ages, allergy, autoimmune pathologies…) and potential side effects: short-term risks (apparently very low), even long term on the immune system.
- Convenience (“packaging”): number of injections (and reminders), type of inoculation (skin injection, nasal …)
- Validation (AMM: FDA, CFDA, EMA…):animaltrials, biological results (humoral/cellular immunity…) and multi-center observed clinics…
- Availability (logistics…): each vaccine is more or less long to produce (cf the “high tech” being faster to develop, but pose other problems such as their long-term effect or storage …) uses a logistic support platform (“off and on line”: tracing, security …)
Thus, it is very likely that there will not be an immediate single vaccine,allowing in one injection to protect for life all types of population, and that these multiple vaccines that will arrive on the market will be complementary (quantitative and qualitative)
In the immediate future, we already have 3 Vaccines against Coronavirus (two “high tech” Americans and one more conventional Chinese), which should be quickly available by the end of the year,and we should be congratulated.
III/ IMPLEMENTATION TO RETURN TO A NORMAL LIFE IN 2021 – THE BEGINNING OF THE END? : THE FREIN IS BEFORE ALL LOGISTICS (material and HUMAIN) FOR AN INTERNATIONAL DISTRIBUTION AND RAPIDE
6 messages to understand current issues:
- Public Health objective: at least 60% of the vaccinated population is needed; you vaccinate yourself… but especially for others…
- Vaccine allocation: what is the level of decision-making in the face of these multiple ethical issues ?
On the face of it, WHO will issue general recommendations. Nevertheless, decisions will necessarily be state-owned, given the specific health issues (so, do some countries with less at-risk populations need to be vaccinated before certain populations are more at risk?)
- Prioritization strategy: who to vaccinate first? On the face of it, fairly consensual opinions on caregivers, frail people, and presentations… There are still many debates on the outlook.
- Logistics: Each technology player must have the industrial and financial power of a large group in order to be able to carry out the various stages on a large scale. Include:
- Supply (cf masks or tests in the past!) in basic equipment: light bulbs, reagents, syringes…
- Large-scale manufacturing: probably robotization of the production line (Japan)
- Securing the process
- Storage – respecting the cold chain: so for high-tech vaccines,the Moderna vaccine is easily stored in the ice carbo at -20 degrees, but the same is not true of the Pfizer vaccine (-80 degrees, before spreading it for a period of 5 days in regular refrigerators). This involves the purchase of specific and expensive equipment.
- Distribution: for example, in France, made available in pharmacies, as on the flu model (more effective than in foreign gymnasiums or consulates as in 2009 with H1N1)
- Financial aspect: Note that among the ongoing debates:
- “Common good of humanity” without economic margin for laboratories: we can dream of a better world …
- The same cost for each country (or in proportion to purchasing power)
- Funding by the Community (SS,…) or individual
- Travel: It is likely that to return to certain countries such as China, Emirates, USA, a vaccination certificate may be mandatory for travellers.
IV/ GEOPATHOLOGY: GEOPOLITICAL READING OF THE VACCINE (SUBMERGED PART OF THE ICEBERG): DIFFERENT ECOSYSTEMS IN THE RACE FOR THE “INDUSTRIES OF THE 21ST CENTURY”
Vaccine diplomacy is a continuation of the war of influence of the various blocs, and for once, the “South” is an integral part of this race:
- A tool to protect its people to revive the economy as quickly as possible. Not everyone is like China, which can currently live “Covid Free”, due to its drastic measures and the size of its internal market.
- Image of attractive scientific power with multiple spin-offs (scientific, economic…)
- Tool ofinfluence abroad: alliances (military, economic…), political-industrial support (5G …)
Inother words, “Soft Power” exists only through a “Hard Power” Foundation
Thus, for the vaccine, the map below illustrates the “Chinese” vision of the world… We will share in our next analysis, how Chinese companies are using the Tangier technology free zone,as a platform for African and European markets.
V/ THE FRENCH CAS: a few tracks
If indeed our dedicated classical structures (Institut Pasteur, Sanofi – which are experimenting with a recombinant protein type vaccine used with hepatitis B), are not yet at the appointment, two elements of appreciation:
- Sometimes the time to think is a saving of time and hope for a quick catch-up in the market…. Moreover, it should be noted that Europe in general and France in particular produce excellent researchers and professionals: the CEO of Pfizer (of Greek origin) and the CEO of Moderna (French) are two examples.
- Nevertheless, it must be recognized (especially as visible as we have lived abroad), that some obstacles remain present, despite some recent progress:
- Under funding: limited to too short term (public and private)
- Complexity of bureaucracy holding back initiatives: statutes, standards, procedures
- Multiple silos of research between the University and Industry (between the fundamental and the applications of the daily newspaper), and interdisciplinary ….
VACCIN’S SOCIOLOGY: France, land of enlightenment?
Recent international study questioning the prospect of accepting the vaccine:
Some thoughts for your WE, to better understand this relatively surprising figure:
- Distrust of any authority (government, medical…) is a product of our critical mind (education), or even of certain errors of communication…
- Risk aversion /new (compared to other cultures: USA, China…): precautionary principle in the extreme…
- France-specific health history: Contaminated blood, Mediator…
- Social networks amplifying certain irrational data (ex film “Hold Up” …)
- Environmental pessimism specific to France, which ranks it at the back of the pack of many studies on population morale (behind Afghanistan!)
Hoping that this rather encouragingnews, help maintain a winning morale,essential to the “Mental Health” …
Thanks to the entire medical team (Dr. Bachir Athmani, Dr. Fadel, Dr. Abecassis…) and the IT team (Richard Coffre, Flavien Palero, Laetitia Grangier), as well as our partner (Paul Bennetot Foundation / Matmut Group)
Dr Guillaume Zagury
Specialist in Sante Publique Internationale (DES-Paris)
Consultant in Medical Innovations (France, Israel, China)
In China for 20 years