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Polio vaccination campaign in Pakistan: a step towards eradication or still a challenge in hand? | Journal Human Vaccines & Immunotherapeutics.

[Pay to View Full Text] [Received 25 Apr 2019, Accepted 06 Jun 2019, Published online: 25 Mar 2020]

Abstract.

Polio is an acute viral disease that is still endemic in Pakistan. The polio vaccination program is facing many challenges that result in an increased number of new cases. The success of polio vaccination has been threatened in different parts of Pakistan. In the past, the immunization program was affected by different factors including insecurity, inducing mass migration and displacement, life threats to polio workers, and restricted access to the vulnerable population. Misconceptions and misunderstanding about the polio vaccine are a major obstacle in polio eradication which need to be erased by organized effects of increasing vaccine awareness.

The Long Read: 'It’s a razor’s edge we’re walking': inside the race to develop a coronavirus vaccine | The Guardian.

[Fri 27 Mar 2020 06.00 GMT]

Around the world, more than 40 teams are working on a vaccine for Covid-19. We followed one doctor in the most urgent quest of his life.

Coronaviruses are named after the corona (crown) of surface proteins (outer dots) that are used to penetrate a host cell. Photograph: Pasieka/Getty/Science Photo Library

Samanth Subramanian writes:

Of the dozens of places where a coronavirus vaccine might be born, one is DIOSynVax, a small company started by a Canadian pathologist named Jonathan Heeney. In ordinary times, I’d have visited Heeney in his office, in a stately red-brick building in Cambridge. I’d have met his team and his Aria III cytometer, which looks like as if might brew a strong, space-age espresso but which, in fact, uses its four lasers to separate cells marked with fluorescent dyes as they flow through the machine at 10,000 cells per second. I’d have tried to wangle my way into the lab designated containment  | level 3, the highest-but-one level of biosafety security, where Heeney’s biologists investigate pathogens such as the West Nile virus or the tuberculosis bacterium. These would be so lethal if they escaped that the lab is nearly hermetic. The joints along the walls, floor and ceiling are sealed and re-sealed; the steel panels in the walls, according to government guidelines, have to be “of the type used in the nuclear industry”; a flow of air must constantly be forced in if the door is open, to prevent the germs inside from drifting out. I would have even seen the coronavirus vaccine candidates themselves: samples of clear liquid, held in glass vials.

But Heeney couldn’t take the risk. Understandably, he didn’t want anyone carrying Covid-19 into his lab and infecting his staff. “It’s a challenge already, because when they go home to their families every day, you don’t know who they’re passing on the bus or the train,” he said when I first spoke to him last week. At the time, Heeney was considering quarantining himself. A Cambridge college had offered him a room, so that he could shuttle between lab and bed, meeting as few people as possible. “I don’t have time to get sick,” Heeney said. He runs his company out of Cambridge University’s department of veterinary medicine, where he is a professor. He’s just a 12-minute bicycle ride from where I live, but we video-conferenced on Zoom.

Since 2016, Heeney has been honing a set of methods – a platform, in vaccine parlance – that can be used to fashion vaccines that destroy whole families of viruses. Last year, he won a Gates Foundation grant of $2m (£1.6m) to fund research into a universal flu vaccine – one that will prevail against every kind of flu virus. “It’s the mother of all challenges, the holy grail,” Heeney said. In January, he kept an eye on a new disease that was flying across eastern China. After two weeks, when Chinese scientists published the coronavirus’s genetic sequence, Heeney told me his team decided: “Let’s do with this what we’re doing with the flu.”

Defeating Covid-19 will call for more than vaccines; it will involve quarantines, social distancing, antivirals and other drugs, and healthcare for the sick. But the idea of a vaccine – the quintessential silver bullet – has come to bear an almost unreasonable allure. The coronavirus arrived at a ripe moment in genetic technology, when the advances of the past half-decade have made it possible for vaccine projects to explode off the blocks as soon as a virus is sequenced. These cutting-edge vaccines don’t use weakened forms of the germ to build our immunity, as all vaccines once did; rather, they contain short copies of parts of the germ’s genetic code – its DNA or RNA – which can produce fragments of the germ within our bodies.

Thus, for the first time ever, scientists have been able to muster up vaccine prospects mere weeks into a new, fast-spreading disease. Right now, there are at least 43 Covid-19 vaccines in development around the world – in Brisbane and Hong Kong, in the US and the UK, in the labs of universities and companies. Most of these are DNA or RNA vaccines. One vaccine, made in 63 days by an American biotech firm named Moderna, moved into human trials on 16 March, entering the bloodstream of the first of 45 healthy adult volunteers in Seattle. It was a “world indoor record”, said Anthony Fauci, the doctor who heads the US National Institute of Allergy and Infectious Diseases. “Nothing has ever gone that fast.”

