FIRST PERSON - Alex Magno (The Philippine Star) - April 8, 2021 - 12:00am

The country is expecting delivery of 2 million doses of Sinovac and Gamaleya vaccines this month. That is not a small number, although it is really just a drop in the bucket.

We are not getting the vaccines we need because of constricted global supply. Many poor countries are getting no vaccines at all despite the World Health Organization (WHO)’s frantic effort to democratize distribution of the scarce commodity. Papua New Guinea, for instance, is frantically begging Australia for whatever vaccines the rich country might be able to spare.

The WHO describes the uneven distribution of vaccines a “travesty.”

Over the next few months, we expect the supply situation to be tight as the richer countries continue hoarding. Even as they have supplies or supply orders that now far exceed their population size, the rich countries want to be assured they will have the means to carry on with the immunization battle should surges happen in the future or should efficacy of available vaccines prove to be short.

The WHO is pleading with the rich countries to share vaccines – although, at the moment, to little avail. The WHO insists there can be no such thing as herd immunity in one country. Global infections need to fall across the board to even have a possibility of herd immunity.

In a word, herd immunity can only happen globally or not at all. That is easy to understand from the point of view of science.

Alas, the governments of the rich countries are not accountable to the WHO. They are accountable to their domestic constituents who are demanding a sense of safety derived from falling infection rates in their localities. Instead of following science, governments of the rich countries will follow political dictate. Their survival in power depends on pandering to the illusion of localized herd immunity.

For instance, Germany now faces a serious third wave of infections. This is a political predicament for Angela Merkel who was once praised for her handling of the pandemic. With infections rising again, it is expected her political coalition will face backlash from voters in federal elections scheduled later this year. Merkel is arguably the most globally sensitive political leader of this time, but the meanderings of political calculation are impossible to ignore.

It might be unseemly to hoard vaccines on the basis of political calculation. It is doubly unseemly to allow poorer people in the poorer countries to perish while the rich countries build stockpiles for their own “vaccine security.” But political leaders, in order to thrive, must bow to political realism.

The incurably political among us have started speculating that the vaccine supply outlook favors the perpetuation of President Duterte’s influence. Since the bulk of our vaccine supply will come later in the year, the administration is likely to profit from it by the time elections happen May next year.

That might be true if stated as a matter of coincidence. But to insinuate the vaccination strategy is intentionally designed to achieve the expected political outcomes is irresponsible and malicious.

The two million doses more or less sure to arrive this month will mostly be disseminated in the NCR Plus area. This is not the result of some astute political calculation. It is a dictate of science.

Prioritizing the NCR Plus area is clearly the more efficient way of doing this. The likelihood of preventing further infections is higher if vaccination occurs where infection is most concentrated.

Everyone, understandably, wants to be prioritized for vaccination. Even our lawyers’ association is demanding that, being agents of the court, lawyers ought to be considered essential workers in the scheme of priorities.

The administration will likely have to deal with griping local executives from areas outside NCR Plus. There will be a political price to pay for this. Fortunately, President Duterte has enough political capital to spare.

But there are other calculations that need to be made in shaping our vaccination strategy.

Recently, the University of Chile released a study on the efficacy of Sinovac doses that should help guide our own strategy. As in Chile, Sinovac has become our staple vaccine for sheer lack of any other option.

The two-dose Sinovac vaccine is administered on a 28-day interval. It is found to be 56.5 percent effective only two weeks after the second dose. Within those first two weeks after the second dose, the vaccine is only 27.7 percent effective.

After the first dose, Sinovac is found to be only 3 percent effective. It must be mentioned that this is also the margin of error. This means after one dose the vaccine may have no effect at all on those who received it.

This is significant for our vaccination strategy.

Over the next few days, as the new delivery of Sinovac vaccines are administered, we are somehow hoping this will reverse the surge. That is not going to happen, unfortunately. We have to wait two weeks after the second dose is administered (or six weeks from now) for the vaccine to factor in the infection rates.

Even then, after six weeks, just over half of recipients are going to have effective protection. For this delivery of a million doses of vaccines, only a quarter of a million are effectively immune.

There is not enough water here to put out the fire.

We can only hope the one million-dose delivery from Gamaleya will deliver the necessary efficacy to turn back the surge. Gamaleya’s Sputnik V has an efficacy rate of well over 90 percent.

Meanwhile, we sit through what is a global surge.

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