2021
DOI: 10.1101/2021.03.27.21254453
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How unequal vaccine distribution promotes the evolution of vaccine escape

Abstract: In the context of the ongoing SARS-CoV-2 pandemic, health officials warn that vaccines must be uniformly distributed within and among countries if we are to quell the pandemic. Yet there has been little critical assessment of the underlying reasons for this warning. Here, we explicitly show why vaccine equity is necessary. We begin by drawing an analogy to studies showing how disparities in drug concentration within a single host can promote the evolution of drug resistance, and we then proceed to mathematical… Show more

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Cited by 15 publications
(23 citation statements)
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“…Likewise, the gradual roll-out of vaccination programs globally is changing the immunological landscape, possibly leading to the emergence of escape strains that are partially or fully resistant to existing vaccinations [8,9,10]. Although this effect may be slowed by greater and more equitable vaccination [11,12], new variants will likely continue to emerge into the future. Identifying new genetic variants of concern as they are arising will thus continue to be important to guide vaccination and other public health strategies.…”
Section: Introductionmentioning
confidence: 99%
“…Likewise, the gradual roll-out of vaccination programs globally is changing the immunological landscape, possibly leading to the emergence of escape strains that are partially or fully resistant to existing vaccinations [8,9,10]. Although this effect may be slowed by greater and more equitable vaccination [11,12], new variants will likely continue to emerge into the future. Identifying new genetic variants of concern as they are arising will thus continue to be important to guide vaccination and other public health strategies.…”
Section: Introductionmentioning
confidence: 99%
“…And even if we knew all this, the appearance and establishment of vaccine escape mutants would still be a probabilistic event that may or may not happen. Moreover, escape mutants can also be imported from other regions (Gerrish et al,2021). When sufficient information on the effectiveness of the primer dose and the duration of immunity is known, it is hence weighing an immediate assessable benefit against an unknown future risk with unknown consequences.…”
Section: Discussionmentioning
confidence: 99%
“…Despite the extraordinarily rapid pace of vaccine development, there are currently many countries where not even a single dose has been administered. This will prolong the pandemic and promote viral evolution and escape 78 . It has also become clear that minimizing the extent of non-SARS-CoV-2 derived immunogenic sequence in the vaccine is highly desirable.…”
Section: Discussionmentioning
confidence: 99%