By Henrylito D. Tacio
Photo courtesy of WHO
“The pandemic is still a major health crisis,” said Dr. Tedros Adhanom Ghebreyesus in his opening remarks at the media briefing on coronavirus disease 2019 (COVID-19) last January 5 at the WHO headquarters in Geneva, Switzerland.
“We have entered a new phase of the pandemic, where solidarity is needed like never before,” said Dr. Tedros, who is the WHO Director-General. “We are in a race to save lives right now.”
He said the world right now is in a “race to prevent infections, bring cases down, protect health systems and save lives while rolling out highly effective and safe vaccines to high-risk populations.”
Dr. Tedros added that only if the world acts together as one, “we can win both races and get ahead of the virus while also limiting the opportunity for the virus to mutate further and threaten the health tools we currently have.”
He was referring to the several COVID-19 vaccines now available for immunization. “One year on from WHO issuing its first Disease Outbreak News report about this virus, more than 30 countries have started vaccinating their high-risk populations with various COVID-19 vaccines,” he pointed out.
The WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) has issued its policy recommendations for the rollout of the first COVID-19 vaccine approved for emergency use, the Pfizer-BioNTech COVID-19 vaccine.
“The Pfizer-BioNTech COVID-19 vaccine is safe and effective,” SAGE pointed out. “Nevertheless, there are specific populations for whom vaccination is not recommended, either due to contraindications, lack of supply, or limited data.”
These populations currently include people with a history of severe allergies, most pregnant women, international travelers who are not part of a prioritized group, and children under 16.
“The priority is to start vaccinating health workers at high risk of exposure, followed by older adults, before immunizing the rest of the population,” the WHO said in a press statement.
In the press conference, Dr. Tedros stated: “We owe it morally to health workers everywhere who have been fighting this pandemic around the clock for the best part of a year, to vaccinate them all as soon as possible. People must come first over short-term profits. It’s in countries self-interest to shun vaccine nationalism.”
According to the WHO official, vaccinating health workers and those at high risk of serious diseases “is the fastest way to stabilize health systems, ensure all essential health services are up and running and that a truly global economic recovery can take place.”
The Pfizer COVID-19 vaccine is not for everyone though. “People with a history of severe allergic reaction to any component of the vaccine should not take it,” the statement released to the media stated.
Pregnant and breastfeeding women should not take the Pfizer vaccine. “Pregnant women are at higher risk of severe COVID-19 than non-pregnant women, and COVID-19 has been associated with an increased risk of pre-term birth,” the statement said. “However due to insufficient data, WHO does not recommend the vaccination of pregnant women at this time.”
In case a pregnant woman has an unavoidable risk high of exposure (that is, a health worker), vaccination may be considered in discussion with their healthcare provider. “It is recommended to avoid pregnancy for 2 to 3 months post-vaccination,” WHO said.
“If a breastfeeding woman is part of a group (that is, health workers) recommended for vaccination, vaccination can be offered,” WHO said, adding that it does not recommend discontinuing breastfeeding after vaccination.
As for children, the vaccine has only been tested in children above 16 years of age. As such, at this time, the WHO does not recommend vaccination of children below 16 years of age, “even if they belong to a high-risk group.”
In their study, the Pfizer vaccine has been found to be safe and effective in people with various conditions that are associated with increased risk of severe disease. This includes hypertension, diabetes, asthma, pulmonary, liver, or kidney disease, as well as chronic infections that are stable and controlled.
“Further studies are required for the impacts on immune-compromised persons,” the WHO said. “The interim recommendation is that immune-compromised persons who are part of a group recommended for vaccination may be vaccinated, though when possible, not before receiving information and counselling.”
Persons living with human immunodeficiency virus (HIV) are at higher risk of severe COVID-19 disease. However, limited safety data exists on HIV-infected persons with a well-controlled disease from the clinical trials. Known HIV-positive vaccine recipients should be informed, and when possible, counseled in relation to the available data, the WHO said.
Meanwhile, vaccination can be offered to people who have had COVID-19 in the past. “But given the limited vaccine supply, individuals may wish to defer their own COVID-19 vaccination for up to 6 months from the time of SARS-CoV-2 infection,” the WHO urged. “As more data becomes available on the duration of immunity after infection, this time period may be adjusted.”
What about those who want to travel to other countries? “At present, WHO does not support the introduction of requirements for proof of vaccination against COVID-19 for international travelers as a condition for exiting or entering a country or for travelling internationally,” WHO said.
To be more effective, a person has to be vaccinated twice. “A protective effect starts to develop 12 days after the first dose, but full protection requires two doses which WHO recommends be administered with a 21 to 28-day interval,” WHO said, adding that additional research is needed to understand longer-term potential protection after a single dose.
With the availability of vaccines, it doesn’t mean COVID-19 will also be gone. “Vaccines will not end COVID-19 alone,” the WHO said. “Safe and effective vaccines will be a gamechanger: but for the foreseeable future, we must continue to wear masks, maintain social distancing, avoid crowds and comply with other health measures.
“Being vaccinated doesn’t mean that we can throw caution to the wind and put ourselves and others at risk, particularly because it is still not clear the degree to which the vaccines can protect not only against disease but also against infection and transmission.”