Rishard Khan

rishard.khan@guardian.co.tt

Health of­fi­cials are dis­pelling the no­tion that the As­traZeneca de­vel­oped COVID-19 vac­cine is not as good a vac­cine as the more pop­u­lar Mod­er­na or Pfiz­er vac­cines.

The con­cern stems from the ef­fi­ca­cy rates of the vac­cines. The As­traZeneca vac­cine has an ef­fi­ca­cy rate of be­tween 60 and 70 per cent while the Mod­er­na and Pfiz­er vac­cines have an ef­fi­ca­cy rate up­wards of 90 per cent. How­ev­er, the Pan Amer­i­can Health Or­gan­i­sa­tion/World Health Or­gan­i­sa­tion (PA­HO/WHO) rep­re­sen­ta­tive Dr Er­i­ca Wheel­er as­sured dur­ing a Min­istry of Health press con­fer­ence on Mon­day that it is just as good.

“You may al­so note that the flu vac­cine has a vari­able ef­fi­ca­cy of be­tween 40 and 70 per cent yet all the coun­tries of the world take the flu vac­cine. So this is not a case of a sec­ond class vac­cine,” she said.

“The rea­son why Trinidad and To­ba­go is re­ceiv­ing these vac­cines, as it said in the com­mu­ni­ca­tion we re­ceived (from CO­V­AX), is that there is a short­age of the Pfiz­er vac­cine and de­ci­sions have to be made about who gets Pfiz­er- it’s lim­it­ed- and who gets oth­er vac­cines.”

The As­traZeneca vac­cine is ex­pect­ed to be giv­en emer­gency use au­tho­ri­sa­tion by the WHO in the com­ing days and Dr Wheel­er as­sured that the WHO would not do this for a vac­cine that is not safe or in­ef­fec­tive. 

“There is no such thing as WHO ap­prov­ing a sec­ond rate, sec­ond class, or un­safe vac­cine be­cause we have very strin­gent in­ter­na­tion­al codes, some of which are al­so le­gal, that we must fol­low be­fore any vac­cine is ap­proved for glob­al use,” she said. 

Min­is­ter of Health Ter­rence Deyals­ingh said that de­spite hav­ing a low­er ef­fi­ca­cy rate, the As­traZeneca vac­cine had a ma­jor ad­van­tage in its dis­tri­b­u­tion lo­gis­tics. 

“The fact that the As­traZeneca vac­cine is stored at two to eight de­grees, which is the cur­rent stor­age tem­per­a­ture for the cur­rent flu vac­ci­na­tion means we can roll out the vac­cines faster as op­posed to (the) Pfiz­er which has to be stored at mi­nus 70 (de­grees). And once you thaw out Pfiz­er, you on­ly have three to five days to ad­min­is­ter those vac­cines,” he said.

“So the As­traZeneca is lo­gis­ti­cal­ly much eas­i­er, there­fore, you’d get much faster cov­er­age rates, high­er com­pli­ance across the coun­try. So there are sig­nif­i­cant ad­van­tages.”

For­mer health min­is­ter Dr Emanuel Ho­sein shared his ex­pe­ri­ence with po­lio when he was a child and urged the pub­lic to take the vac­cines when they ar­rive. 

On Sat­ur­day, Min­is­ter of Health Ter­rence Deyals­ingh an­nounced that T&T has been al­lo­cat­ed be­tween 100,000 and 120,000 dos­es of the As­traZeneca vac­cine by the CO­V­AX fa­cil­i­ty. The coun­try bought in­to the fa­cil­i­ty back in Sep­tem­ber. The dos­es are ex­pect­ed to reach T&T by March.

Vac­cine Dis­tri­b­u­tion

Phase 1-

Deyals­ingh said this first batch would con­sti­tute the first phase of vac­ci­na­tions and would be car­ried out in the pub­lic health­care sys­tem. At the top of the list to re­ceive the shots would be health­care work­ers and then it would be ex­tend­ed to the el­der­ly, those with­in the pub­lic sec­tor with non-com­mu­ni­ca­ble dis­eases, es­sen­tial work­ers and the most eco­nom­ic or so­cial­ly vul­ner­a­ble in the coun­try.

To fa­cil­i­tate ad­min­is­tra­tion in the el­der­ly pop­u­la­tion, he said the min­istry be­gun reach­ing out to long-stay homes. In par­tic­u­lar, he said the min­istry was gath­er­ing in­for­ma­tion on the rel­a­tives or guardians of el­der­ly peo­ple at these homes who may not be in a po­si­tion to make an in­formed de­ci­sion and give con­sent for the shot. This he said was to pre­vent any sub­se­quent le­gal is­sues. This first phase of dis­tri­b­u­tions, he said, would be mon­i­tored close­ly and its out­come would in­form the roll-out of the sec­ond phase of vac­ci­na­tions.

“There is noth­ing like re­al-world ap­pli­ca­tion to throw up prob­lems which you can­not fore­see,” Deyals­ingh said.

Phase 2-

If there are dos­es left from the first batch of vac­cines of if the min­istry pro­cures ad­di­tion­al dos­es, he said the min­istry would com­mence with the sec­ond phase of vac­ci­na­tions. This phase, he said would be a mass vac­ci­na­tion pro­gramme. It would be in col­lab­o­ra­tion with the T&T Med­ical As­so­ci­a­tion (TTMA) “to man three of four mass vac­ci­na­tion sites through­out the coun­try.”

“We are not start­ing with mass vac­ci­na­tion sites at the start be­cause we want to get the ex­pe­ri­ence. We want to know if there are any side ef­fects as rare as they could be and how to treat it,” he said. 

There would al­so be vil­lage out­reach pro­grammes be­fore fi­nal­ly al­low­ing pri­vate hos­pi­tals to as­sist. 

Stor­age

Ac­cord­ing to the Min­is­ter of Health, there is cur­rent­ly ca­pac­i­ty to store 390,000 dos­es of As­traZeneca COVID-19 vac­cines. 

“At NIPDEC we have ca­pac­i­ty of 120,000. The Ari­ma Gen­er­al Hos­pi­tal was built with a chiller. They can store 120,000. The new Point Fortin Hos­pi­tal phar­ma­cy was built with a chiller-(with a ca­pac­i­ty to store) 100,000. To­ba­go has a chiller. They can store 50,000. Cou­va hos­pi­tal, un­for­tu­nate­ly, was not built with a chiller and that is why we have to go in now and con­struct a chiller there,” he said.

Deyals­ingh said the con­tract to build the chiller at the Cou­va hos­pi­tal was award­ed and site vis­its are un­der­way. How­ev­er, he not­ed, “we can more than get by with­out the Cou­va chiller.”

BOX

The As­traZeneca vac­cine is cur­rent­ly be­ing used in the Unit­ed King­dom, Ar­genti­na, El Sal­vador, Do­mini­can Re­pub­lic, In­dia, Bangladesh, Mex­i­co, Nepal, Pak­istan, Brazil, Sau­di Ara­bia, Iraq, Hun­gary, Thai­land, South Africa, and the Eu­ro­pean Union.