Aşı Paradoksu

Aşı bilindiği üzere bulaşıcı hastalıklarla mücadelede önemli bir yer tutmaktadır. İçinde bulunduğumuz pandemi sürecinde aşının hastalıkla mücadelede ne denli önemli bir silah olduğunun önemi bir kez daha anlaşılmıştır. Şu an yapılmakta olan aşı tedarik zinciri süreçleri ve aşılama stratejilerinin dezavantajlı olduğu gözlenmektedir. Aşı tedarik zincirinde yer alan “Aşı dozu üretimi” sürecinde aşı için gerekli olan yeterli antijenin üretilmemesinden kaynaklanmaktadır. Aşının bireylere uygulanabilmesi için sağlık personeline ve uygulama yerlerine ihtiyaç duyulmaktadır. Yaşadığımız bu süreçte de görüldüğü gibi toplumsal aşılamada fazla zaman ve kaynağa gerek duyulmaktadır. Pandeminin yeni tanımına bakıldığında elimizdeki kaynakların (malzeme ve insan) yetersiz kalması şeklinde yorumlanabilir. Aşı lojistiği süreçleri ve aşılama stratejilerine bakıldığında matematikte yer alan Zeno paradoksuna benzer bir aşı paradoksu ile karşı karşıyayız. Makalemizde tüm dünyanın karşı karşıya kaldığını düşündüğümüz “Aşı Paradoksu’ndan, nedenleri ve çözüm odaklı önerilerinden bahsedeceğiz.

Anahtar Kelimeler:

Pandemi, Aşı tedarik zinciri süreçleri, Aşı paradoksu, Zeno paradoksu

Vaccine Paradox

As it is known, vaccination has an important place in the fight against infectious diseases. In the current pandemic process, the importance of the vaccine as an important weapon in the fight against the disease has been understood once again. It is observed that the current vaccine supply chain processes and vaccination strategies are disadvantageous. It is caused by the insufficient production of antigen required for the vaccine in the "vaccine dose production" process in the vaccine supply chain. Health personnel and application sites are needed for the vaccine to be administered to individuals. As can be seen in this process we live in, social vaccination requires a lot of time and resources. Looking at the new definition of the pandemic, it can be interpreted as the inadequacy of the resources (material and human) we have. When we look at vaccine logistics processes and vaccination strategies, we are faced with a vaccine paradox similar to the Zeno paradox in mathematics. In our article, we will talk about the "Vaccination Paradox", which we think the whole world is facing, its causes and solution-oriented suggestions.

Keywords:

