The Manila-based Asian Development Bank (ADB) has apportioned $25 million (around P1.2 billion) to loan out to the Philippines this year to buy vaccines for the coronavirus disease 2019 (COVID-19), while the government aims to inoculate as many as 70 million this year.
The agreement will allow the Philippine government to pay vaccine manufacturers in advance to secure the delivery of vaccines as the number of cases in the country continues to grow, with the total confirmed cases at 525,618 as of January 31.
The financing is part of the ADB's $125-million Health System Enhancement to Address and Limit (HEAL) COVID-19 Project approved in August which seeks to prevent and control the spread of the pandemic and assist the government in tests, surveillance, and infection prevention and control.
"Vaccination is the next critical step to protect lives and promote livelihood opportunities," said ADB President Masatsugu Asakawa.
"We stand ready to support the government in these unprecedented times and help the economy navigate back to its pre-pandemic growth path."
The funding will follow the vaccine access and eligibility requirements of ADB's Asia Pacific Vaccine Access Facility (APVAX) launched in December. This mandates that the vaccines must meet one of three criteria — must be procured via COVAX, prequalified by the World Health Organization, or authorized by a stringent regulatory authority.
At present only two vaccines have secured the emergency use authority: Pfizer BioNTech and British pharmaceutical firm AstraZeneca.
'Continue health standards'
The World Health organization said Monday the public should continue following minimum health standards as vaccination against COVID-19 might take several years.
Dr. Rabindra Abeyasinghe, WHO Representative to the Philippines, said “It is necessary to sustain performing hand hygiene, observing physical distancing, and wearing of face masks as these have been proven to be effective not just against the coronavirus but also in suppressing its new variants.”
"The vaccines are not going to help open the world right now. We will still need to follow all the behaviors we've been following over the last 1 year because the transmission is going to continue and we’re not going to be able to vaccinate everybody probably for another 2 years or more," Abeyasinghe said in an interview on ANC's Headstart.
"In that, we’re talking about nobody is absolutely safe until the whole world is safe."
The government is urged to continue to monitor the pandemic "very carefully and be proactive" to prevent large-scale lockdowns that have economic consequences, Abeyasinghe said.
As for face to face classes, the WHO representative said the level of virus transmission must be taken into account.
"If the pandemic transmission is decreasing, there may be an opportunity for us to open up schools. Where you're seeing increased transmission in the community, countries which opened up schools have seen a significantly higher proportion of infection among children. So this is something that needs to be weighed and balanced," he said.
"Another thing we need to factor in is congestion in schools, the access to hand hygiene."
Clear decision
The WHO does not have a "clear decision" on requiring vaccination documents to be able to travel, according to Abeyasinghe.
The international body also has yet to confirm any positions or findings about the new COVID-19 variants which reportedly are more contagious and may lead to severe cases, he added.
"It’s not surprising that we’re seeing the emergence of new variants. The critical issue is to understand what is the capacity of these new variants," he said.
"These issues are being studied jointly with WHO and the respective countries seeing those variants. Data is very premature and it needs to be carefully evaluated."
The Philippines has reported 17 cases of the UK variant of COVID-19, which is among the country's 525,618 confirmed coronavirus infections, as of Sunday.
Globally, nearly 103 million infections have so far been tallied by the US-based Johns Hopkins University, including over 2.2 million deaths.
In early December, the world's first COVID-19 vaccine shot was received by a British grandma in the United Kingdom. A few other countries, including the United States, Singapore, and Indonesia, subsequently launched their respective inoculation programs.
The Philippines will start receiving its COVID-19 vaccine supplies this month. Up to 70 million people are targeted for vaccination to achieve herd immunity against the coronavirus.
Age restriction
WHO also said it would not advise putting an age restriction for the government's COVID-19 vaccination program.
Abeysinghe said the priority was to protect the most vulnerable, healthcare workers and other frontliners.
Some 20 percent of vaccines that the Philippines will get from the WHO-backed COVAX facility is "primarily earmarked" to said groups, he added.
"We are not actually advising a cap on the age because if you look at the age groups, the mortality becomes increasingly higher as age increases. Priority is to vaccinate and protect the most elderly," he told ANC's Headstart.
