Figueroa sees trouble ahead for vaccines under COVAX

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Figueroa sees trouble ahead for vaccines under COVAX

BY ALICIA DUNKLEY-WILLIS
Senior staff reporter
dunkleywillisa@jamaicaobserver.com

Friday, January 15, 2021

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PROFESSOR of Public Health, Epidemiology and HIV-AIDS at The University of the West Indies, Mona, Dr Peter Figueroa says standing contractual arrangements for COVID-19 vaccines with countries with deeper pockets might thwart efforts by the COVAX facility to get the jabs to lower- and middle-income countries, like Jamaica, this year.

Several countries including Jamaica have pinned a lot of hope on receiving moderate supplies of the approved vaccines through the COVAX facility, run by the World Health Organisation (WHO) along with Gavi, the vaccine alliance, and the Coalition for Epidemic Preparedness Innovations (CEPI). COVAX is one of three pillars of the Access to COVID-19 Tools (ACT) Accelerator, which was launched in April by the WHO, the European Commission and France in response to the pandemic, merging governments, global health organisations, manufacturers, scientists, private sector, civil society and philanthropy, with the aim of providing innovative and equitable access to COVID-19 diagnostics, treatments and vaccines.

But speaking as a guest at the weekly meeting of the Rotary Club of downtown Kingston on Wednesday, Dr Figueroa said there might be trouble up ahead for COVAX.

“The big challenge is that the vaccine supply is limited. When you look at all the manufacturers and the candidates for vaccines it is estimated that for 2021 there will be just under eight billion vaccine doses available. Already there are bilateral agreements between developed countries, primarily, high-income companies and the pharmaceutical companies for 7.4 billion doses. COVAX is trying to get two billion doses for 2021, but there are some countries that have contracts for doses significantly more than their population, so this puts a tremendous challenge on COVAX to get vaccines to low- and middle-income countries and that is what may undermine the attempt to get the equitable distribution of vaccines,” the professor stated.

Professor Figueroa, who is also a member of the WHO working group on COVID-19 vaccines and chair of the PAHO technical advisory group on immunisation, noted further that there might be other shortcomings with COVAX itself.

“The challenges that are faced is that through the COVAX facility you may not necessarily get the vaccine that best suits your conditions and many developing countries don't have a ready platform for vaccinating adults,” he pointed out, adding that countries “are used to vaccinating children but when we try and encourage adults to take influenza vaccine, which saves lives every year, many people refuse”.

“It is not easy to identify and mobilise those targeted for vaccines, and for some of the vaccines there are issues of storage, cold chain, logistics, so it is a lot of planning and work that needs to be done to ensure that when the vaccine does come it is delivered efficiently and you can see that countries like the great United States cannot roll out their vaccine efficiently. They have not planned for it adequately and they don't have the public health infrastructure that usually does this and thy have also had a lot of challenges with their leadership as we all know,” Professor Figueroa pointed out.

Just last week Prime Minister Andrew Holness, in an interview with Bloomberg Quicktake's Tim Stenovec, accused cash-rich countries of “hoarding” the COVID-19 vaccines for their own people, leaving poorer countries to scrounge and wait months to get the doses.

In the meantime, Professor Figueroa said of the three vaccines that have already received full approval for use, Jamaica should choose Moderna for now. Three coronavirus vaccines are currently at the forefront of the vaccine sprint and have been licensed in the United Kingdom, the European Union and the United States namely: BioNTech-Pfizer's and Moderna's mRNA vaccines, and a vector virus vaccine co-developed by researchers at Oxford University and AstraZeneca.

“I think Jamaica is going to take the decision not to try and get the Pfizer vaccine because it requires ultra-cold chain storage, meaning a freezer that is minus 70 degrees centigrade, so we are not going to bother with the Pfizer vaccine, as far as I know,” said the professor.

“The Moderna vaccine requires a freezer of minus 20 degrees which we have, so we could take the Moderna vaccine but there are other vaccines like the Astrazeneca and a range of other candidates with vaccines that are coming forward, which could be very comparable to the traditional vaccines and we would manage them more readily,” he said.

In the meantime, he said Jamaicans, in his opinion, should prepare to live under COVID-19 conditions for “most of this year”.

“Until we have sufficient vaccines to get at least 60 per cent or more of our adult population vaccinated we will not have what they call herd immunity protection. So we have to prepare. We are going to have to be patient this year and support each other to continue the protocols that are being promoted,” Professor Figueroa added.

His assessment could be the impetus behind the Government's indications earlier this week that it intends to conduct bilateral meetings with several countries to include India, China and Cuba as it seeks out other arrangements to access additional safe supplies for Jamaicans, in addition to efforts to obtain vaccines under the COVAX facility.

Health Minister Dr Christopher Tufton told Parliament in a statement on Tuesday that based on the pace of development and the need to safeguard the population, the Government, through Cabinet, has also agreed to begin to explore Jamaica's access to safe vaccines outside of the COVAX facility. Additionally, he said an agreement has been made to explore bilateral arrangements with countries that have indicated their willingness to partner with Jamaica to ensure the safe vaccination of the population.

As such, said Tufton, his ministry, in collaboration with the Ministry of Foreign Affairs and Foreign Trade, “will begin the process of exploring how we can leverage our international engagements to secure additional supply access for safe vaccines”.

The Government, through the COVAX facility, has been able to negotiate vaccine dosages at the price of US$10.55, reduced from the going average price of US$35.00.This price is negotiated for 16 per cent of the population and represents Phase 1 of Jamaica's vaccination roll-out plan.The first batch of vaccines are supposedly due in April 2021 and have been increased from an original one per cent to five per cent, a total of approximately 292,000 doses.

Under the first phase of the programme priority will be given to health-care personnel, people 60 years and older, members of the Jamaica Defence Force, the Jamaica Constabulary Force, the Jamaica Fire Brigade, the Department of Correctional Services, employees of the Passport, Immigration and Citizenship Agency, infirmaries, Members of Parliament, senators, parish council representatives as well as residents and staff of nursing homes and those in penal institutions.

This, said the minister, represents approximately 440,000 people.


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