COVID vaccine recipients to be prioritized if vaccine is developed

WHO has listed around 160 COVID-19 vaccine candidates of which 137 vaccine candidates are at pre-clinical and 23 are in clinical evaluation

The health ministry has already prioritized who will get the COVID-19 vaccine in the country first if the vaccine is developed, according to health authorities.

Health Minister Dechen Wangmo said that the ministry has already discussed on prioritizing who should be getting the COVID-19 vaccine first and phase it wisely.

“It has been already prioritized,” said Lyonpo.

Lyonpo mentioned that if the vaccine comes, firstly it will be given to high-risk groups like children, pregnant mothers, people with existing medical conditions and elderly people.

In the second phase it will be given to high-risk people and who are at risk geographically.

However, Lyonpo shared that so far the ministry has not really decided how much quantity will be procured because that will really be contingent on the finances and cost of the vaccine. 

Lyonpo said that the ministry has also not particularly allocated budget for the COVID-19 vaccine but it is working towards it.

“We are at least trying to identify the source to get the vaccine budget,” said Lyonpo.

Lyonpo Dechen Wangmo mentioned that they have been lobbying to the international agencies for the vaccine, because being a small and developing country, it may be difficult to get the vaccine easily.

“We are discussing with multilateral and bilateral partners if there is a vaccine coming up; we are requesting them to get a share of it,” said the Lyonpo.

The World Health Organization (WHO) is already working on this kind of mobilization at the member state level not just each country.

“Within ourselves we are planning if the vaccine does come where we can mobilize the fund for the vaccines. We are also discussing with the Bhutan Health Trust Fund if they will be able to meet the cost of the COVID-19 vaccine; we are exploring domestically.”

She added that internationally they are trying to work with partners to procure the vaccines for Bhutan.

Microbiologist at the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) Dr Tshokey said that there is an accelerated procedure for COVID-19 vaccine development in the world.

He said that normally it takes more than 10 years to develop the vaccine. However, authorities expect the COVID-19 vaccine to be available within a year. Already there are so many vaccine claims that WHO has listed around 160 COVID-19 vaccine candidates of which 137 vaccine candidates are at pre-clinical and 23 vaccines are in clinical evaluation.

He said that any vaccine development needs pre-clinical testing on animals then clinical testing phase wise and at last monitoring the vaccine.

The stage of vaccine development includes vaccine target identification, laboratory isolation and preparation and animal trials.

Then it will undergo human trial which will be clinical trials phase wise: Phase I for safety, Phase II for exploratory efficacy, dosage and Phase III for therapeutic efficacy, comparative. The last will be monitoring Phase IV which will be mass production and marketing and post-marketing monitoring. The trial should be kept for at least three years in each stage and phase.

He mentioned that currently the vaccine called AstraZeneca or Oxford University and CanSino Biological Inc./Beijing Institution of biotech of China vaccine seem to promising. It has reached Phase III.

He mentioned that the vaccine trials at WHO would develop safe and effective vaccine for control of the pandemic.

He said that the challenges and efforts needed to rapidly develop, evaluate and produce this in scale are enormous and vital to evaluate as many vaccines as possible which cannot predict viability. There is also high level of attrition during vaccine development and increased chances of success by testing all candidate vaccines until they fail.

WHO Representative in Bhutan Dr Rui Paulo de Jesus said that WHO commits and supports their member states to ensure that each and everyone will have access to the vaccine.

He said the mechanism to ensure this is Access to COVID-19 Tools (ACT) accelerators. It is access to three main groups of commodities like diagnostic, therapist and on vaccine availability.

“We have identified in collaboration with member states to find ways how to accelerate the process. Normal vaccine development takes more than 10 years,” he said, adding that there is also a need to ensure that there is safety, effectiveness and availability.

Dr Rui said that with the funding that they have hopefully they can ensure the country can afford the COVID-19 vaccines. “With the mechanism in place, it will reduce the financial burden of the country.” “Even after the arrival of the vaccine we need to continue to practice the preventive measures,” he said.

He mentioned that the mechanism at global level is already there. WHO is also working with the agency of supply chain for the supply of the vaccines.

At the global level, it is estimated that more than US$ 30bn is needed to meet the demand for the vaccine.

He also said that so far some amount has been pledged by the member states of WHO however there is no such allocation for vaccine at the country level.

“The ACT mechanism will ensure that no one will be left behind in the sense of access to COVID-19 vaccine,” said Dr Rui.

Dr Tshokey said that for the current COVID-19 patients the country’s national guideline for COVID-19 treatment does not recommend any antiviral or specific treatment for asymptomatic or mild symptom. He said investigation like X-Rays, ECG and baseline blood test are conducted. “We test patients for other infectious diseases. If there is large abnormality in X-rays we do the CT scan. Almost all the patients so far have been either asymptomatic or shown mild symptoms. We monitor and give them supplements like Vitamin C, Zinc and medicines for related diseases,” said Dr Tshokey.

However, the ministry urges people that since the vaccine is being developed and it cannot be guaranteed that this vaccine will be successful, people still need to take precautionary measures like hand washing, wearing face mask, maintaining physical distance and avoiding crowds.

Dechen Dolkar from Thimphu