This week, the vaccine made by Oxford University in collaboration with the British-Swedish firm AstraZeneca was said to have 60-90% efficacy against Covid-19. The Oxford Vaccine has relevance for Nepal because the Serum Institute of India had started manufacturing millions of doses of this vaccine long before the preliminary results of the trial came in.
The Serum Institute of India is the world’s largest vaccine producer and already well-known in Nepal, especially for its anti-rabies vaccine that is commonly used here. The company had so much faith in the Oxford Vaccine, and it felt there would be such a rush later on, that it just went ahead and started manufacturing the vaccine, glass vials and stainless steel vats.
Sure enough, preliminary results of the Oxford Vaccine now show that this gambit may have paid off for all concerned, including the people in India and its neighbouring countries.
Adar Poonawallah, CEO of the Serum Institute of India has clearly made it his mission to manufacture the Covid-19 vaccine for the world’s poor. None other than Bill Gates is so impressed with his dedication that his foundation has committed millions of dollars to help with the project.
Even as global Big Pharma roll out new vaccines, the difficult part will be to find ways to pay for the poorest people in the world’s poor countries to be immunised against Covid-19. Collaborative efforts like the one by the Serum Institute of India and COVAX appear to be the way to go.
There is another interesting connection between the Oxford Vaccine and Nepal. The Chief Investigator of the Oxford Vaccine study, Prof Andrew Pollard has a long history of working in Nepal, especially in the prevention of typhoid fever. In December 2019, a paper on the milestone typhoid conjugate vaccine trial was published in The New England Journal of Medicine by doctors at Patan Hospital in collaboration with Pollard and colleagues. This breakthrough may well lead to policy changes around the world where typhoid is still rampant.
The unusual thing about the Oxford Vaccine is that, for some reason, the scientists administered only a half-dose of the vaccine on one group followed by the full second dose, as opposed to administering two full doses. Amazingly, the group that got the half dose followed by the full dose had a 90% vaccine efficacy compared to the group that was administered the full two doses, which registered only a 60% efficacy.
It will be intriguing to see if the half dosage was planned, or was an oversight that leads to this welcome finding. The history of medical breakthroughs abounds in such serendipitous discoveries.
The Oxford Vaccine announcement was preceded by American companies Pfizer and Moderna unveiling the breathtaking efficacy (>90%) of their own Covid-19 vaccines. However, besides the $60 cost per dose, the cold chain maintenance of -70oC for Pfizer’s vaccine would be impossible for countries like Nepal.
The Oxford Vaccine, on the other hand, does not require such extreme cold chain maintenance. The regular vaccine cold chain 2-8oC will suffice. More importantly, the cost is thought to be substantially less.