What will it take to be a front runner in the vaccine race?
Kenyans are renowned for dominating their marathon championships. It takes our athletes years of focused planning, training, conditioning and preparation. Yet in the race to obtain and deploy Covid-19 vaccine, it doesn’t seem that we are doing well enough to win. At least not yet.
Like flu or other pandemics, we need to accept the fact that Covid-19 is here to stay. And it is critical that we don’t squander this window of opportunity as we await to identify and get regulatory approval of suitable vaccines.
Needless to say, we need coordinated leadership at the national, county, and community levels to urgently develop and implement a coherent vaccine strategy.
The deployment of the vaccine poses five unique challenges. First, most routine vaccines are focused on infants and children who are typically taken to a health facility at regular intervals for vaccination.
The Covid-19 vaccine is for adults above the age of 18. So, for it to have an impact, we can only achieve sufficient coverage if we take it to where the people live, work or congregate.
These are also the groups of people who often rarely visit health facilities despite the fact that they are the most affected by the virus.
Second, nine out of the 11 vaccines under development, particularly those that are closest to approval, require two doses over two visits (some by injection). These doses need to be taken or administered 21 to 28 days apart.
If we learned any lessons from HIV testing, particularly before rapid tests were introduced, up to 40 percent of the people won’t return for follow-up visits for the second dose).
The third issue has to do with logistics. The two vaccine candidates announced over the past week by Pfizer and Moderna need ultra cold storage that isn’t easily possible for our decentralised and weak system.
The vaccines have to be shipped and stored at minus 70 and minus 20 degrees Celsius respectively, to retain efficacy. To maintain such extremely low temperatures requires a high efficiency cold chain we don’t yet have in this country.
Fourth, there’s the issue of production and acquisition at the global level. About 80% of the estimated production capacity of the current leading vaccine contenders have been pre-purchased by the developed countries.
Thus, there may not be enough available to Low to Middle Income Countries (LMIC) such as Kenya. For instance, 1.1 out of the 1.3 billion doses projected to be manufactured by the leading companies by mid-next year have already been secured by the United States, European Union, Japan, the U.K., Canada and Australia, leaving only 200 million for the rest of the world.
Finally, with over 150 vaccines in various stages of development, some are more suitable for countries like ours than others.
These are likely to be tested in LMIC and approved for use within the first half of 2021. The majority of people vulnerable to infection in this country are unlikely to afford paying for the vaccines without subsidies or some kind of help.
