US Vaccine Rollout Lessons For Developing Countries: Fauci

The United States doesn’t test people for antibodies or the coronavirus before vaccinating them against Covid-19, says Dr Anthony Fauci.

KUALA LUMPUR, Feb 3 — American infectious disease expert Dr Anthony Fauci has advocated strong local capability in countries to administer Covid-19 vaccines, citing initial inefficiency in the United States.

Dr Anthony Fauci, a member of the White House coronavirus task force, also said the US vaccination programme prioritised health care providers, as well as people in nursing homes and extended care facilities who disproportionately made up serious disease and deaths from Covid-19.

“One of the lessons that we learned, you got to have a pretty well organised on-the-ground local capability of getting it into people’s arms because in the beginning, we had vaccines that were delivered, and it wasn’t an efficient process getting it into people’s arms,” Dr Fauci told a media roundtable Monday ahead of the International AIDS Society’s (IAS) Covid-19 Conference: Prevention.

He was asked about lessons from the US Covid-19 vaccine rollout for developing countries.

“There was a discrepancy between the amount of vaccines that was delivered, and the amount that was in people’s arms. In some areas, what we’re facing now is overwhelmingly, the demand is greater than the supply. We went from inefficiently getting it into people’s arms, to quickly having a situation right now, we have an enormous demand and the supply has not yet met it,” said Dr Fauci.

According to the US’ Centers for Disease Control and Prevention (CDC) dashboard, the US has administered more than 32 million doses so far, with 26 million people receiving at least one dose and 5.9 million people getting two doses. Nearly 50 million doses have been distributed to date.

Dr Fauci also stressed that rich countries had a “humanitarian obligation” to get people across the globe vaccinated, pointing out that variants of the coronavirus have emerged in different countries, such as South Africa, Brazil, and the UK.

“If you protect your own country without protecting the world, this will go on and on and on,” he said. “We’ve got to get the whole world vaccinated.”

Vaccine Better In Somebody’s Arm Than A Freezer

The director of the US’ National Institute of Allergy and Infectious Diseases also said Covid-19 vaccines should be administered as soon as they are delivered, while ensuring that people get the second dose. The United States initially reserved doses for people’s booster shots when coronavirus vaccines were first rolled out in the country last December.

“What we found out was once you get confidence that you would roll things out, instead of holding anything back, as soon as you get a dose, give it to people as their first dose. As the next shipment comes in, when the people are ready for their second dose, they get the first priority to make sure everybody gets the second dose,” Dr Fauci said.

“And then what’s left over, then you give others their first dose, which means you’re never holding things back. Better it in somebody’s arm than in a freezer or a refrigerator.

“So long as you have confidence that the flow and cadence of doses will not have people who get their first dose miss their second dose, because you don’t want them to miss their second dose. That’s what the confusion is sometimes when people talk about holding back versus giving everyone a first dose.”

The United Kingdom has made an unusual decision, amid limited vaccine supplies, to delay the second dose of the Pfizer-BioNTech vaccine until 12 weeks after the first, instead of the prescribed 21-day interval.

No Red Flags In Vaccinated Pregnant Women

Dr Fauci said shortly after Covid-19 vaccines received emergency-use authorisation in the US, 10,000 pregnant women got vaccinated. More pregnant women have received Covid-19 vaccines in the US since.

“Many of them were health care providers who were taking care of Covid patients, saying, ‘I’m pregnant, to me the risk benefit is, I want to protect myself against Covid’.”

He also said the US’ Food and Drug Administration (FDA) continues to follow up with pregnant women who received Covid-19 vaccines and so far, has found no red flags.

“So the CDC sticks by its recommendation saying: ‘It’s up to the woman. It’s a risk benefit ratio’. Even though we don’t have good data on it, the data we’re collecting so far, there’s no red flags. A woman who’s pregnant who wants to get vaccinated, that’s fine.”

Dr Fauci also clarified that the World Health Organization (WHO) has since changed its stance that pregnancy is a contraindication, or a condition when a vaccine should not be administered, to saying that pregnant women in high-risk situations should probably get vaccinated.

According to the CDC, pregnant women with Covid-19 have an increased risk of severe illness and death from the virus, as well as a higher probability of adverse pregnancy outcomes like preterm birth. There is limited data on the safety of coronavirus vaccines, including mRNA vaccines, in pregnant women.

“Based on current knowledge, experts believe that mRNA vaccines are unlikely to pose a risk to the pregnant person or the fetus because mRNA vaccines are not live vaccines. The mRNA in the vaccine is degraded quickly by normal cellular processes and does not enter the nucleus of the cell,” said the CDC.

US Doesn’t Do Testing Before Administering Vaccines

Dr Fauci also said the US does not put up barriers to vaccination by testing people for antibodies or the virus before vaccinating them.

“We just vaccinate people who want to get vaccinated,” he said.

“If there’s another reason to test for antibody or virus, we go ahead and do it. But if somebody walks into a clinic or some of our health care providers or people in the community want to get vaccinated, we just vaccinate.”

Malaysia’s Ministry of Health (MOH) has yet to list recommendations on who should or should not be vaccinated against Covid-19. The US’ CDC lists severe allergic reaction, like anaphylaxis, after a previous dose of an mRNA Covid-19 vaccine or any of its components as a contraindication.

The CDC states that allergic reactions (including severe ones) not related to vaccines or injectable therapies — such as food, pet, venom or environmental allergies — are not a contraindication or precaution to vaccination with either the Pfizer-BioNTech or Moderna coronavirus vaccine.

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