Health ministry submits application to COVAX Facility for vaccine supply

Younten Tshedup 

With the country recording over 200 positive cases in the past 10 days, the concern is that the outbreak would escalate or trigger a deadlier future explosion of the virus among the population.

With all the uncertainties surrounding the outbreak and the nationwide lockdown, hopes are pinned on the recently approved vaccines.

Dr Sonam Wangchuk, a member of the technical advisory group (TAG), said that the ministry had submitted an application to the COVAX Facility detailing its strategies and vaccine deployment plans.

For now, he said that Bhutan’s only access to the Covid-19 vaccine is through the COVAX Facility.

COVAX is one of three pillars of the Access to Covid-19 Tools (ACT) Accelerator, which was launched in April by the World Health Organisation (WHO), the European Commission and France in response to the pandemic.

As a member of the facility, Bhutan would receive free vaccines for 20 percent of its population. Meaning, about 150,000 people of the total 756,129 population would be the first recipients of the vaccine.

However, Dr Sonam Wangchuk said that COVAX would deploy the 20 percent in tranches. He said that the first tranche would cover around three percent of the population. The remaining 17 percent would be deployed in the next tranche.

This would mean that about 20,000 Bhutanese would receive the first batch of vaccine, which would be likely dispatched in the first quarter of 2021.    

World Health Organisation (WHO) representative to Bhutan, Dr Rui Paulo de Jesus, said the government will need to submit the final component of the application to COVAX in the first week of January 2021 to request for access to vaccines when they are approved and made available.

“As per the plan, the countries can expect to receive the vaccine for three percent of the population and the remaining 17 percent most probably in tranches by the end of 2021,” he said. “However, these are projections with assumptions that everything will fall in place as planned.”

Which vaccine?

Until recently, there were two Covid-19 vaccines — Pfizer/BioNTech and Moderna — that received the emergency use authorisation (EUA) from the US Food and Drug Administration (FDA) for public usage.

EUA is a mechanism to facilitate the availability and use of medical countermeasures, including vaccines, during public health emergencies.

Dr Sonam Wangchuk said that although the deployment of vaccines would depend on the COVAX and their assessment and subsequent authorisation, Bhutan had expressed its interest in Moderna vaccine.

This was because of the logistical issues associated with the Pfizer/BioNTech vaccine. It requires an ‘ultra-low’ temperature of -70 degree Celsius storage facility. On the other hand, the Moderna vaccine could be stored in a facility of around -20 degree Celsius.

Dr Sonam Wangchuk said that while arranging the cold chain facility for both the vaccines was challenging, logistical issues would have been more with the Pfizer vaccine. “But we have prepared strategies for both, should COVAX approve either of the two.”

However, he said that with the United Kingdom approving the use of the Oxford-AstraZeneca vaccine, it was also possible that Bhutan could receive the Oxford vaccine. It is comparatively cheaper and logistically more friendly vaccine as it can be stored in a normal fridge temperature.

The UK government on December 30 approved the use of the Oxford-AstraZeneca vaccine, with first doses due to be given next week in the UK.

“We are yet to receive a response from the COVAX,” said Dr Sonam Wangchuk. “For now, we have prepared all the strategies and vaccine deployment plans.”

He said that the first 20,000 (three percent) vaccine recipients would include the active frontline and health workers, including the elderly population with pre-existing conditions.

Once the 20 percent share is distributed, the COVAX would still facilitate the deployment of vaccines to the member countries. However, it would then be on a cost-sharing modality, for which the details are not yet out.

Dr Sonam Wangchuk said that despite the outbreak of the pandemic, less than one percent (0.096 percent) of the population had contracted the disease so far. This means that the majority of the population were still uninfected and a vaccine could still be effective against the pandemic.

WHO’s Dr Rui said that the office in collaboration with UNICEF was supporting the health ministry in conducting a country readiness assessment for Covid-19 vaccine and had developed the vaccine deployment plan.

However, he said that although vaccines would help to end the pandemic, they wouldn’t solve everything.

“As the Covid-19 crisis continues, we still need to take all necessary measures to prevent the virus from spreading and causing more deaths,” he said. “There is no magic bullet to end the Covid-19 pandemic. We will need to use the combination of all proven approaches to keep the virus at bay.”