Favourable time to explore more evidences on Covid-19 vaccines

Younten Tshedup 

While the government has devised a new strategy to vaccinate the entire eligible population in the country, the campaign will not start before mid-March.

As the plan is to begin the programme on an auspicious day, the Dana (inauspicious month) that starts from February 14 until March 13 gives the government and the people to observe the potential adverse effects of the Covid-19 vaccine.

This comes at a time when there are numerous reports of countries reporting severe side effects including some deaths following the inoculation.

Despite the hesitancy, many countries have stepped up their vaccination efforts. But there are also countries who are taking a relatively slower pace in the race, for the need of more evidence and data.

The government has almost closed the deal with India in procuring the vaccines, with the first batch of the vaccine arriving “soon” according to Prime Minister Dr Lotay Tshering.

However, the country won’t immediately start vaccinating the population even if the first consignment arrives, explained Lyonchhen. The government would roll out the vaccination only once it receives enough doses to vaccinate all the 533,000 eligible people at once.

Is waiting  advisable? 

Yes, say health experts. This is also because the pandemic situation in Bhutan was not as grave as in some other countries.   

The country has seen two notable outbreaks of Covid-19 so far, and both have been effectively contained, said an official on the condition of anonymity. He said that the patients infected by the virus in Bhutan have been relatively mild without any major complication.

“We know that the health preventive measures have worked out well for us. So technically, we can afford to wait for some time,” he said, adding that as the country waits, more evidence would be available on the vaccine.

On a similar note, Lyonchhen on Monday also said that while the country waits for the inauspicious month to end, it would provide an opportunity to learn from the experiences of other countries including possible side effects.

What is an EUA  vaccine? 

Most of the uncertainties surrounding the Covid-19 vaccines today is because of the fact that the vaccines have been developed within months after the discovery of a new virus. This otherwise would take at least a decade.

Speaking to Kuensel, World Health Organisation’s (WHO) country representative, Dr Rui Paulo de Jesus, said that for any medical product including a vaccine, it takes several years to study the data before it gets the formal approval for public usage.

However, he said that in an emergency situation like the current pandemic, global bodies like the WHO and regulatory authorities in respective countries give the emergency use authorisation (EUA) or an emergency use listing (EUL) to a drug or vaccine.

Dr Rui said that on December 31 last year, the WHO granted an EUL to Pfizer/BioNtech vaccine. “WHO is in the process of reviewing the Moderna and AstraZeneca vaccines.”

He said that although there were ‘good evidences’ that showed the EUA vaccines which are in use had proven effective in reducing the severity among those infected, there still was no information on the effectiveness of the vaccine in terms of preventing a person from getting the infection.

Lyonchhen had also said that the reason some groups in the population were not eligible for the vaccine was due to the limited knowledge and studies done of the effectiveness of the vaccine in these groups.

Adverse effects 

Countries across the world have been recording adverse effects after the inoculation like fever, nausea, diarrhoea, shortness of breath, and anaphylaxis (severe allergic reaction to venom, food, or medication).

Some countries including Norway and Germany have reported deaths after the inoculation of the Pfizer vaccine. However, it has not been conclusively established that the deaths were due to the vaccine.

Both the countries recorded death among the elderly population (75 years plus) and all them had underlying health conditions.

Lyonchhen said that because the vaccines were EUA approved, it would be wrong to say there would be no side or adverse effects following the vaccination. However, he said that they don’t see a life-threatening situation from the vaccine.

He said that the health ministry had trained and prepared health workers to respond to any possible side effects including anaphylaxis following the vaccination.

Led by the health ministry and WHO Bhutan, a training to monitor the adverse effects following the inoculation was held last week.

Dr Rui said that the government has come up with a good initiative for rolling out the vaccine and that a simulation on how to execute the plan in the field would be now critical. “In order to successfully start the campaign, we need to prepare and the WHO is ready to support the government in implementing its plans.”

He added that while the government was doing everything possible to get the vaccines, it was important to practice the proven health measures such as handwashing, wearing facemasks and practicing physical distancing. “Vaccine is not the silver bullet to fight this pandemic.”

A worrying trend 

Dr Rui Paulo de Jesus said that as countries across the world joined the race to secure the Covid-19 vaccines, a great deal of inequality among countries has surfaced.

He said that over 40 million doses of different Covid-19 vaccines had been administered as of yesterday across the world. “The issue, however, is that most of these vaccines have been administered in the rich and developed countries.”

The COVAX Facility, of which Bhutan is also a member, was established to ensure equal distribution of the vaccines. However, Dr Rui said that countries that had agreements with the manufacturers of the vaccines have gone ahead and procured the vaccines for themselves. “What we are witnessing today is the nationalisation of the vaccines.”

He added, “Although we understand that every government wants to protect their own citizens, some countries have given the vaccines to the relatively lower-risk population, while many high-risk populations in developing countries have not received any. This is a big concern for the WHO.”

WHO director general, Tedros Adhanom Ghebreyesus, on Monday had said that the world was on the brink of a ‘catastrophic moral failure’. “And the price of this failure will be paid with the lives and livelihoods in the world’s poorest counties.”

He said that over 39 million vaccine doses had been given in more than 45 richer countries, but one poor nation had only 25 doses.