WHO: Achieving 70% COVID-19 Immunization Coverage by Mid-2022

WHO, Geneva, Dec 23 – The Independent Allocation of Vaccines Group (IAVG) has issued a set of recommendations to make the allocation of COVID-19 vaccines more equitable and more effective.

The group was established a year ago, to validate and assess vaccine allocations recommended by WHO’s and Gavi’s Joint Allocation Taskforce (JAT) of COVAX. [1] Since then, much has changed. COVAX was envisioned to be the world’s primary distributor of COVID-19 vaccines, with IAVG serving as an independent referee for needs-based allocations. But rich nations largely sidestepped COVAX, hoarding doses for their own populations and cutting deals directly with low- and middle-income countries. This has made subsequent allocation decisions even more challenging.

The IAVG is concerned that the primary priority use of available vaccines is not consistent with the goals outlined in the Strategy to Achieve Global COVID-19 Vaccination by Mid-2022 in October 2021. [2] The group also notes that it has validated the allocation of only 730 million of the estimated 8 billion doses of vaccine that have been administered globally, which is less than 10%. The rapid emergence of the Omicron variant is a stark reminder of the ongoing threat posed by the evolution of the COVID-19 pandemic and reinforces the critical need to achieve high levels of immunization coverage in all countries, including in highly vulnerable populations, in a timely manner.

The IAVG is therefore calling for:

Achievement of 70% coverage with COVID-19 vaccines in all countries as a global imperative.

As the overall vaccine supply to COVAX is anticipated to continue to grow substantially next year, COVAX will have a greater opportunity to contribute to achieving this goal. Manufacturers, vaccine-producing and high-coverage countries must prioritize vaccine equity and transparency, including the sharing of information about manufacturing capacity and supply schedules with COVAX, as well as vaccine access plans.

All countries to work with COVAX with considerable urgency to optimize the strategic use of the growing vaccine supply.

This means that high-coverage countries will need to establish complementary, “dual-track” approaches that consider both domestic and international goals.

Greater attention must be paid to who is being immunized. Equity must remain the overarching principle, and priority must be given in all countries to ensuring that the primary series is offered first and foremost to all adults and adolescents, in the step-wise manner recommended by the WHO, given that a high proportion of these populations still require primary immunization. However, as more is known about the required vaccination response in the face of Omicron, the need for booster doses and need to immunize children, the COVAX vaccine allocation decisions must consider these recommendations.

Given the global health and epidemiologic consequences of failing to immunize vulnerable populations, including those in humanitarian settings, the IAVG recommends that COVAX continue to work with all manufacturers and countries to immediately increase the availability and uptake of vaccines in these populations.

All countries to have a steady, predictable supply of COVID-19 vaccines, which meet the unique needs of each country. Attention must be paid to addressing prohibitive absorptive challenges in countries that request support.

This may include support for vaccine storage, distribution, administration and/or record-keeping, which may in part be due to competing health and immunization crises [3]. It will be important to have close collaboration between all COVAX partners, donors, and participants.

In order to increase demand for COVID-19 vaccines, ongoing, concerted global, national and local leadership is required to address vaccine misinformation.

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