Global Health Asia-Pacific March 2022 March 2022 | Page 48

Singapore
Singapore has a high vaccination rate
these countries . And the donation of these vaccines should not be done at the last possible minute .
Q . Will a fourth and then a fifth dose of the COVID vaccines be necessary or will it just be needed for at-risk people ?
A . Most people will not require the fourth or fifth dose of the current COVID vaccines . Unless there is a change in the composition of the vaccines , providing additional doses for the average man on the street offers no significant advantage . The T-cell immunity from the third dose will be adequate , and the B-cell
Singapore is relying on an array of tools to live with COVID-19 without lockdowns
specificity will not improve further with additional doses . Our current vaccines target the original ancestral strain , whereas Omicron is at least 50 mutations beyond that .
There is a role for a new vaccine composition targeting the new variants or future variants . However , this would be challenging to manufacture . As we all learnt in the past year , new variants may appear unexpectedly , right under our noses . This new variant may upend any attempts at changing the next vaccine composition .
There are now several new and promising therapies for treating COVID-19 , including Paxlovid and Molnupilavir . Which ones do you think will turn out to be the most useful to keep the disease at bay ?
A . Paxlovid will be the preferred drug for most people because of the excellent results achieved — 89 percent reduction in hospitalisation is an incredible achievement . Molnupiravir , on the other hand , suffers from a lower overall result of 30 percent reduction , and the company has yet to explain adequately the marked differences between its interim results and final results .
This drug will be used in the outpatient setting and offered at no cost to at-risk individuals , reducing the need for hospitalisation .
The challenge is identifying the right individuals . When the drug trial was conducted in unvaccinated individuals with the more severe disease-causing Delta variant , only six percent of the individuals required hospitalisation . This would be the baseline benefit . In other words , 94 percent of the individuals
46 MARCH 2022 GlobalHealthAsiaPacific . com