How will a COVID-19 vaccine be delivered?

Picture Source: EPR

17 June 2020 | IVAC Webinar Series

Picture credit: Elderly Health

Speakers

Naor Bar-Zeev, PhDIVAC Deputy Director

Lois Privor-Dumm, IMBASr. Advisor, Policy, Advocacy, &

Communications

Director of Adult Vaccines

Maria Deloria-Knoll, PhDDirector of Epidemiology

Our Speakers

CO

VID

-19

Vac

cin

e

Vaccination Strategy Targets

Health

Care

Workers

Older

adults

Population

immunity

Essential

WorkersHigh Risk

Vaccination Strategy Trade-offs

Number of People Vaccinated

Cost,

Complexity,

Effort

70M 770M 2-3 Billion >6 BillionCumulative dose requirement

(single dose, one time)

Given only 100 million doses are available for the world, how would you allocate them? (choose one)

1. Equally divided per population size of the country

2. Countries with the worst burden currently (e.g. death rate)

3. Driven by purchasing power – more doses to the highest bidder

4. Priority (more doses) to countries that invested in the vaccine’s

development

5. Based on capacity to deliver the vaccine (i.e., can’t receive more

doses than have the infrastructure to distribute)

6. It’s a private market anyway, companies will decide

Poll:

POLL RESULTS

70M 770M 2-3 Billion >6 BillionCumulative dose requirement

(single dose, one time)

9

COVID-19 Vaccine

Global Allocation –multiple vaccines likely needed

Technology Candidates/Phase

Attributes

Current Scale Single

Dose

Licensed

PlatformOther considerations

Protein subunit Ph 1/2 High ✓ Adjuvanted

DNA Ph1 MediumRegulatory – device & biologic

review (with electroporation)

Nonreplicating vector Ph 1, 2b/3 High

✓ Preexisting immunity to vector -

effectiveness?

Replicating viral vector Preclinical High✓ ✓

Inactivated Preclinical, Ph 1, 2 Medium to High✓ Adjuvanted

Live attenuated Preclinical High✓ ✓

RNA Ph 1, 2Low to

Medium

New technology, storage temps

Uncertain

10

Sources: WHO Draft Landscape COVID-19 Vaccine Candidates, Jun9 ;Lurie et al. NEJM. 2020.

What do you think will be your country’s primary challenge for COVID-19 vaccination?

1. Insufficient cold chain capacity

2. Ability to get the vaccine to all parts of the country (particularly

rural areas)

3. Infrastructure/plan to reach most vulnerable populations

4. Acceptance by public

5. Competing priorities/ insufficient resources for new programs

6. Inadequate safety surveillance

7. Other (put comments in chat box)

11

Poll:

POLL RESULTS

+Italy

Countr

y T

ypolo

gie

s (

Arc

hety

pes)

Privor-Dumm et al. Vaccine. 2020.

Adult immunization program

archetypes in 34 countries

Malaysia

Public Acceptance: what will it be a year from now?

14

Source: AP-NORC Poll conducted May 14-18, 2020 with 1,056 AdultsAdditional Considerations are described by DeRoo et al. https://jamanetwork.com/journals/jama/fullarticle/2766370

Do you plan to get vaccinated with a Coronavirus vaccine?

40

67

56

25

37

49

35

21

27

32

37

31

23

1216

40

23 20

< 6 0 6 0 + W H I T E B L A C K H I S P A N I C

A G E R A C E O V E R A L L

Yes Unsure No

Not

demanding

the vaccine

Current global response model: pillars/silos with little integration

GAVI, Briefing on the COVAX Facility. June 11 2020

Participating

countries

Manufacturers

COVAX FacilityOffer to

manufacturers

Secure supply

for countries

Access to

appropriate product

Make commitments

to purchase doses

Make price and

supply commitments

GAVI, Briefing on the COVAX Facility. June 11 2020

Current global response model: pillars/silos with little integration

GAVI, Briefing on the COVAX Facility. June 11 2020

Delivery

strategy

Product profile

Demand Program

priorities

Ethics &

politics

Supply &

financing

Integrating framework of considerations

19

Delivery

strategy

Product profile

DemandProgram

priorities

Ethics &

politics

Supply &

financing

Global and

country

coordination

Strategy to consider public perspectives

Design new Platforms,

Plan for known bottlenecks,

Track

Communicateallocation

Reliable supply of

affordable & appropriate

products

Needs to store, deliver, administer and dispose

Potential Framework: Integrating experience and new perspectives

Global actors should ask:

• What are the local conditions needed to make it work?

• What are the differing priorities of countries?

• How do we integrate all perspectives while meeting global health & economic goals?

Country actors should ask:

• What do we need to do to make it work here?

• Are we bringing in diverse voices to meet our strategic priorities?

• How are we working with the global community?

21

Participating

countriesThe Facility

Thank you!

Q&A

22

Let’s continue the discussion:

Naor Bar-Zeev: nbarzee1@jhu.edu

Lois Privor-Dumm: lprivor1@jhu.edu

Maria Deloria Knoll: mknoll2@jhu.edu