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WHO urges nations to plan efficient roll out of Covid vax

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As Covid-19 cases continue to increase in most countries of WHO South-East Asia Region, the World Health Organization on Thursday called for stronger collective efforts by one and all to curtail the virus transmission, while also urging countries to plan for efficient roll out of Covid-19 vaccines as soon as they are available.

“Like the rest of the world, the Region continues to be at risk. To stop the spread of Covid-19 virus, we need to do it all – continued strong leadership; robust public health measures; clear communication and an engaged, empowered and enabled population – to turn the tide,” said Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia Region.

In a communication to member countries, the Regional Director said, the global race for Covid-19 vaccine has gathered momentum. In anticipation of development of a safe and effective Covid-19 vaccine, countries should be prepared with an efficient and coordinated strategy and plan for roll-out of vaccination.

Vaccine availability is likely to be limited initially, hence it will be important to clearly identify goals of national vaccination strategy, she said.

In the spirit of promoting fair and equitable access to the vaccines across all countries, the WHO is proposing that countries prioritize the at-risk population as they develop in-country vaccination strategies. Available vaccines should first be provided to priority populations and then expanded to others.

“The Covid-19 vaccination should aim at minimizing the societal and economic impact by reducing deaths caused by the disease,” Khetrapal Singh said.

Listing nine priority areas for Covid-19 vaccine introduction and roll out, the Regional Director said a national level coordination committee would be needed to oversee vaccination; an expedited regulatory pathway for approval of new vaccine; a technical advisory group to recommend prioritization of risk groups; protocols on infection prevention and control measures to minimize exposure during immunization sessions; training plans for vaccine introduction; and monitoring systems to measure coverage, acceptability and disease surveillance.

Countries would also need to strengthen vaccine cold chain systems; ensure trained staff perform vigilance activities for vaccine safety; and importantly, a vaccine demand generation plan to instil confidence and acceptance among people for the new vaccine.

Ensuring continued WHO support, the Regional Director said, “Together we must continue to strengthen the Covid-19 response by aggressively applying the basic public health measures, and also looking ahead and ensuring that we make full use of emerging tools to control spread, save lives and minimize impact.

Corona

Call for Covid-19 studies to focus on mucosal immunity

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Researchers have stressed that more Covid-19 studies should be devoted to how immunity to coronavirus emerges in the mucous membranes of the nose and mouth.

Anyone who has undergone a nasal swab or saliva test for Covid-19 knows that the virus is most easily detected in the nose and mouth, the study, published in the journal Frontiers in Immunology, reported.

Noting that the mucosal immune system is the immune system’s largest component, the researchers expressed concern that it hasn’t been a focus of much of the research on Covid-19 to date.

“We think it is a serious omission to ignore the mucosal immune response to SARS-CoV-2, given its initial sites of infection,” said study author Michael W Russell from the University at Buffalo in the US.

“Clearly the response of the systemic immunoglobulin G antibody (the most abundant circulating antibody) is important — we do not deny that — but on its own it is insufficient,” Russell added.

Russell noted that naturally, the initial focus of research on the disease was on cases of severe disease when the virus descends into the lower respiratory tract, especially the lungs, where the cellular immune responses exacerbate the inflammation rather than fight the infection.

But since the upper respiratory tract, including the nose, tonsils and adenoids are the initial point of infection for the SARS-CoV-2 virus, the immune responses that are triggered there are of special interest.

“Given that many infected people remain asymptomatic, and that a large number of those who develop symptoms suffer only mild to moderate disease, this suggests that something, somewhere, does a fairly good job of controlling the virus,” said Russell.

“Could it be that this is due to early mucosal immune responses that succeed in containing and eliminating the infection before it becomes serious? We will not know unless these questions are addressed,” he asked.

The paper recommends that studies are needed to determine the nature of mucosal secretory immunoglobulin A (SIgA) antibody responses over the course of infection, including asymptomatic or pre-symptomatic infection, and mild and moderate cases of Covid-19 disease.

In addition, the authors point out that the mucosal immune responses may vary depending on different age groups and populations.

 

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