Uttam Maharjan

The vaccination campaign against COVID-19 began in Nepal on January 27. Since then, over 2.50 million people have received the first shot, which represents over 8.33 per cent of the total population. And 1.12 per cent of the population has been fully vaccinated. At first, frontline workers, including healthcare workers, security personnel and janitorial staff, got the shot. Then, the elderly over 55 and 65 were prioritised. The government has planned to vaccinate 72 per cent of the population through the COVAX facility and other means like procurement through government to government agreements, diplomatic channels and direct procurement agreements.
Procuring vaccines in sufficient quantities is an uphill task. The inability of Nepal to procure Covishield vaccines from India has been a setback for its vaccination campaign. A large number of people who have received the first shot of the vaccine and are waiting for the second shot have been stranded. Although the United Kingdom showed its readiness to supply 1.5 million doses of Oxford-Astra-Zeneca vaccines the other day, when the country will receive them is still up in the air.

Procurement
The government has changed in Nepal. Now Sher Bahadur Deuba has taken over the reins of the government. The new government, like the Oli government, has prioritised the procurement of vaccines. For this, the government has approved a budget of Rs. 5 billion for the procurement of vaccines, a budget of Rs. 961 million for the management of ICUs and HDUs, a budget of Rs. 524 million for the mobilisation of state and local governments and a budget of Rs. 564 million for various COVID liabilities and COVID risk allowances. These are the good gestures on the part of the new government.
Nepal has been administering Covishield and Vero Cell vaccines to its people. Covishield is manufactured in India, whereas Vero Cell is a Chinese product. Now, the country has received 1.5 million doses of Johnson & Johnson vaccines. The vaccines are being administered to certain targeted groups of people: people aged 50 to 54; the disabled; the refugees living in Nepal; and healthcare workers and janitorial staff working in the health sector who have not received the jabs yet.
The Janssen vaccine, as it is otherwise called, was developed by Janssen Vaccines, Leiden, the Netherlands and its Belgian parent company Janssen Pharmaceutical, a subsidiary of the American company, Johnson & Johnson. The vaccine has been authorised for emergency use by the US Food and Drug Administration. And it has been authorised for conditional marketing by the European Medicines Agency and the UK Medicines and Healthcare Products Regulatory Agency.
The Janssen vaccine is cheaper than Pfizer and Moderna vaccines as it requires just a single dose. Unlike Pfizer, Moderna, Covishield and Vero Cell vaccines, a booster dose need not be given. As such, it may be useful for lower- and lower-middle income countries, where the rate of inoculation is dismally low. Further, it may be helpful for the homeless, prisoners and refugees. These are the groups difficult to contact for the second booster shot. However, the technology of manufacturing the vaccines is similar to that used for Sputnik V and Oxford-Astra-Zeneca vaccines.
The Janssen vaccine is easy to store, transport and distribute. It can be stored at temperatures of 9 to 25 degrees Celsius for up to 12 hours. However, it can keep for months in a standard refrigerator. It need not be shipped or stored frozen, which is one of benefits vis-à-vis other vaccines like Pfizer-BioNTech and Moderna vaccines. The Janssen vaccine can be administered to people aged 18 and above.
Like other vaccines, the Janssen vaccine is also shown to produce some side reactions. A study shows that 97 per cent of the reported side reactions are mild to moderate. Such reactions may occur two days after the vaccination but are found to wear off within one or two days. The most common side reactions include pain or swelling in the injection site, headaches, fever, chills, muscle pain, weakness and the like. Rare side reactions like hypersensitivity and an itchy rash are found in less than one in 1,000 people.
A serious side reaction has also been found in people after the vaccination. Formation of blood clots in the blood vessels, together with thrombopaenia (a low count of platelets), has also been reported. However, it has been found in only seven out of a million women aged 18 to 49. This condition rarely occurs in women 50 or above in age. Such a side reaction has not been observed in people receiving Pfizer-BioNTech or Moderna vaccines.

Side reaction
Another side reaction that can occur is anaphylaxis. But this condition is rare. In May, when 7.98 million doses of the Janssen vaccine had been administered, the Centres for Disease Control and Prevention (CDC) reported four cases of anaphylaxis with no deaths. However, three deaths were reported in 28 cases of cerebral venous sinus thrombosis. Furthermore, there is an increased risk of developing Guillain-Barre syndrome during 42 days after the vaccination.
Every vaccine or drug has some side reactions. The side reactions associated with the Janssen vaccine are not serious. There may be grave side reactions only in rare cases. COVID-19 has been playing havoc with human lives and the world economy as a whole. It has been overdue to control the disease at any cost. At present, herd immunity seems to be the only viable means for curbing the disease. Vaccination is the best means for developing herd immunity in people.
At a time when Nepal is reeling from a shortage of vaccines, the arrival of Janssen vaccines has proved to be a boon. The target of inoculating 72 per cent of the population within a year or so can be achieved only when the country can arrange for sufficient quantities of vaccines.

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