Recovery, Renewal, Resilience

COVID-19 vaccination rollout is taking place in many countries, with many more planning to implement mass vaccination strategies for in the near future. The widespread nature of the pandemic has meant that huge numbers of people require vaccination, and a result, demand for vaccines currently far outstrips supply in some countries[1]. Fear surrounding COVID-19 has led to criminals utilising black markets to develop and sell fake vaccinations on the dark web[2]. The demands on government vaccination programmes has also promoted the online sale of other fake medicines such as the malaria drug hydroxychloroquine and the steroid dexamethasone[3] as these have been associated with COVID-19 treatment. In other cases, some online vendors were claiming to sell vaccinations or medicines that would have never been shipped to buyers[4],

And in the UK, there were incidents of scammers turning up at people’s doorsteps offering a vaccine for payment, following a spate of fake text messages[5].

Vaccines are a financially lucrative commodity, and while the pharmaceutical industry is prepared with regular audits and vetting of supply chains, minimising human contact, stops and handovers during distribution, and real-time digital devices which measure temperature and location, there are other risks. Some of those at risk include:

• Desperate consumers believing they can purchase the vaccine online
• Hospitals and healthcare facilities that have been hit with a barrage of phishing and ransomware attacks which can try to sell fake vaccines
• Vaccination centres which may be points of vulnerability; one supply chain security expert stated “we need to tell people at the vaccine centres that they carry gold”[6].

The rise in fake vaccines and medications requires approaches that protect people, and infrastructure.

Protecting people

• Widespread information campaigns that advise people not to buy any vaccines online, with particular focus on informing people with pre-existing health conditions or those in certain vaccine priority groups as these groups may feel an urgency to be vaccinated
• Remind people that they should consult their registered doctor about vaccination, and only be vaccinated at an official vaccination point[7] and that NHS England will never ask for bank details, Pin numbers or passwords, when contacting you about a vaccination
• Monitor online chatrooms and forums that may be regularly used by vulnerable groups to scan for attempts to sell fake vaccines and medications
• Set up and regulate certification organisations which undertake due diligence on sources of drugs (e.g. pharmacies) and medications e.g. pharmacychecker.com to create a transparent solution for the public to check the sources of their online medications to ensure their legitimacy and safety
• Work with healthcare professionals to build trust in vaccinations. The spread of fake vaccines may deter people from legitimately being vaccinated

Protecting infrastructure

• Regularly assess cyber security and train staff in recognising and reporting any phishing scams or malware attacks
• Train staff and volunteers administering vaccinations in the safe and careful disposal of empty vaccine vials which could be stolen and used to package fake vaccines that look authentic[8]
• If required, consider security at vaccination centre sites, especially those which have been set up in temporary locations or do not have adequate security systems

References:

[1] https://www.swissinfo.ch/eng/swiss-regulator-warns-of-fake-covid-19-vaccines-online/46279734

[2] https://www.japantimes.co.jp/news/2020/11/27/asia-pacific/covid-19-vaccine-china-black-market/

[3] https://iea.org.uk/will-there-be-a-black-market-in-covid-vaccines/

[4] https://www.ft.com/content/8bfc674e-efe6-4ee0-b860-7fcb5716bed6

[5] https://www.bbc.co.uk/news/uk-england-london-55577426

[6] https://www.ft.com/content/8bfc674e-efe6-4ee0-b860-7fcb5716bed6

[7] https://www.swissinfo.ch/eng/swiss-regulator-warns-of-fake-covid-19-vaccines-online/46279734

[8]https://www.dw.com/en/officials-warn-of-fake-covid-19-vaccines/a-56123830

There is much concern about the combination of coronavirus with winter flu and the effects on transmission rates and a recent report outlines concerns and plans. It recommends to plan for coronavirus during winter months by:

• Analysing current COVID-19 data to develop prevention and mitigation strategies for winter, considering the rise in other illnesses during colder weather
• Considering how mitigation strategies should protect, and pose no further disadvantages to high risk patients or communities
• Engaging with patients, carers, public and healthcare professionals with enhanced coordination, collaboration and data sharing between central and local initiatives

It also suggests considering:

• Minimising community SARS-CoV-2 transmission and impact through:
  • developing effective policies to maximise population engagement in essential control measures e.g. participation in test, trace and isolate (TTI)
  • extensive autumn public information campaigns co-produced by communities and professional organisations
  • guidance for commercial, public and domestic properties on temperature, humidity and ventilation to reduce virus transmission indoors
  • consideration of those most vulnerable to COVID-19 who are least able to heat their homes adequately in winter
• Maximise infection control and ensure that COVID-19 and routine care can take place in parallel by:
  • prioritising system-wide infection prevention and control measures
  • o providing training to use personal protective equipment (PPE) and other infection prevention and control measures
  • maximising remote consultations for hospital and community care
  • testing and quarantining patients being discharged into the community or care
  • prioritising the backlog of clinical care by clinical need, not waiting times
• Improving public health surveillance for COVID-19, influenza and other winter diseases through:
  • comprehensive, population-wide, near-real-time, health surveillance systems
  • conducting large-scale population surveys comparable data collected from hospitals and the community
  • overseeing and coordinating data centrally
• Minimise influenza transmission and impact by maximising influenza vaccination uptake