COVID19: Update on Treatment Pathways
Even as the world prepares for a second wave of the coronavirus pandemic, it is now clear that a return to economic and human normalcy can only be achieved through the development of a vaccine that will make it possible to contain the disease in the longer term.
and as such, trials are under way around the world, notably in British and Chinese laboratories.
These vaccine projects generate a "strong immune response" and appear to be well tolerated by patients.
The first, developed by Oxford University in partnership with the pharmaceutical group AstraZeneca, has generated the production of antibodies and T lymphocytes, two types of immune response, in a clinical trial on more than 1,000 patients.
The second project is being conducted in Wuhan (China) by researchers from several organizations. It is funded by the biotechnology group CanSino Biologics. The good news is that it also resulted in this dual immune response against coronavirus in most participants, according to a separate trial involving about 500 people.
So there is hope that an effective solution to the pandemic may emerge in the medium to long term. However, what is of concern today is the place of pharmaceutical lobbies in the implementation of this vaccine, which could potentially constitute a financial windfall for the laboratory that will hold the patent.
Moreover, the American laboratory Moderna announced on July 27 that it had begun phase 3 trials of its Covid-19 vaccine candidate on 30,000 people in the United States: half of them will receive a 100 microgram dose, the others a placebo.
To date, only one other laboratory, Sinovac of China, is as advanced, having announced on July 6 that the third and final phase of development of its vaccine is underway, in collaboration with Butantan of Brazil.
The question now is who will benefit from the implementation of this vaccine and the cost to the world's health systems.
In this respect, the HAS (French High Authority for Health) is working to define the strategy best suited to the French situation, which will govern the use of vaccines as soon as the first vaccines come on the market, taking into account the availability of doses.
With a view to assisting public decision-making, the HAS anticipates possible vaccination scenarios in France and makes preliminary recommendations on the populations considered to be priorities for vaccination in a production context fraught with strong uncertainties regarding both the evolution of the epidemic and the characteristics of the vaccines being developed.
In accordance with its framework note, and in response to the referral from the Director-General for Health on 13 July, the HAS has begun to consider, in advance of the phase, a vaccination strategy against SARS-CoV-2 that could be recommended in France when the vaccines become available. It is also anticipating several vaccination scenarios based on the possible evolution of virus circulation in France, but also on the arrival of vaccines and the characteristics of the vaccines developed, and in particular, their capacity either to protect against infection or to reduce the severity of the disease, their safety and the number of doses that will gradually be made available.
These vaccines, once they have demonstrated their safety and efficacy, will constitute, in addition to the indispensable barrier measures and possible alternative treatments, the best tool for preventing and combating the pandemic.
To sum up, the juicy vaccination jackpot is worrying despite the fact that vaccination seems to be the best remedy for this pandemic.
Laurence HIRR

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