Covishield is made with the help of an adenovirus, itself one of the common cold viruses. The outer membrane of SARS-CoV-2 is studded with spikes as commonly pictured, and Covishield embeds this spike protein in the adenovirus which is then injected into humans. This triggers the body’s immune system to produce antibodies against Covid-19 infection.
Because Covishield is associated with DNA for viral instruction storage and not RNA (which is more fragile) it only needs 3-6oC storage temperature, and not the -70oC that vaccines made by Moderna and Pfizer require. Those two vaccines that are being administered now in Europe and North America are expensive, and would have been a logistical nightmare for Nepal.
However, because of the gap between the supply of vaccines and demand, and given the history of corruption in the procurement of Covid-19 test kits and equipment in Nepal last year, there is danger of the vaccines getting into the black market, or going to rich and powerful individuals and not frontline workers.
Health Minister Hridayesh Tripathi said on Wednesday that the first 500,000 doses of Covishield would start with health workers, and then to the elderly, both getting the second dose after three weeks. More vaccines will then have to be purchased to inoculate the target of 6 million people in the first phase of the campaign.
The efficacy of the Oxford-Astra Zeneca vaccine ranges from 62% to 90% depending on the dose, and there have not been any major reports of side-effects. However, India’s Covaxin made by the state-owned Bharat Biotech is an inactivated virus made in the traditional way which is in Phase 3 trails. But no data is available yet to show the efficacy or side effects of this vaccine.
The Chinese candidate vaccines Sinopharm and Sinovac are said to have efficacy rates of 79 % and 50 % respectively. The Chinese have an impressive track record of making vaccines, and to combat infectious diseases. But until data is clearly presented, it may be prudent for Nepal not to obtain Covaxin, Sinopharm and Sinovac.
The World Health Organization’s COVAX program in April promised that Nepal would get enough vaccines to inoculate 3% of the population, and provide a further 20% of Nepalis with free shots. But there are doubts about when these vaccines will be available because of high global demand from other developing countries.
The Ministry of Health has reportedly drawn up a list of those who will get vaccines first, and has also laid out the logistics so that the 1 million vials that arrived on Thursday will be dispatched to all districts with inoculations starting next week.
It would have been a masterstroke if Nepal had used ‘vaccine diplomacy’ right at the outset by taking part in the initial vaccine trials conducted by universities and other countries. We would then have a stronger claim to vaccines, since the country does not have the financial heft to procure them. This has put Nepal at the mercy of vaccine producing countries for now.
China did such a commendable job in controlling Covid-19 that it was not able to conduct proper vaccine trials in their own country. So they did it in countries like Brazil and Bahrain. If Nepal had agreed to trials, with China, India or the Oxford researchers at the very outset of this pandemic, we would have been ahead in the queue.
The oft-used argument that other countries are using us as ‘guinea pigs’ for Covid-19 vaccine studies would not be valid because Covid-19 is a universal problem. But it is too late for that now. The challenge ahead for Nepal is to acquire enough vaccines, administer both doses promptly, efficiently and equitably, and set about reviving the economy.