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Friday, March 29, 2024

Vaccines as a booster

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"Even if we do get inoculated, we should still remain careful."

 

With the arrival of close to a million doses of COVID-19 vaccines (about half a million each from AstraZeneca and Sinovac), courtesy of the COVAX facility, we are now part of the growing list of countries – 50 out of the 193 UN member countries — rolling out their vaccination plans. Though quite late among ASEAN member nations (only Laos, East Timor and Malaysia have yet to do their first inoculations), we remain hopeful that by yearend we should be able to vaccinate at least 20 percent of our population or 20 million people. That means that by then we have secured and used up 40 million vaccines if we go by the existing metric of two doses per person. That should not be a big problem at all if we are to finally take the word of the officials in charge of this massive operation.

The only problem is the vaccines may not be available as hoped for. As of February, reports have it that the seven accredited manufacturers, Pfizer/BioNTech, Moderna, Oxford/AstraZeneca, Sinopharm, Sinovac, Gamaleya (Sputnik) and Novavax, could only commit to a maximum of five billion doses this year, almost half of which already committed to the host countries (US, UK, European Union) and of course, China and India – although the latter two have advised that they may be able to ramp up production to accommodate their committed buyers.

The case of the state-owned manufacturer Sinopharm is instructive. As part of its “vaccine diplomacy” the Chinese government has committed to supply as many vaccines to as many countries which need these. In implementation of that pledge, Sinopharm even had to conduct its final clinical trial with the assistance of the United Arab Emirates (UAE) and was able to convince the UAE health authorities to issue an emergency use authorization for its vaccine.

The latest report we have is that Sinopharm’s initial shipment to the UAE has been slow in coming so the host government had to look around for alternative suppliers in the meantime. The same is true with Egypt and Morocco, both of whom also participated in the Sinopharm trials like the UAE but were only able to get 40,000 does and 500,0000 doses, respectively. Notwithstanding that hiccup, the company has committed to deliver more than 500 million does just to eleven countries (Indonesia 125 million, Brazil 100 million, Chile 80 million, Turkey 60 million, Egypt 40 million, US 40 million, Morocco 40 million, Peru 38 million, Philippines 25 million, UAE 18 million and Italy 10 million) and 10 million for the WHO/COVAX facility. This is quite apart from its mandate to provide at least 500 million for China’s own requirements. Whether it will be able to ramp up its production to meet its commitment to its own government and the other countries remains to be seen. Hopefully, it will be able to.

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A spokesman for another Chinese vaccine maker, Sinovac Biotech Ltd.—which has also signed numerous global supply contracts—pointed to the company chairman’s forecast that a second production line this month will raise annual capacity to a billion doses. Again, that remains to be seen. To be fair, China’s Foreign Ministry has said that despite huge domestic demand, the country is committed to sharing vaccines with dozens of other countries. That statement amounts to an order from the highest Chinese leadership if we go by our experience with the shortage of face masks and other medical supplies at the start of the global pandemic response operations last year.

We are advised that at that time, Chinese iPhone factories, car makers and even state-owned energy producers moved quickly to fill the gap. But making vaccines may not be as easy as there is as yet no precedent for ramping up production so quickly and on such a large scale.

One constraint is that China’s homegrown COVID-19 vaccines are based on so-called inactivated viruses, and the first step in making them is to grow the virus, which requires sophisticated laboratories. People familiar with building high-level biosafety labs and obtaining stringent regulatory approvals for them say it takes eight months, and the timeline can’t be compressed.

Medical analysts are saying that the country’s two leading vaccine manufacturers, Sinopharm and Sinovac, are unsure whether they can hit their combined target of two billion doses this year. Sinopharm has a record of producing hundreds of millions of doses annually. Sinovac, the smaller private maker, was only able to manufacture in the range of tens of millions of doses in 2019 and not much bigger last year. In addition to growing the inactivated virus, these analysts point to the availability of the glass vials that contain the vaccine which at this time local manufacturers cannot supply in the numbers needed to ramp up vaccine production to billions of doses. The country’s main domestic producer, a subsidiary of state-owned China National Building Material Co., won’t be able to increase production until the second half of the year, according to sources close to the facility’s leadership.

Of course, we can also look at the possible ramping up of production of the other possible not-yet-committed- manufacturers – India’s Bharat Tech and Serum Institute, both of which are already into vaccine manufacture: the former in contract with AstraZeneca and the latter with its own-about-to-be-licensed vaccine and Russia’s Gamaleya with its Sputnik 5. In addition, there are at least five more Indian manufacturers, Johnson & Johnson (J &J) and a Japanese and a Korean. Again, whether these companies would be able to deliver as planned is one thing we hope and pray for.

Until such time as we get firmer assurances and the vaccines roll out of the facilities, we have no other recourse but to be careful, stay well within the protocols and ensure that each and every citizen is properly informed and educated about the need to restrain themselves from undue exposures and hazards.

Yes, the vaccine roll out globally is a huge boost to our united effort to get things moving and get us up on our feet as quickly as possible. But until we get these critical items in the hands of the vaccinators and our citizens are ready to be jabbed, being on the guard and practicing protocols remains the norm.

In fact, even if we get jabbed, we should remain careful.

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