Some countries began vaccination for those aged over 90 to minimize deaths, he added.
The Food and Drug Administration earlier said it might issue an advisory on the use of the Pfizer COVID-19 vaccine on "very old and very frail" individuals following 33 deaths among elderly people in Norway who received their first dose.
Norway has said no link has been established between the inoculation and the deaths but recommended doctors consider the overall health of the most frail before giving them the vaccination.
Pfizer vaccines arrival
Meanwhile, around 117,000 doses of Pfizer’s COVID-19 vaccine under the COVAX facility will arrive in the second or third week of February, Abeyasinghe said.
“The COVAX has promised that they deliver approximately 117,000 doses within the second or third week of February. These vaccines will be Pfizer-BioNTech vaccines,” he said in a press conference.
Aside from this, 5.5 to 9.2 million doses of AstraZeneca’s COVID-19 vaccine are expected to arrive in the country either in late February or early March.
However, Abeyasinghe said AstraZeneca’s vaccine was still under evaluation for Emergency Use Listing, and the evaluation could be finished in two to three weeks.
“We are potentially looking at some quantity of those AstraZeneca vaccines also reaching the Philippines either late February or early March,” he said.
On Sunday, vaccine czar Secretary Carlito Galvez Jr. announced that the Philippines would receive at least 5.6 million doses of the Pfizer-BioNTech and AstraZeneca’s vaccines within the first quarter of 2021.
Challenges still up
Abeyasinghe also commended the COVID-19 vaccination plan of the Philippine government.
However, Abeyasinghe said challenges were still possible to happen during the actual rollout, which is expected to start by February.
“I believe they have a very good comprehensive plan. What we are concerned about is oftentimes the actual rollout faces challenges although you plan very well,” Abeyasinghe said in an interview on ANC.
“This is what we have been discussing with the Department of Health in the case of logistics arrangements, and the National Task Force,” he added.
Last Saturday, the National Task Force Against COVID-19 announced that the government had approved and ratified the Philippine National Deployment and Vaccination Plan for COVID-19 Vaccines.
The task force, its regional and local COVID-19 counterparts, as well as the regional and local COVID-19 vaccination operations centers are mandated to implement and adapt the plan.
In a memorandum dated January 26, regional COVID-19 vaccination operations centers are directed to develop “macroplans” for deployment and inoculation.
Emergency use
While the COVAX Facility has confirmed that it will be sending COVID-19 vaccines to the Philippines this quarter, those coming from British company AstraZeneca will have to wait to be included in the World Health Organization’s emergency use listing.
WHO, which is a member of the COVAX Facility, an initiative that aims to ensure equitable distribution of vaccines, has so far listed only Pfizer’s COVID-19 vaccine for emergency use.
The Philippines is already set to receive 117,000 doses of the Pfizer-BioNTech vaccine in the 2nd or 3rd week of this month, and 5.5 to 9.2 million of AstraZeneca’s vaccine this quarter through COVAX.
“I am aware that the (Philippine) FDA (Food and Drug Administration) has granted EUA (emergency use authorization) for AstraZeneca as a vaccine. But WHO still hasn’t granted an EUL (emergency use listing) for AstraZeneca,” Abeyasinghe said during a DOH briefing.
"For COVAX to deliver vaccines, they must be listed under the EUL of WHO,” he said.
“We are in the process of reviewing the vaccine portfolio. We believe that that will be completed within the next week or two. So we are optimistic that the EUL status will be granted to AstraZeneca vaccine,” he added.
While the Philippines’ EUA allows a vaccine to enter the country to be used under the national immunization program, the WHO’s EUL is used as a guide by countries to expedite their own approval process.
Although, in this case, the Philippines already approved AstraZeneca by subjecting it to the review of its own scientific panels and referencing the EUA’s of other countries with stringent regulatory authorities, like the United Kingdom.
Abeyasinghe said once the WHO includes AstraZeneca in its emergency use listing, “this could potentially free up the movement of vaccines to the Philippines through the 2nd allocation in late February or March.”