Finding the right vaccine for Filipinos

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    PRESIDENT Duterte’s overarching concern about Filipinos’ access to a COVID-19 vaccine — not just any vaccine but the right one — has reached the United Nations. In a recorded message to the 31st special session of the UN General Assembly, Duterte reiterated the nation’s call for universal access to safe and effective vaccines for COVID-19 disease, calling the possible exclusion of poor countries from the race to secure vaccines a “gross injustice.”

    Duterte’s message is classic: “If any country is excluded by reason of poverty or strategic unimportance, this gross injustice will haunt the world for a long time. It will completely discredit the values upon which the United Nations was founded. We cannot let this happen. No one is safe unless everyone is safe.”

    The Philippines is on the right track in supporting the medical initiatives of the World Health Organization (WHO) as well as the multilateral approach in finding access to the vaccine.
    A report from the WHO said there are 48 candidate vaccines undergoing clinical evaluation and 164 in preclinical evaluation as of Nov. 12. Pharmaceutical companies, universities, researchers and almost every scientific mind are working to achieve the same goal: to develop a COVID-19 vaccine.

    ‘As the purchasing country which needed billions of pesos in loans just to buy, we cannot afford to commit a monumental mistake this time.’

    Of the nine vaccine technology platforms, the one using the protein subunit has the most number of candidates at 76. Novavax and Sanofi Pasteur GSK are among those that have taken this track. RNA-based platforms like that of Moderna and the non-replicating viral vector of AstraZeneca have the same number of candidates at 31 followed by the replicating vector of Merck Sharp & Dohme/IAVI at 21 and the DNA-based platform like that of Takara Bio with Osaka University at 19. The others are: inactivate virus, 14; virus particle, 13; and live attenuated virus, 4.

    According to Dr. Nina Gloriani, head of the Department of Science and Technology COVID-19 expert panel, the Philippines has done initial preparations for the WHO Solidarity vaccines clinical trial, with the Philippine General Hospital as the lead venue. Also, there are applicants for Phase 3 clinical trials, among them are Sinovac, Gamaleya, Janssen, Clover and AstraZeneca. In the United States, however, Novavax is set to start this month Stage 3 of its COVID-19 trials and it has been given a “fast-track” status by the US Food and Drug Administration. It also has conducted a late-stage study of the vaccine in the United Kingdom.

    The Philippines’ private sector has a trial order of some 2 million doses of the vaccine developed by British-Swedish firm AstraZeneca for the government’s priority recipients. Western-made vaccines reportedly need special, ultra-cold storage facilities and this poses a logistical challenge for this first order.

    Health Undersecretary Ma. Rosario Vergeire said the Research Institute for Tropical Medicine (RITM), the DOH’s national storage facility for vaccines, has enough space at regular cold temperatures. This should be an advantage for products like Novavax made by Serum Institute of India (SII) which allows handling in an unfrozen, liquid formulation than can be stored at 2 to 8 degrees Centigrade, allowing for distribution using the standard cold chain system for vaccines in the Philippines.

    All these vaccines have yet to go into production but the challenges in storage and shipping for certain types of vaccines are already evident, and are being addressed.

    According to Budget Secretary Wendel Avisado, the Bayanihan 2 law has allocated P10 billion for the purchase of COVID-19 vaccines, while the forthcoming General Appropriations Act 2021 gave P2.5 billion. Avisado said Finance Secretary Sonny Dominguez reported to the President that we can access P73 billion in loans from multilateral sources, Asian Development Bank and World Bank for this purpose, to immunize at least 60 million Filipinos and thus achieve herd immunity.

    With such a tall order and with these vaccines having their own advantages and disadvantages, such as their differing efficacy rates among various races of people, it is wise that the government not limit itself to buying from just one pharma or one or two countries.

    As the purchasing country which needed billions of pesos in loans just to buy, we cannot afford to commit a monumental mistake this time.