COVID-vaccine: Making a wise move

Bhutan has been in discussion with international agencies for six months now over the procurement of vaccines for COVID. Recently, Lyonchhen said that the authorities are closely discussing procuring the Oxford-Astrazeneca vaccine developed by India and also enough vaccines for 20% of the population through the Global Alliance for Vaccines and Immunizations’ COVAX facility. Reportedly around 1mn-1.2mn doses would be required to vaccinate the country’s entire population.

Currently, five vaccines have been approved for COVID-19: the US-Germany collaboration Pfizer-BioNtech, and US-produced Moderna vaccines with efficacy of 95% each; Oxford-Astrazeneca and Covaxin produced by India and China’s CoronaVac with an efficacy of 50%.

Now, the standard for vaccines is an efficacy of 78% but the Oxford-Astrazeneca depending on the levels of dosage administered is 62%-90% effective while the Chinese vaccine does not meet the international standard. There is one other vaccine developed by Russia-the Sputnik-V with a supposed efficacy of 91% but it was rushed and developed in August 2020 so even the Russian folks are skeptical about taking the vaccine.

Now, the question would be: which vaccine would be best for Bhutan and how could we possibly procure it? Seeing that Bhutan has no choice but to depend on donors and other intermediary agencies, the cost of vaccines and availability would play a huge factor here. Further, the fact that India has its own two vaccines (though Covaxin is mired in controversy because it was given emergency use approval without completing its third phase of clinical trial), and it has promised to support Bhutan in its vaccination drive could play another major role in the choice of vaccine the country would opt for. The US-based vaccines also need deep freezing storage so this could involve problems with logistics including huge transportation costs. But the COVAX facility could possibly make these available for 20% of the population which means that it would probably be used on the priority population of frontliners, the elderly, those with comorbidities, business people and public-transport drivers.

WHO has stated that the COVID vaccines will not be able to develop herd immunity immediately and there is very limited supply of vaccines for the global population. However, Bhutan’s advantage is that it has a limited population. Additionally, proactive intervention from the authorities to contain the virus has helped. Efforts on such a huge scale are not going to be flawless but every lesson learnt will teach us how to manage future crises together.

However, one important lesson we can already learn is that some countries which placed huge orders of vaccines without pre-emptying their efficacy are regretting their decisions like Brazil that ordered CoronaVac from China. Though we blame the government for being too slow in procuring vaccines, in hindsight, they might actually have made a wise move, knowingly or not, by choosing to wait. Now that there are a variety of vaccines to choose from, not ignoring the fact that our choice is limited because of underlying factors, we can still ruminate about the best choice from the alternatives we do have.

While rashness can get us into trouble so can delaying indeliberately. Therefore, the government must take it into their hands to do thorough groundwork on the matter and make a move that is viable for the nation in every respect.