50% vaccine efficacy is like ‘cara y cruz’

Controversies swirl in Malacañang over unlicensed COVID-19 vaccines. Latest is President Duterte’s disclosure of Sinopharm injections of soldiers. Questions hound the rush to purchase doses from Sinovac. Both are state-controlled China firms; neither have completed clinical trials, nor applied with Philippine authorities for domestic use.

“Halos lahat ng sundalo natusukan na,” Duterte bared in a televised meeting with health officials Saturday night. “I have to be frank, I have to tell the truth... marami nang nagpatusok and lahat up to now wala akong narinig for the select few, not all soldiers hindi pa kasi policy eh.”

Under various development stages worldwide are 96 vaccines and 135 drugs against COVID-19. The Food and Drug Administration has yet to issue any Emergency Use Authority. Only Pfizer-USA has applied for such EUA. Evaluation can take till January 2021. Sinovac is seeking permission to include the Philippines in clinical trials. Sinopharm has no official dealings with Filipino regulators. No import, distribution and dispensing can be made until the FDA’s go-signal. Duterte reiterated that early this month.

A vaccinee’s informed choice is a must, says the Philippine Council for Health Research and Development. Under its mass inoculation plan, doctors, nurses and technicians directly fighting COVID-19 are to be first. Vulnerable sectors, including the sickly and elderly, are next. Uniformed servicemen and other frontline workers come later.

Presidential spokesman Harry Roque initially disavowed knowledge of the Sinopharm inoculations. But Interior Secretary Ed Año clarified that the jabs were administered on soldiers and policemen in the Presidential Security Group. Some Cabinet members also were vaccinated, said Año, vice-chairman of the Inter-Agency Task Force on the Management of Emerging Infectious Diseases. Army chief Lt. Gen. Cirilito Sobejana confirmed that some troops were vaccinated but was unsure of the number. Asked if Duterte allowed the vaccinations, Sobejana reportedly said, “Of course, our President is our Commander-in-Chief.”

Then Roque tried to douse hot comments of rule violations. “Let’s just say that our military who guards our security is now safe from COVID when they can do their job,” he said. Denying that Duterte authorized the shots, he added: “It must have been the decision of the commanders and the soldiers. It’s not illegal to be vaccinated with an unregistered vaccine. What is prohibited is the distribution and sale.”

FDA director general Eric Domingo disagreed. His agency is to investigate whoever imported and dispensed the unlicensed doses. The health department advised vaccinees to consult doctors at once in case of adverse effects.

Sinopharm has advertised 80-percent vaccine efficacy. But its studies have yet to be published and subjected to peer review.

Similar preference for Chinese Sinovac’s inoculant is touchy. Why purchase a vaccine with unpublished studies, and no official examination, blogged Dr. Tony Leachon. At once, Roque berated the former chief medical adviser of the national anti-COVID task force. Leachon persisted: “They are going to inject my fellow health workers. We have a right to know more.”

Sinovac’s product rated 50-percent efficacy in initial trials. Meaning, it can prevent contagion of half a population previously uninfected and to be injected, medical journals explain. The World Health Organization came out in April with such 50-percent minimum acceptability, but preferred 70 percent. Most FDAs followed suit.

That was before Pfizer notched 95-percent efficacy; Moderna of USA, 94; and AstraZeneca of Britain, 70. Those results, reported in October and November, promise far more people to be saved from infection and death. Even China has ordered 100 million doses from Pfizer. That company is so far the only one green-lighted in America and Europe to distribute COVID vaccines.

In comparison, Sinovac’s 50 percent is like “cara y cruz” or toss coin, a tweet spread. Senate Majority Leader Juan Miguel Zubiri, who has twice contracted COVID-19, remarked: “That means there’s a 50-50 chance of you getting COVID even after being vaccinated, (which is) a joke.”

Sinovac isn’t cheap either. Two doses, 28 days apart, will cost P3,629.50, Sen. Sonny Angara estimates. Double doses from AstraZeneca come to P610; Pfizer, P2,379; Moderna, P3,904-P4,504. Other upcoming alternatives: Novavax, P366; Johnson & Johnson, P480; Gamaleya, P1,220; COVAX facility with WHO, P854.

The government needs to maximize the number of vaccinees with its budget of P82.5 billion. Mass inoculation includes other costs, Angara says: training per vaccinator of 350 persons, P1,200; peripherals, including face mask, shield, alcohol, cotton balls per vaccinator, P962 per dose, or P1,924 for two doses.

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