Securing C-19 vaccine to move from new normal to new future
Finally, the COVID-19 vaccine is here, and may be, this will end the recently acquired new normal. Pfizer COVID-19 vaccine has shown the fastest track record of development of a vaccine for human use and most importantly, it is not just one vaccine candidate that people will be relying on. This is a remarkable progress made by the scientific community, where a handful of frontline vaccine candidates showing comparable efficacy and likely to receive emergency approval by the FDA for mass vaccination. As a matter of fact, an effective vaccine is expected to bring the world back to normal. Scientists have done their job successfully, now it is our responsibility at the government level how to secure COVID-19 vaccine for the emergency use.
It was highly commendable in the developed countries when given full support to the research laboratories to find a suitable vaccine candidate that could potentially end the current pandemic in this world. Unfortunately, there was not much a country could have done except shutting down the economy in an exchange of saving people's life. Given that the conditions forced us to stay home, each country sought for short-term to long-term solutions. Therefore, even before approval of COVID-19 vaccines, all developed countries have already pre-ordered nearly 10 billion doses to protect the health of its people.
An unequal race leaving billions left behind in developing countries: The potential production capacity of 10 frontline vaccine candidates is around 10 billion doses by 2021. To vaccinate 7.5 billion people in the world, it will require 15 billion doses (two doses per person) of vaccines. High-and middle-income countries have confirmed the required amount through a pre-order agreement with manufacturing companies. Billions of people in 92 low-middle and low-income countries could be deprived of the COVID-19 vaccines due to unequal competition. According to research conducted by the Duke Global Health Innovation Center, many low-middle and low-income countries may have to wait until 2023-2024 for vaccines, therefore, Bangladesh must move immediately to secure the COVID-19 vaccine doses required to vaccinate its population.
When can Bangladesh get enough vaccines?
The Government of Bangladesh has recently entered into an agreement with the Serum Institute, India to procure the Oxford-AstraZeneca vaccine. According to the agreement, 30 million doses will be provided to Bangladesh. The Serum Institute has also entered into agreements with several other countries and the World Task Force (named COVAX). Serum Institute also has to meet the demand of India as a producing country. Considering all these factors, Bangladesh may get the Oxford-AstraZeneca vaccine by the end of 2021. More importantly, with the procured 30 million doses, only 1.5 crore people (8.8%) can be vaccinated.
On the other hand, the COVAX initiative mediated by the World Health Organization (WHO) and GAVI has been established with a primary objective for equitable vaccine distribution among developed and developing countries. COVAX's goal is to procure 2 billion doses by 2021 to vaccinate 20% of the population in each country (high-risk groups). The first target is to vaccinate 3% (health and social workers) population and then scale up to 20%. So far COVAX has only pre-ordered 500 million doses. Due to the unfortunate and unequal pre-order competition, COVAX is likely to deviate from its original purpose and target. Therefore, Bangladesh must not rely only on COVAX to get the required number of doses and pre-order is absolutely necessary.
Recently, Adar Poonawalla, the chief executive of the world's largest vaccine manufacturer, Serum Institute, has warned that not enough Covid-19 vaccines will be available for everyone until the end of 2024. "It's going to take four to five years until everyone gets the vaccine on this planet".
Does everyone need to be vaccinated now?
"COVID-19 vaccine for all"- it is completely understandable to have vaccine ASAP. But the reality is that vaccine is not reachable for many countries in next few months as for mass vaccination. Do all need vaccines? "NO". Absolutely not. There are people, who are more vulnerable, and should get the vaccine when available. We need to be honest and respectful to the list of people who are deemed to be the first. The second most important thing is that the government must do to offer COVID-19 antibody titer testing. If anyone has antibody titer, he/she could avoid this rush of vaccination.
It is possible that some of us got past COVID-19 and some got recent and might have antibody titers. It is also possible that we may not see any titer even was positive for the COVID-19. In any of the cases, keep your patience and wait for your time to be vaccinated. Once this is done, a country can already reduce the number in the list who might need to be vaccinated after the frontline workers and older groups.
Why is it necessary to order in advance?
It is the responsibility of the government to ensure the health of the people. Moreover, the issue of 'COVID-19 vaccine passport' is circulating in the world media. All developed nations will take every effort to ensure that the horror of the COVID-19 pandemic comes back. Millions of Bangladeshis go abroad for business, employment and education. Without vaccination, we may not be allowed to travel abroad and therefore, the economy will be impacted heavily. So, the government has to act smartly to secure required doses of COVID-19 vaccines to protect human lives and to save the economy of the country.
Dr Rezaul Karim is an immunologist and former project lead at WHO-Utrecht Centre of Excellence for Affordable Biotherapeutics, The Netherlands.
Dr M Shamsul Alam, Immunologist working at the National Institutes of Health, USA.
Dr Jubayer Rahman. Immunologist working at the National Institutes of Health, USA.
Dr Md Anwar Hossain, Vice-Chancellor, Jessore University of Science and Technology, Researcher on vaccine development.
Dr Mohammad Sorowar Hossain, Former Senior Manager (R&D), Biotech Division, Incepta Pharmaceutical Ltd; Associate Professor, Independent University, Bangladesh; Executive Director, Biomedical Research Foundation, Bangladesh