[Herald Interview] ‘Making vaccines accessible is biggest COVID-19 challenge’

The International Vaccine Institute said participation in international efforts is critical to improving the chances of not only developing a vaccine for COVID-19, the respiratory disease caused by the novel coronavirus, but achieving its equitable distribution.

“There are billions of people in this world who could potentially need a COVID-19 vaccine. If we were to vaccinate all of them, we may need as many as over 10 billion doses,” the institute’s director general, Dr. Jerome H. Kim, told The Korea Herald at his office in Gwanak, Seoul, Wednesday.

“We have to start planning now for the supply and the availability of the vaccines, and think very carefully about the costs.”

In the joint push for a COVID-19 vaccine, the Seoul-based nonprofit organization is working with the Korea National Institute of Health -- a state medical research center under the Korea Centers for Disease Control and Prevention -- for clinical trials on vaccine candidates.

“We’re hoping to do it faster, but June 1 is our target for starting clinical trials,” Kim said, explaining that the KNIH will run the assay to determine whether the vaccine generates the right protective immune responses.

The KNIH said last month that the Coalition for Epidemic Preparedness Innovations, a nongovernmental organization founded in 2017 for coordinating and financing the development of vaccines for new diseases with pandemic potential, has provided a grant of around 8.4 billion won ($6.86 million) for the research.

Partnerships attained through bodies like the CEPI consolidate global commitment to making the vaccines available to countries that couldn’t otherwise afford it, Kim said.

Given the scale of the pandemic, ensuring some equity in the distribution of the vaccines is something that needs to be figured out, he said.

“Our biggest challenge will be access. I’m convinced that we will have a vaccine. But the question will be how to manufacture them in significant quantities and get the vaccine into the arm of the person who needs it.”

Some 3.2 million people have been reported to be infected with COVID-19 globally, the World Health Organization’s Saturday situation report shows, and 229,971 have died from the disease so far.

Kim said only governments are capable of making the needed interventions to prevent certain players from profiting off the vaccines, and to make sure the vaccines are accessible at a reasonable price.

“The companies developing the vaccines are often funded by their governments, and usually, there are agreements built into the contract known as the access agreements or the general access agreements that compel companies to cooperate and price the vaccines reasonably.”

As the vaccines will be in short supply in the initial phase of production, prioritizing who gets the vaccination and in what order is a serious decision that policymakers are going to have to make, for which the WHO can help set guidelines, he said.

“Do we protect people who are most vulnerable, like the elderly, because they are at the greatest risk of death, or people who are providing care, like doctors and nurses, because they have a significant risk of exposure? Or people working essential jobs like in logistics, because you want to maintain a healthy economy?”

Kim said that because no country alone can produce the necessary amount of vaccines quickly and cheaply enough, international collaboration is critical.

“Maybe if you’re the United States or China, you can invest billions of dollars in COVID-19 vaccine development. But if you are a smaller country without an intrinsic vaccine industry, that is not the case.”

In pandemic times, being a good player in the international arena means sharing information, he said.

“None of us have all the answers all the time. If we agree to work with each other, that reduces some of the stress associated with getting the vaccine.”

For instance, Korea, as a country that has controlled COVID-19, has made its experience with the outbreak widely available, which helped other countries understand how to control their own outbreaks, he said.

Plus, failing to be transparent could jeopardize the global response to the health crisis.

“If a country harbors significant COVID-19 outbreaks that they won’t disclose, they are actually a threat to everybody, in the same way a person who is infected that doesn’t stay in quarantine is a threat,” he said.

“Countries that don’t do their part in controlling the outbreak, don’t report it and don’t collaborate with everyone else, really are putting other countries at risk.”

COVID-19 is a reminder of the importance of vaccine security, Kim said, adding, “A part of pandemic preparedness is having a reasonable vaccine industry.”

Kim said he believed Korea’s vaccine industry “has enormous potential.”

“Korea is a country with lots of vaccine manufacturing and antibody manufacturing capability, technology and innovation,” he said. “And there is enough of a community of vaccine developers in the universities who would be able to spin things out quickly.”

But developing a vaccine is nothing like developing a diagnostic test kit, which is much faster and less costly. A vaccine development program needs continued funding to move forward.

“Someone needs to look at the next set of pathogens that are going to develop. Maybe it’s a coronavirus or a mutation in the Ebola virus,” he said. 

“These are big questions that research can help us sort out, and the kind of research -- not immediately practical with uncertain returns -- that only the government can fund.”

Korea’s lessons from the 2009 H1N1 flu pandemic have motivated the country to ramp up efforts in increasing self-sufficiency in vaccine development and production, Kim said.

A pandemic is a bad time to turn to other countries for millions of doses of vaccines, as most are equally affected and inclined to take care of their own citizens first.

In fact, the Korean government’s 215.1 billion won plan for developing vaccines for emerging diseases, approved in March last year, is set to kick off in July, he said.

“Korea’s Health Ministry planned this before COVID-19 hit -- just the timing was wrong, because it’s hard to predict an epidemic.”

Kim said every country around the world should invest in pandemic preparation, which may not necessarily be expensive.

“It’s in thinking through what needs to be done should an outbreak occurs in the country, what needs to be mobilized, who they need to talk to.”

In an outbreak response, vaccine is always going to be the second step, after you control a major part of the outbreak and earn time to focus on other things, Kim said.

“As Korea prepares for the next outbreak -- the second wave -- it needs to be collaborating with other groups to ensure that Korea has access to the vaccines or drugs when they’re here.”

Amid the race for the COVID-19 vaccine, many have started talking about a universal coronavirus vaccine, which would protect against lots of different coronaviruses in the same group, he said.

Kim said there are many instances of “spin-offs” in vaccine developments.

“Some of the advances made in regular vaccines came out of HIV vaccine research. A lot of the labs that worked on HIV vaccines are working on COVID-19 vaccines, because they have the technology and the skills and the ability to do analysis that can be swiftly applied to something else -- the next pathogen,” he said.

By Kim Arin (arin@heraldcorp.com)