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The development, manufacture, and deployment of new vaccine technologies to combat SARS-CoV-2 enabled an unparalleled rapid response to the emerging health threat. However, the unequal global distribution of these vaccines highlighted a major gap in existing thermotolerance profiles and cold chain infrastructure that needs to be addressed to maximize their global health impact.

A Quick Assessment of Vaccine Hesitancy approach was developed to collect population insights on vaccination hesitancy for low resource environments. Insights into COVID-19 vaccine hesitancy were collected through online webinars with heads of healthcare departments and anonymized online surveys of healthcare managers (HCM) and primary healthcare workers (HCW) in four countries in Central and West Asia (Armenia, Georgia, Tajikistan, and Kyrgyzstan) between 28 February 2022 and 29 March 2022. From the responses to the survey some key themes identified that underpinned in vaccine hesitancy across the region were perceived understanding of vaccine efficacy, conflict with individual religious beliefs, concerns for side effects, and the relatively rapid development of the vaccine and that improving communications strategies to address these concerns would be critical in combatting vaccine hesitancy through any future public health emergencies., Competing Interests: SA, AB, JH, DP, HR, SL, GR, and LK were employed by Crown Agents. BC was employed by Asian Development Bank., (Copyright © 2023 Adambekov, Bongers, Hare, Popovic, Rajashekharaiah, Lawson, Riggall, Kokareva and Chin.)

The ability to support a comprehensive vaccine research and development (R&D) portfolio from a health security perspective has taken on enhanced significance over the past 3 years whereby countries that had existing vaccine R&D infrastructure (G7, Russia and China) have been at the forefront of global efforts to combat COVID-19. Few countries outside of these key players have the infrastructure necessary to develop national vaccine programs, though this is beginning to change with investment across many low- and middle-income countries. These same opportunities exist for countries in Central and West Asia, and in this perspective, we highlight the existing infrastructure and expertise across seven countries (Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Tajikistan, and Uzbekistan) and propose opportunities for enhanced collaboration along with a bold proposal for establishing a new-build, regional vaccine translational research institute to facilitate the development of a robust, regional vaccine R&D environment to combat existing and future health challenges., Competing Interests: Authors JH, GR, AB, and LK were employed by Crown Agents. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Hare, Riggall, Bongers, Ramesh, Kokareva and Chin.)