Pandemic, Vaccine supply chain processes, Vaccine paradox, Xeno paradox,

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1.Baş, FY. Pandemide Aşılamanın Önemi ve Covid-19 Aşılama Çalışmaları. Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi, 2021, özelsayı-1,245-248.
2.Bozkurt, İ., Keleş GT. COVID-19 Hastalığı Tanı ve Tedavisinde Kullanılan Laboratuvar Testleri. Manisa Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 2021, 8(2), 380-387.
3. WHO, Coronavirus (COVID-19) Dashboard. http:// https://covid19.who.int/ , 2021, (accessed 19.10.2021).
4. Arısoy ES, Çiftçi E, Hacımustafaoğlu M, Kara A, Kuyucu N, Somer A. Clinical practical recommendations for Turkish National Vaccination Schedule for previously healthy children (National Vaccination Schedule) and vaccines not included in the Schedule-2015. J Pediatr Inf. 2015, 9, 1-11.
5. Avras A. Çocuklarda Aşılamanın Önemi. Klinik Gelişim, 2012, 25, 1-3.
6. Erkekoğlu P, Köse Sbe, Balci A, Yirün A. Aşı Kararsızlığı ve COVID-19’un Etkileri. Literatür Eczacılık Bilimleri Dergisi, 2020, 9(2), 208-20.
7. Keskin F. COVID-19 Pandemisinde Aşılanmanın Önemi.
8. Cutts F, Smith PG. Vaccination and world health. J. Wiley & Sons, 1995.
9. John TJ, Samuel R. Herd immunity and herd effect: new insights and definitions. European journal of epidemiology, 2000, 16(7), 601-6.
10. Salmon DA, Dudley MZ, Glanz JM, Omer SB. Vaccine hesitancy: causes, consequences, and a call to action. Vaccine, 2015, 33, D66-D71.
11. İngiltere Halk Sağlığı, Why vaccinate? - Public health matters. https://publichealthmatters.blog.gov.uk/2014/05/01/why-vaccinate/ , 2014, (accessed 19.10.2021).
12. Qi Lin, Qiuhong Zhao, Benjamin Lev. Cold Chain Transportation Decision in the Vaccine Supply Chain. European Journal of Operational Research, 2020, 283(1), 182.
13. WHO, Clinical Trials. https://www.who.int/health-topics/clinical-trials, 2021, (accessed 18.10.2021).
14. ClinicalTrials.gov, SARS-CoV-2 Vaccine | Phase Early Phase 1, 1, 2, 3, 4 - Search Details. https://clinicaltrials.gov/ct2/results/details?cond=SARS-CoV-2+Vaccine&phase=01234 ,2021, (accessed 19.10.2021).
15. ClinicalTrials.gov, SARS-CoV-2 Vaccine | Phase 3 - Search Details. https://clinicaltrials.gov/ct2/results/details?cond=SARS-CoV-2+Vaccine&term=&cntry=&state=&city=&dist=&phase=2 ,2021, (accessed 19.10.2021).
16. ClinicalTrials.gov, SARS-CoV-2 Vaccine | Phase Early Phase 1, 1, 2, 3, 4 - Search Details. https://clinicaltrials.gov/ct2/results/details?cond=SARS-CoV-2+Vaccine&phase=01234 ,2021, (accessed 19.10.2021).
17.Balaban, BG., Tanyeri, Y., Tokyay, BK., İslambey, S., Şerefoğlu, B., Yolalan, G., Koç, RÇ. SARS-CoV-2’ye Karşı Geliştirilen Aşılar ve Üretim Metotları. Türkiye Sağlık Enstitüleri Başkanlığı Dergisi, 2021, 2, 14-32.
18.Kazak, A., Hintistan, S., Önal, B. Dünyada ve Türkiye’de COVID-19 Aşı Geliştirme Çalışmaları. Manisa Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 2020, 7(4), 571-75.
19. Duijzer, LE., Jaarsveld van W., Dekker R. Literature Review: The Vaccine Supply Chain. European Journal of Operational Research,2018,268(1),175.
20. McClung, N., Chamberland, M., Kinlaw, K., Matthew, D.B., Wallace M,Bell, B.P. The Advisory Committee on Immunization Practices’ ethical principles for allocating initial supplies of COVID-19 vaccine—United States, 2020. Morbidity and Mortality Weekly Report. 2020, 69(47), 1782.
21. Omer, S., Faden, R., Kochhar, S., Kaslow, D., Pallas, S., Olayinka, F. WHO SAGE roadmap for prioritizing uses of COVID-19 vaccines in the context of limited supply. World Health Organization,2020.
22. Ball, P. “The Lightning-Fast Quest for COVID Vaccines - and What It Means for Other Diseases,” Nature, 2021, 589, 17.
23. Jamey Keaten. WHO: 10% of world’s people may have been infected with virus, https://news.yahoo.com/10-worlds-people-may-infected-114759146.html/ , 2021, accessed (12.12.2020).
