Jab grab

Sri Lanka has stepped into the global fray for COVID-19 vaccines with an order for 3.5 million doses to be placed with India’s Serum Institute on Friday. The order, to be placed by the State Pharmaceutical Corporation (SPC), will be used to inoculate more healthcare and frontline workers as well as start on the general population above 60 years of age. But this will just be the start to a complicated process to get the local population sufficiently vaccinated. 

For starters, according to Government officials, about seven million doses will be needed to vaccinate the 3.5 million over-60-year-olds in Sri Lanka. However, an independent German body has warned that there is insufficient data to show the levels of efficacy the Oxford AstraZeneca vaccine has on over-60-year-olds.

This has thrown more fuel into a faceoff between AstraZeneca and the European Union (EU) over supply delays and increases speculation over whether it is more productive to focus initial vaccinations on younger members of the population who are likely to be more economically active and will help economies recover faster from the COVID-19 impact.   

There are also concerns over how governments of developing nations will be able to afford large amounts of vaccine and even if they are able to pay whether they will be able to get the vaccines soon. Several countries in Africa are likely to get the vaccine only in 2022 and poorer countries are disgruntled by what they see as vaccine hoarding by richer countries. Unless countries such as Canada, which has ordered five times the vaccines its population requires works to donate excess vaccines to developing countries the fabric of international cooperation could fray even further. 

Sri Lanka is fortunate to have India as a neighbour but even then, there are new decisions to be made every day. For example, will an individual be able to decide whether they get the Covidshield vaccine or the Chinese vaccine after 300,000 doses are given to Sri Lanka? Questions are being raised about the efficacy of the Sinopharm vaccine and transparency of data with the two vaccines likely to have different acceptance from the public.  

To add to the challenge the Serum Institute is also expected to start manufacturing the Novavax vaccine in the next two months. Novavax is already stockpiling vaccine at six operating manufacturing locations, and said it expects a total of eight plants in seven countries to produce at the rate of two billion doses per year, including from the Serum Institute of India. Novavax is 89% effective according to data released this week but has performed lower in South African trials.

How different vaccines will respond to COVID-19 variants will also need to be gauged by policy makers before procurement decisions are made. Countries like Sri Lanka have limited resources to expend on vaccine purchases and the funds will have to be stretched as far as they can go. There will also need to be decisions on private sector participation and how cost sharing structures will work so more vulnerable groups can get the vaccine as soon as possible. 

Companies will also want to see if vulnerable segments such as workers at export processing zones can get priority access to the vaccine and who will bear the cost. Scaling up the vaccine effort will undoubtedly require priority attention and transparency will need to be a key component of the vaccine program in the coming months, if not years.