Antibody testing could transform the distribution of the Covid-19 vaccine – .

Antibody testing could transform the distribution of the Covid-19 vaccine – .

The writer is co-director of the Institute of Global Health Innovation at Imperial College London and chairman of the Preventive Medicine and Health Safety Initiative at Flagship Pioneering, the bioplatform company that founded vaccine maker Moderna.

As countries in the north of the world step up their vaccination programs against Covid-19, the world’s poorest countries are being left behind. While most of the world’s population has yet to receive a single dose, some countries are already planning booster shots for the end of the year.

A new strategy could unleash hundreds of millions of doses from advanced economies to less developed countries. Rather than offering reminders to the entire population, countries could set up screening programs to protect against Covid-19. Antibody levels would be tested and quantified, and booster shots would only be offered to those who needed them.

While antibodies are not a perfect measure – the body has an alternate system called T-cell immunity that can provide protection even when antibodies go undetected – scientists know that individuals with Covid antibodies- 19 at or near vaccine-induced levels are protected against serious disease.

People with enough antibodies do not currently need an extra dose that could be given to those who are not vaccinated. Indeed, the inhabitants of the rich countries could be invited to “donate” their dose of reminder to those of the poorest countries – an act of solidarity on a global scale.

A recent opinion poll conducted by YouGov for the Institute for Global Health Innovation at Imperial College revealed broad public support for this approach on both sides of the Atlantic. Nearly four in five Britons and more than two-thirds of Americans said they would be happy to donate their booster dose to poor countries if a test showed they did not need it themselves.

Mass testing programs that seek to identify active Covid-19 infections could be redeployed for quantitative antibody testing as initial vaccination programs are nearing completion. Most advanced countries have already invested in infrastructure that would better prioritize the limited doses available around the world.

Never before has the world needed 10 billion doses of vaccine as quickly as possible. With Covid-19 having spread to every country in the world, the whole world must now be vaccinated, which means effective distribution is essential.

Much emphasis has been placed on intellectual property as the biggest obstacle to increasing production and distribution. If only it was that easy. The problems are practical rather than intellectual. Vaccine manufacturing is technically complex, so it takes time to get new facilities up and running. And it’s not just the final stage of manufacturing – there are global shortages of the biochemicals that go into vaccines. Focusing on intellectual property is a distraction from other strategies that could make a difference immediately.

This is because AstraZeneca has cleared its Covid-19 vaccine to be produced at cost by the Serum Institute of India and others. Moderna, meanwhile, announced in October 2020 that it would not apply its patents covering Covid-19 vaccines based on its mRNA technology during the pandemic, so others can benefit. This announcement was in fact a unilateral waiver of the application of patents.

Governments and businesses are scrambling to increase vaccine supply as quickly as possible; there is no disagreement that it is both necessary and desirable. But it will take time, which means there will be shortage in the short term. Introducing antibody testing – so that booster doses are distributed around the world based on need rather than nationality – is one strategy that could help end this terrible pandemic sooner.


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