Unfortunately, for a lot of rural African areas where people don't have a hospital they can regularly go to, and vaccines are administered almost exclusively by traveling charity clinics, that...
It shows three initial doses followed by a booster a year later gives up to 80% protection.
Unfortunately, for a lot of rural African areas where people don't have a hospital they can regularly go to, and vaccines are administered almost exclusively by traveling charity clinics, that dose schedule is going to be a bit of a nonstarter. Even in America, a dose schedule like that can lead to compliance issues, but it turns into a logistical nightmare in underserved, extremely poor African countries.
Did they study what happens if you don't get all the doses? Like, what happens if you only get a single one? If there's still an effect, it might be good enough to improve people's lives, even if...
Did they study what happens if you don't get all the doses? Like, what happens if you only get a single one?
If there's still an effect, it might be good enough to improve people's lives, even if doing all doses would probably be even better.
That is true. However, in those places, there are many people still alive who saw friends and relatives die from preventable diseases, and the concrete improvements vaccinations brought to their...
That is true. However, in those places, there are many people still alive who saw friends and relatives die from preventable diseases, and the concrete improvements vaccinations brought to their communities, so it is not uncommon for them to display a very sane and realistic sentiment towards vaccination in general.
Oh, I don't disagree. I grew up with my parents doing long term humanitarian work in sub-Saharan Africa, and people are always grateful for such help. Even so, under-education can make compliance...
Oh, I don't disagree. I grew up with my parents doing long term humanitarian work in sub-Saharan Africa, and people are always grateful for such help. Even so, under-education can make compliance an issue. For example, we had multiple times where we gave someone an antibiotic and stressed that they had to take the whole course and not to stop when the infected wound was visually looking better, or the infection would come back. Only about half the people complied, most of the rest would try to save the remaining medication, due to the difficulty of acquiring it in the first place. Many will get a single dose and either think they are now protected, or be unable to afford to travel to get the vaccine 'a second time'.
And compliance issues aside, the logistics on the distribution side would be an utter nightmare. I remember the gates foundations polio vaccine drives, and even a one time oral dose could be moderately logistically difficult due to the freezer requirements (you cant just store in ice, below-freezing temps are required). A vaccine like this, with multiple doses needed, potentially separated by weeks with the booster shot a year out, means that the traveling clinic model wont work with this, as a clinic would have to stay in place for upwards of a month, depending on the schedule, all to give one round of vaccinations. Then they would have to revisit the same place a year later and attempt to get all the people they vaccinated previously back for their booster. Unfortunately, even for large medical charities like doctors without borders, that schedule will be infesable compared to 1 or 2 dose vaccines, where they can move rapidly through villages, inoculating large populations.
Where this could be very useful will be urban centers where medical infrastructure already exists and education tends to be a bit better. However, sub-Saharan Africa has a very low urbanization rate*, potentially reducing the effect that this would have on malaria mortality rates below that of, say, mosquito net campaigns.
*Data on the exact number varies. this source says that in 2010 the rate was 36% and that it is currently 41%, but this claims it was only 11% in 2010 and wont reach 20% till 2050. the council on foreign relations seems to back up statistica.
Trial results from 409 children in Nanoro, Burkina Faso, have been published in the Lancet Infectious Diseases. It shows three initial doses followed by a booster a year later gives up to 80% protection.
[…]
The team will start the process of getting their vaccine approved in the next few weeks, but a final decision will hinge on the results of a larger trial of 4,800 children due before the end of the year.
The world's largest vaccine manufacturer - the Serum Institute of India - is already lined up to make more than 100 million doses a year.
Prof Hill said the vaccine - called R21 - could be made for "a few dollars" and "we really could be looking at a very substantial reduction in that horrendous burden of malaria".
[…]
Malaria has been one of the biggest scourges on humanity for millennia and mostly kills babies and infants. The disease still kills more than 400,000 people a year even after dramatic progress with bed nets, insecticides and drugs.
That seems unlikely to me. This isn’t a product for rich countries. Since it will be manufactured at high volume in India, I don’t think the preferences of US or European pharmaceuticals or...
That seems unlikely to me. This isn’t a product for rich countries. Since it will be manufactured at high volume in India, I don’t think the preferences of US or European pharmaceuticals or regulators will matter much. India will export directly to the third world countries that can most benefit from it.
Getting it approved in developed countries (for travelers) might be a tougher challenge, though?
Unfortunately, for a lot of rural African areas where people don't have a hospital they can regularly go to, and vaccines are administered almost exclusively by traveling charity clinics, that dose schedule is going to be a bit of a nonstarter. Even in America, a dose schedule like that can lead to compliance issues, but it turns into a logistical nightmare in underserved, extremely poor African countries.
Did they study what happens if you don't get all the doses? Like, what happens if you only get a single one?
If there's still an effect, it might be good enough to improve people's lives, even if doing all doses would probably be even better.
That is true. However, in those places, there are many people still alive who saw friends and relatives die from preventable diseases, and the concrete improvements vaccinations brought to their communities, so it is not uncommon for them to display a very sane and realistic sentiment towards vaccination in general.
Oh, I don't disagree. I grew up with my parents doing long term humanitarian work in sub-Saharan Africa, and people are always grateful for such help. Even so, under-education can make compliance an issue. For example, we had multiple times where we gave someone an antibiotic and stressed that they had to take the whole course and not to stop when the infected wound was visually looking better, or the infection would come back. Only about half the people complied, most of the rest would try to save the remaining medication, due to the difficulty of acquiring it in the first place. Many will get a single dose and either think they are now protected, or be unable to afford to travel to get the vaccine 'a second time'.
And compliance issues aside, the logistics on the distribution side would be an utter nightmare. I remember the gates foundations polio vaccine drives, and even a one time oral dose could be moderately logistically difficult due to the freezer requirements (you cant just store in ice, below-freezing temps are required). A vaccine like this, with multiple doses needed, potentially separated by weeks with the booster shot a year out, means that the traveling clinic model wont work with this, as a clinic would have to stay in place for upwards of a month, depending on the schedule, all to give one round of vaccinations. Then they would have to revisit the same place a year later and attempt to get all the people they vaccinated previously back for their booster. Unfortunately, even for large medical charities like doctors without borders, that schedule will be infesable compared to 1 or 2 dose vaccines, where they can move rapidly through villages, inoculating large populations.
Where this could be very useful will be urban centers where medical infrastructure already exists and education tends to be a bit better. However, sub-Saharan Africa has a very low urbanization rate*, potentially reducing the effect that this would have on malaria mortality rates below that of, say, mosquito net campaigns.
*Data on the exact number varies. this source says that in 2010 the rate was 36% and that it is currently 41%, but this claims it was only 11% in 2010 and wont reach 20% till 2050. the council on foreign relations seems to back up statistica.
I’ve read that the Rwandan health care system has had impressive results. Maybe it will work well there?
From the article:
[…]
[…]
This is probably going to end up being true. And yet, I still worry the vaccine itself will end up costing dramatically more, all for profit's sake.
That seems unlikely to me. This isn’t a product for rich countries. Since it will be manufactured at high volume in India, I don’t think the preferences of US or European pharmaceuticals or regulators will matter much. India will export directly to the third world countries that can most benefit from it.
Getting it approved in developed countries (for travelers) might be a tougher challenge, though?