24.Moore, KA. “COVID‐19: The CIDRAP Viewpoint, Part 1,The Future of the COVID‐19 Pandemic: Lessons Learned from Pandemic Influenza. CIDRAP, University of Minnesota, 2020, pp.5.
25.Çevik, VA., Tarihin En Kapsamlı Soğuk Zincir Uygulaması: Koronavirüs (Covid-19) Aşısının Lojistiğinde Karşılaşılan Zorluklar. Üsküdar Üniversitesi Sosyal Bilimler Dergisi, 2021, 12, 155-204.
26. D So, A., Woo, J. Reserving Coronavirus Disease 2019 Vaccines for Global Access: Cross Sectional Analysis. Bmj, 2020, 371, 1.
27. Euronews.com. Global COVID Vaccine Inequality becoming More Grotesque Every Day, WHO Warns Euronews, https://www.euronews.com/2021/03/22/global-covid-vaccine-inequality-becoming-more-grotesque-every-day-who-warns/ ,2021, (accessed:27.08.2021).
28. Marie O’Halloran. Taoiseach Warns against Global Interruption of Vaccine Delivery, https://www.irishtimes.com/news/politics/taoiseach-warns-against-global-interruption-of-vaccine-delivery-1.4518904/ ,2021, (accessed:28.08.2021).
29. The Economist. American Export Controls Threaten to Hinder Global Vaccine Production, https://www.economist.com/science-and-technology/2021/04/22/american-export-controls-threaten-to-hinder-global-vaccine-production/ ,2021, (accessed:28.08.2021).
30. The Economist. Almost One Billion Doses of Covid-19 Vaccines Have Been Produced. https://www.economist.com/international/2021/03/31/almost-one-billion-doses-of-covid-19-vaccines-have-been-produced/ ,2021, (accessed:27.08.2021).
31.Durhan, G., Bir Mantık Problemi Olarak Paradoks. Mantık Araştırmaları Dergisi, 2019, 2, 21-37.
32.Lynds, P., Zeno Paradoxes: A Timely Solution, http://www.quantum-gravitation.de/media/f483977d7e58f426ffff8253ffffffef.pdf/ , 2018, (accessed:25.03.2019).
33.Uchoa, P., BBC Dünya Servisi, Covid-19 aşısı: Şu ana dek üretilen 2 milyar doz kimlere yapıldı? https://www.bbc.com/turkce/haberler-dunya-57322642/, 2021, (accessed:18.10.2021).
34.Davis, SS., Nasal Vaccines. .Drug Deliv. Rev.,2001, 51, 21-42.
35.Almeida, AJ., Alpar, HO., Nasal Delivery of Vaccines. J. Drug Target.,1996, 3, 455-467.
36.Childers, KN., Tong, G., Mitchell, S., Kirk, K., Russel, M.W., Michalek, S.M., A controlled clinical study of the effect of nasal immunization with a Streptococcus mutans antigen alone or incorporated into liposomes on induction of immune responses Infect Immun., 1999, 67, 618- 623.
37.Baca-Estrada, ME., Foldvari, M., Snider, M., Harding, K., Kournikakis, B., Babiuk, LA. and Griebel, P., Intranasal immunization with liposome-formulated Yersinia pestis vaccine enhances mucosal immune responses. Vaccine, 2000, 18, 2203-2211.
38.BharatBiotech. BBV154, https://www.bharatbiotech.com/intranasal-vaccine.html/, 2021, (accessed:03.06.2021).
39.Özdarendeli, A. Covid-19 ve Aşı Çalışmaları [PDF belgesi]. Covid-19 Data Portal Turkey, https://covid19.tubitak.gov.tr/sites/default/files/inline-files/aykut-ozdarendeli_inaktif.pdf/, 2020, (accessed:03.06.2021).
40.Mestecky, J., Moldoveanu, Z., Michalek, S.M., Morrow, C.D., Compans, R.W., Schafer, D.P. and Russell, M.W. Current options for vaccine delivery systems by mucosal routes. V. Control. Rel,1997, 48, 243-257.
41. O'Hagan, DT. Microparticles and polymers for the mucosal delivery of vaccines. Adv. Drug Deliv. Rev., 1998, 34, 305-320.
42.Marcelino, I., Vachiéry, N., Amaral, A. I., Roldão, A., Lefrançois, T., Carrondo, MJT. Effect of the purification process and the storage conditions on the efficacy of an inactivated vaccine against heartwater. Vaccine, 2007, 25(26), 4903–4913.
43.van Riel, D., & de Wit, E. Next-generation vaccine platforms for COVID-19. Nature Materials, 2020 , 19(8), 810–812.
44.Dizbay, İE., Öztürkoğlu, Ö., Aşı tedarik Zinciri Süreçleri: Karşılaşılan Sorunlar ve Dijital Çözümler. Journal of Yasar University, 2021, 16/62, 922-944.
45. Liang, Z., Zhu, H., Wang, X., Jing, B., Li, Z., Xia, X. Adjuvants for Coronavirus Vaccines. Frontiers in Immunology, 2020,11.