Vaccine in Vietnam - availability. By Dr. Rafi Kot

Vaccine in Vietnam - availability

We understand the frustration among our patients in view of the lack of vaccines in Vietnam. However, this lack does not plague Vietnam only, as many other countries are awaiting vaccines supply. The lack and difficulties of supply of vaccines stems from production reasons, Logistic challenges and lack of money funding those vaccines- the later turning to the WHO which has promised vaccines to every country at a coverage of 15% of its population by creating an int’l funded vaccine bank.

To summarize the current situation for many of our patients which are questioning which vaccine is better and when vaccines will be available in Vietnam or at FMP :

-Moderna

-Pfizer/BioNTech

-Astra Zeneca

-The Russian Sputnik V

As to the First three vaccines which have been produced under Western Standards of Trials (3 stage completion) the issues which affect us are follows:

Moderna- Expensive, and deals ONLY with Governments. In other words, the demand or order must be made in behalf of a government. Until now no local demand is known to be made.

The two-dose regimen of the Moderna COVID-19 Vaccine at the 100 µg dose is expected to be protective against emerging strains detected to date. Vaccination with the Moderna COVID-19 Vaccine produced neutralizing titers against all key emerging variants tested, including B.1.1.7 and B.1.351, first identified in the UK and Republic of South Africa, respectively. The study showed no significant impact on neutralizing titers against the B.1.1.7 variant relative to prior variants. However, A six-fold reduction in neutralizing titers was observed with the B.1.351 variant relative to prior variants. Despite this reduction, neutralizing titer levels with B.1.351 remain above levels that are expected to be protective. The Logistical part in shipping is do=able as it can be transferred at -20’c, a common temperature of transferring some Lab reagents.

2. Pfizer/BioNTech – Probably until now the best documented vaccine around. In wide usage. Expensive, however seems to be able to handle both, the UK Mutation and the S. African Mutation, and the new Combined S. African-UK Mutation. The downside of the Vaccination is its logistical part. As it’s a mRNA based – it Needs a transport at -70’c which is challenging, and probably not a best model for third world countries or countries which are stretched geographically in a way where access remains a challenge. No information when it will arrive to Vietnam, if at all.

3. Astra Zeneca – Main Vaccine used in the UK. The manufacturer claims that the Vaccine can deal with the UK mutation. Less is known about the S. African strain. Made in mainly in two sites of the U.K and two secondary sites in Belgium and Netherlands. Embroiled currently in behind order supplies with the EU, in a severe way, it blames production issues at European plants, but the EU says that doses made elsewhere (in the UK) should make up the shortfall. Reports said last week that the EU would get 60% fewer doses of the vaccine than promised for January-March 2021. The EU block consists of a population of 448Million pop. Correct to January 25th the EU has vaccine a mere 1.92% of its pop. The number of doses ordered by the EU stands on 2.3 Billion. 400M doses are to be supplied by Astra Zeneca.

The vaccine is Easy to be transported as it does need minimal refrigeration in transport.

There has been information in the Media that the Vaccine will be available in Vietnam, sold only by a Private Company which becomes the sole distributer and injector at the same time.

No date of delivery yet, taking in account previous commitments, date of Delivery and the true amount per delivery remains questionable. As of the 8th of February, this vaccine has been discontinued in S Africa as its protection ability is very poor. The S. African Variant has been identified in Vietnam already. As this is a vector vaccine (“trojan horse” mechanism) it will take time to “re-adjust “a new better version which is supposed to be ready maybe by Autumn.

4. Sputnik V - Probably a Good Vaccine- vector based, produced by the Gamleya institute, However got embroiled in a political agenda reminding old cold war style of winning the title for the first vaccine to be produced:

The Russians data published in the Lancet medical journal left many scientists questioning the accuracy and probability of the results...

….On November 9th 2020, Pfizer announced that its interim Phase III data had shown its vaccine to be more than ninety per cent effective. Two days later, the Gamaleya Institute issued a press release saying that Sputnik V was ninety-two per cent effective. Then, on November 16th 2020, Moderna said that its vaccine was almost ninety-five per cent effective. Another week passed, and the Gamaleya Institute updated its interim figures: actually, Sputnik V was ninety-five per cent effective, too. In mid-December 2020, based on data collected from some twenty-three thousand participants in its Phase III trial, Gamaleya issued its final determination of the vaccine’s efficacy: 91.4 per cent.

Effective against the UK mutation. Not much data regarding the S. African strain. Like The Astra Zeneca- easy to be transported and unlike the first 3, is not mRNA Based and therefore cold chain not needed (Vector vaccine).

Contracts according to Russian sources include almost 50 countries. To date, more than fifty countries, including Algeria and Mexico, have preordered Sputnik V, and half a dozen plan to produce the vaccine themselves. A Phase III trial is under way in India, where a leading producer of generic medicines has already agreed to make more than a hundred million doses per year. In late December 2020, after Argentina’s negotiations to acquire the Pfizer vaccine stalled, an Aerolíneas Argentinas jet departed from Moscow loaded with three hundred thousand doses of Sputnik V, the first of twenty-five million that Argentina has agreed to buy. In January, officials in Kyrgyzstan, concerned about the cold chain needed to transport the Pfizer vaccine, stated their preference for Sputnik V. That month, after Hungary accused the E.U. of being too slow in its vaccine rollout, the country approved Sputnik V, becoming the first in the E.U. to do so. (E.U. officials criticized Hungary for undermining European solidarity.) There is currently No information as to its availability in Vietnam.

In view of the information above, the readers can understand that the time of appearance of Vaccine in Vietnam is not going to be immediate, and questionable if at mid-term or this year at all. Advice is that if foreigners feel at risk being with pre-existing conditions which might translate to life threatening situation when infected with Covid-19, and they CAN fly home and receive 2 doses at home and then somehow return to Vietnam- This possibility should be entertained seriously. At this point it is important to note that HAVING both vaccines might not make you sick, but you might still be able to transmit the virus to others , hence a face mask this time is not so much to protect yourself, but protect the public around.