Choosing a vaccine

SKETCHES - Ana Marie Pamintuan (The Philippine Star) - January 20, 2021 - 12:00am

People I know who are 70 or older were spooked by the reported deaths of up to 33 frail and elderly people in Norway after they took the first dose of the Pfizer / BioNTech COVID vaccine.

Their bigger concern, however, is that they are now pushed lower in the priority list of recipients of all vaccines.

Later on Monday, the Norway government announced that there was no “direct link” between the Pfizer shots and the deaths.

After that “dropping of the ball” on the Pfizer vaccine delivery this month, and reports of allergic reactions to the jab, most Pinoys appear to be actually counting more on the shot developed by the UK’s AstraZeneca and University of Oxford.

I’m basing this on the vaccine orders announced by local government units and the private sector led by presidential adviser on entrepreneurship and Go Negosyo founder Joey Concepcion. We know the no-profit, no-loss price for the AstraZeneca shot: about P500. And the cold chain logistics requirement is easier.

Pfizer was the first to secure an emergency use authorization from our Food and Drug Administration. The quick FDA action on the EUA was based on the approval of the Pfizer shot in countries whose national drug regulatory bodies are classified by the World Health Organization as SRAs, or stringent regulatory authorities.

But we all know no Pfizer shot will be arriving earlier than July. So those looking for vaccination before then, particularly private businessmen and mayors, are aiming for the speedy delivery of the AstraZeneca shots, and possibly the one from US biotech firm Moderna.

Incidentally, there are 35 countries in the SRA list: the US, UK, Australia, Austria, Belgium, Bulgaria, Canada, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Japan, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, the Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden and Switzerland. They have cornered the initial massive orders for the Pfizer shots, but the company is ramping up production.

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Even before Norway’s denial of the direct link between the deaths and the Pfizer shot, the story did not sufficiently erode preference for the vaccine, since no such deaths have been reported among the elderly in the US, the UK, Canada and several dozen other countries where the Pfizer jab has been rolled out.

President Duterte, miffed at senators for investigating the Sinovac procurement, said he might send them the Pfizer vaccine for their use.

Even some of the senators older than 60 will likely accept Duterte’s offer. Leaders past age 60 of countries that have rolled out the Pfizer vaccine have reported no problems with their health, including new US President Joe Biden, age 78, who has already received the complete two doses. Also getting the Pfizer shots in public are Israel’s Benjamin Netanyahu (age 71) and Singapore Prime Minister Lee Hsien Loong (age 68).

The first person in the world to receive the Pfizer shot, a 91-year-old woman in Britain, is doing well as far as we know.

America’s top infectious disease expert, 80-year-old Dr. Anthony Fauci, opted for the Moderna shot, with 94.1 percent efficacy.

What the Norway deaths might indicate is that you can’t administer the Pfizer shot – or most vaccines for other diseases for that matter – to seriously ill elderly patients.

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Even if the deaths had been directly linked to the Pfizer shot, they would also not ease public distrust in this country of COVID vaccines made in China, as Malacañang seems to hope.

That distrust is fueled by the lack of transparency in the Chinese vaccine program. Its virology center in Wuhan continues to be suspected of being the source of the COVID-19 outbreak, and Chinese doctors who spoke up about it are either dead or in jail. At least Pfizer and BioNTech are transparent about the potential side effects of their vaccine. In contrast, if anyone in China has died after taking its local COVID vaccines, the world may never know.

Filipinos’ distrust of the China-made shots is also fueled by the widely divergent efficacy rates for Sinovac reported in different countries.

This is aggravated by the Duterte administration’s stonewalling on the Sinovac deal, starting with a basic issue since tax money is at stake – the price.

Senate President Vicente Sotto III, who faced us on “The Chiefs” last Monday night on Cignal TV’s OneNews, wondered why Joey Concepcion could readily tell the senators the procurement price for the AstraZeneca shot while Galvez could not for Sinovac.

The corruption cloud that hangs over Sinovac isn’t going to be dispelled like a magic wand just because President Duterte says the deal is clean. If he’s serious about his campaign against corruption, he should be the first to promote transparency especially in something as critical in this crisis as the national vaccination program.

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The deaths linked (and then denied) to the Pfizer vaccine in Norway initially worsened general vaccine hesitancy, and is not having the effect hoped for by Malacañang, which is to improve Pinoy confidence in vaccines made in China, whether by private firm Sinovac or Chinese state-owned Sinopharm.

What will help overcome vaccine skepticism, as I have written, is to have top administration officials receive the Sinovac shot in public, with pride in its safety and efficacy.

The Pfizer problem with elderly vaccine recipients in Norway, even if already denied, gives Duterte an excuse to be last in line for any vaccine from whichever country (unless he already received his shots last year together with his loyal Presidential Security Group).

But there are spring chickens in his Cabinet and in the Inter-Agency Task Force for the Management of Emerging Infectious Diseases, who can serve as public champions of the Sinovac vaccine.

After the Dengvaxia hysteria, Filipinos’ vaccine hesitancy is a serious problem that could derail the national COVID inoculation program.

Since Duterte says the deal with Pfizer is already “binding” (contrary to the Senate testimony of Galvez, age 58), all the President’s men and women below 60 must prepare to get their Sinovac shots… in public.

The Chinese vaccines are coming. In the words of the 54-year-old presidential spokesperson, Cabinet folks, don’t be choosy.

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