A team of researchers led by UCL has developed a new scoring tool that helps to “transparently” prioritize which countries have the greatest need for Covid-19 vaccines.
Researchers say the tool takes into account a much wider range of factors than the current global COVAX facility, which has been criticized by some countries, particularly poorer nations, for insufficient access and a lack of flexibility to respond to rapid local increases in infections. The study, published in BMC Public Health, asked 28 experts from 13 different countries what they believed were the most important factors in assessing countries’ vaccine needs.
The panel of experts, which included people based at universities and national institutes of public health in countries including the UK, Japan, Kenya, Norway and South Africa, felt that the most important consideration in deciding where vaccines were needed was the proportion of the total population that were not fully vaccinated.
Other important factors included the proportion of the high-risk population not fully vaccinated, the capacity of the health system, the ability to purchase vaccines, and the proportion of the population classified as clinically vulnerable.
These important factors were then included in a choice task to determine how each factor should be weighted, in order to create a scoring tool.
The scoring tool is expected to be able to make the process of allocating Covid-19 vaccines fairer around the world, being explicit in the criteria used to identify needs and transparent about how they were identified the evidence-based factors and process. used to derive the tool.
In the future, it is hoped that the tool will also be able to inform international discussions about how to respond to the next public health crisis.
The global equitable allocation of vaccines against Covid-19 has received considerable attention, although the concept of “equal allocation” of vaccines has so far been poorly defined.
Understanding vaccine equity requires an assessment of vaccine need across countries. This includes assessing how resources are prioritized between those with different needs, as well as ensuring that countries with similar vaccine needs have comparable levels of access.”
Dr Vageesh Jain, Corresponding Author, UCL Institute of Global Health
Vaccines are currently allocated through the COVAX Facility, which aims to allocate enough vaccines to cover 20% of each national population. It also considers a small range of metrics (such as vulnerability to serious disease) and a qualitative assessment.
However, the COVAX facility has suffered from insufficient access to vaccines. This was amplified with the arrival of the Omicron variant, which resulted in high-income countries initially administering more booster doses than all vaccine doses combined in low-income countries.
Dr Jain said: “The current process used to allocate scarce vaccines between countries, which was hastily designed during a global health crisis, warrants scrutiny and, if possible, improvement.
“Assessing the needs of vaccines against Covid-19 is complex, given the extensive but variable impacts of epidemics among populations and the diversity present in social value judgments.
“But our study has found that there are several factors, extending beyond traditional metrics, that may cause particular countries to have a greater need for vaccines compared to others.
“On average, the proportion of the total population and the high-risk population not fully vaccinated were the most highly rated factors related to vaccine needs. Several other factors considered important, such as the economic impact of confinements are not routine.considered in the global vaccine allocation mechanisms.
“We are likely to see a similar situation in terms of vaccine equity and monkeypox, with vaccines being a key part of controlling outbreaks. However, we have already seen wealthier countries buying most of vaccines leaving a general lack of supply for the rest of the world.
“This transparent scoring tool will aid qualitative assessments to improve the role of equity in global vaccine allocation.”
Source:
University College London
Journal reference:
Jain, V., et al. (2022) Which countries need the most COVID-19 vaccines? Development of a prioritization tool. BMC Public Health. doi.org/10.1186/s12889-022-13948-6.