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Polio this week as of 25 March 2020 | ReliefWeb.

[Source: GPEI] [Published: 25 Mar 2020] [Origin: View original]

• The COVID-19 emergency means that many aspects of the polio eradication programme will be affected. In light of the situation, the Polio Oversight Board (POB) has come up with a set of recommendations for polio eradicators read more…
• Summary of new viruses this week (AFP cases and environmental samples):
  • Afghanistan: four WPV1 positive environmental samples
  • Pakistan: two WPV1 cases and six WPV1 positive environmental samples
  • Central African Republic: one cVDPV2 positive environmental sample
  • Angola: two cVDPV2 cases
  • Cameroon: one cVDPV2 case and three cVDPV2 positive environmental samples
  • Chad: five cVDPV2 cases and two cVDPV2 positive environmental samples
  • Côte d’Ivoire: two cVDPV2 positive environmental sample
  • Ethiopia : three cVDPV2 cases
  • Malaysia: one cVDPV1 case
  • Ghana: two cVDPV2 positive environmental samples

Download report (PDF | 951.13 KB)

WHO publishes Emergency Use Listing procedure and roadmap to make new medical products more readily available during health emergencies | ReliefWeb.

[Source: WHO] [Published: 27 Mar 2020] [Origin: View original]

WHO today published the Emergency Use Listing (EUL) procedure to streamline the process by which new or unlicensed products can be used during public health emergencies. The EUL replaces the Emergency Use Assessment and Listing (EUAL) procedure, which was used during the West Africa Ebola outbreak of 2014-2016.

The EUL is a risk-based procedure for assessing and listing unlicensed vaccines, therapeutics and in vitro diagnostics with the ultimate aim of expediting the availability of these products to people affected by a public health emergency. It will assist interested UN procurement agencies and Member States in determining the acceptability of using specific products, based on an essential set of available quality, safety, and efficacy and performance data.

The procedure is a key tool for companies wishing to submit their products for use during health emergencies.

Eligibility of candidate products.

The EUL concerns three product streams (vaccines, therapeutics and in vitro diagnostics), each of which has specific requirements for products to be eligible for evaluation under the EUL procedure.

The following criteria must be met:

• The disease for which the product is intended is serious or immediately life threatening, has the potential of causing an outbreak, epidemic or pandemic and it is reasonable to consider the product for an EUL assessment, e.g., there are no licensed products for the indication or for a critical subpopulation (e.g., children);
• Existing products have not been successful in eradicating the disease or preventing outbreaks (in the case of vaccines and medicines);
• The product is manufactured in compliance with current Good Manufacturing Practices (GMP) in the case of medicines and vaccines and under a functional Quality Management System (QMS) in the case of IVDs;
• and The applicant undertakes to complete the development of the product (validation and verification of the product in the case of IVDs) and apply for WHO prequalification once the product is licensed.

Looking forward: Roadmap for evaluation of novel oral polio vaccine type 2.

One of the first applications of the EUL is likely to be for the novel oral polio vaccine type 2, for which WHO has developed a roadmap. Novel oral polio vaccine type 2 is expected to become a key tool in addressing type-2 vaccine derived polio and could significantly impact on progress in polio eradication.

Type 2 vaccine derived polio is currently affecting a number of countries, notably in Africa but also in some parts of the Middle East and Asia (including Somalia, Pakistan and the Philippines). Over the past five years, a total of 423 cases have been detected in 19 countries. It occurs when routine immunization coverage is low or when supplementary immunization activities are poorly conducted and not enough children are reached with the vaccine. As a result, a population is left under-immunized and the vaccine virus is able to circulate among unvaccinated children and undergo genetic changes. Hence, the main risk factor is low vaccination coverage. A fully immunized population is protected against both vaccine-derived and wild polioviruses.

The best measure against vaccine-derived poliovirus is to ensure high-quality outbreak response. If a population is fully immunized against polio, it will be protected against both wild polio and vaccine-derived polio.

One of the key actions to address the current vaccine-derived polio emergency is to roll out the novel OPV type 2 (nOPV2). The vaccine is currently in Phase II clinical trials. With the streamlining of the WHO emergency use procedure and the roadmap published today, access to the vaccine could become possible as early as the second quarter of 2020.

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