Uttam Maharjan

With the coronavirus showing no sign of abatement, medical scientists and researchers all over the world are trying to develop COVID vaccines. Some pharmaceutical companies have notched up remarkable success on this front as evidenced by the fact that some vaccines are in the last testing stages.
Forerunners in the development of COVID vaccines are, however, in developed countries, laying bare the gap between healthcare and health research facilities and expertise between developed and poor countries. Some of the pharmaceutical companies holding the limelight now are Pfizer, BioNTech, Moderna, AstraZeneca, Wuhan Institute of Biological Products, Sinopharma and Gamaleya Research Institute of Epidemiology and Microbiology.
Recently, AstraZeneca, a British drug maker, has announced that the COVID-19 vaccine it developed in collaboration with Oxford University has a 70 per cent effectiveness rate. The vaccine is cheaper to make, easier to distribute and faster to scale up than the ones developed by other companies like Pfizer, Moderna and Gamaleya Research Institute of Epidemiology and Microbiology. AstraZeneca intends to manufacture 200 million doses of the vaccine by the end of 2020, 700 million doses by the end of the first quarter of 2021 and three billion doses by the end of 2021. The cost per vaccine is cheap at three to four dollars per dose vis-à-vis 25 dollars or more for the vaccine developed by Moderna.

Vaccine exigency
As COVID is still raising its ugly head in almost all the countries and territories, the need for vaccines has been exigently felt across the world. AstraZeneca is trying to make available COVID vaccines as early as possible. It is planning to bring the vaccine to the market in January, February and March 2021. The vaccine is said to be 70 per cent effective. In clinical trials, one group of 8,895 volunteers were given two full doses of the vaccine one month apart, while another group of 2,741 volunteers were given half a dose and a full dose. The effectiveness rate was found to be 62 per cent in the first group and 90 per cent in the second group. The reason for higher effectiveness with half a dose followed by a full dose is not fully known.
Unlike the vaccines developed by Pfizer and Moderna, the AstraZeneca vaccine can be stored at refrigerator temperatures, whereas the Pfizer vaccine has to be stored at minus 70 degrees Celsius temperatures, and the Moderna vaccine at minus 20 degrees Celsius temperatures. So there may not be problems with transportation, storage and distribution of the AstraZeneca vaccine. This is another advantage of the vaccine over its rival candidates.
The vaccines developed by Pfizer, Moderna and AstraZeneca have to be given in two doses. Moderna and Pfizer adopt more or less the same approach. The Moderna vaccine needs to be given in two doses four weeks apart, whereas the Pfizer vaccine needs to be given in two doses three weeks apart. The Pfizer vaccine needs to be transported in a special box packed in dry ice (solid carbon dioxide) and equipped with GPS trackers. Due to some advantages over rival vaccines, the AstraZeneca vaccine has engendered the hope that even poor countries which do not have copacetic health infrastructure such as cold storage for vaccines can take advantage of the vaccine so as to cope with the COVID pandemic. Although the effectiveness rate of the vaccine is 70 per cent, this is considered satisfactory as the Food and Drug Administration of the USA has announced that it will allow the use of a vaccine that has an effectiveness rate of 50 per cent or above for the general public.
Vaccination is important in preventing a disease. Even if a person who has taken a COVID shot has been infected with the virus, he will be protected from serious symptoms. AstraZeneca has reported that the volunteers that developed the coronavirus during the trials did not have to be hospitalised and no serious cases were detected. As per the company, vaccinated people develop fewer asymptomatic infections and are less likely to transmit the virus to other people.
Before administration of any COVID vaccine to people, it is important that trials show that the vaccine is safe to use, the vaccine be manufactured in huge quantities to cope with surging cases, the vaccine be approved by the regulatory bodies before use and the duration of the protection the vaccine gives against COVID be ascertained.
At a time when all the countries in the world are falling over themselves to procure COVID-19 vaccines (some developed countries have made deals with pharmaceutical companies that will roll out the COVID vaccine in the foreseeable future), Nepal has also made preparations for the procurement of the vaccines. To facilitate the procurement, the government has revised relevant laws through the Medical Ordinance. The government has set up a fund of Rs. 50 billion to procure the vaccines as soon as they are available for public use after approval by the regulatory bodies. The government has sent diplomatic notes to the countries producing the vaccines. The government is also holding discussions with various pharmaceutical companies on acquiring vaccines suitable for the country.

Fair distribution
The country has established its own standard, according to which the vaccines that can be stored at the refrigerator temperatures of 2 to 8 degrees Celsius need to be procured. So AstraZeneca vaccine will be suitable for the country, as the country lacks cold storage facilities for storing vaccines like those developed by Pfizer ultra-cold temperatures. The country is also bracing for procuring vaccines under the WHO-initiated Covax campaign and other vaccines produced by pharmaceutical companies. The WHO has announced that vaccines will be distributed even to poor countries like Nepal under the campaign on the principle of fair and equitable distribution and the country is expected to get vaccines for 20 per cent of the population.
The country is planning to procure COVID vaccines at concessional rates, too. There is a taskforce consisting of secretaries from Health, Finance and Foreign Affairs Ministries that will look after the procurement of necessary vaccines. The taskforce will also get help from various expert groups. Given the initiative taken by the government, the prospects for COVID vaccines arriving in the country are growing. The sooner the vaccines arrive, the better.

(Former banker, Maharjan has been regularly writing on contemporary issues for this daily since 2000. uttam.maharjan1964@gmail.com)