Questions, questions surround vaccine plan

We are not forcing anybody to join… the cause of the national government,” President Duterte was quoted as having said Wednesday night, referring to his administration’s plan to begin mass inoculation for COVID-19 using a vaccine supplied by China. He said he was assuming full responsibility for the safety and efficacy of the vaccine, branded as CoronaVac, produced by Sinovac Biotech, a private pharmaceutical company.

Petulantly reacting to local government units (LGUs) which have signed deals to buy the vaccine from AstraZeneca (a British firm) – which reportedly costs only $5 per dose ($10 for two doses) – for use in inoculating their constituents, Duterte reportedly said:

“Kung ayaw ninyo, OK lang, walang problema (If you don’t like [the Chinese vaccine], it’s OK, no problem). You can choose any vaccine you like to buy. Wala kaming pakialam kung ano ang pipiliin ninyo. Hindi kami makialam (We don’t care which vaccine you choose. We won’t interfere).”

In contrast, he used gentle language in welcoming efforts by private businesses to procure vaccines for their employees’ inoculation. “If they can buy outside government structures,” he remarked, “eh di mas maganda (that’s better).”

The League of Cities of the Philippines, headed by Bacolod City Mayor Bing Leonardia, asserted that LGUs should have the authority to choose their own COVID-19 vaccine sources, based on their constituents’ preference and financial capabilities. Baguio City Mayor Benjamin Magalong urged all LGUs to initiate and aggressively procure vaccines for their constituencies, while emphasizing, in reference to the national government’s inoculation plan, “We adhere to the strong advocacy of equal distribution.”

Backing up the LGUs that have laid out concrete plans for localized vaccination, the Kilusang Magbubukid ng Pilipinas urged the national government to present a viable national inoculation program and to initiate a “science-based, massive information drive on the importance of vaccination… to allay public fear and apprehension on getting COVID-19 shots.”

Reiterating his full trust in retired AFP chief Carlito Galvez Jr., whom he had designated as vaccine “czar,” Duterte stressed: “Whatever Secretary Galvez would choose would bind me. It’s as if I was the one that purchased the vaccines. So I would not buy a vaccine that is not appropriate.”

Exuberantly, Galvez announced that Sinovac’s vaccine is expected to be granted emergency use authorization (EUA) by the Food and Drug Administration before Feb. 20. (The firm applied for EUA on Wednesday, but submitted data only on its Phase 1 and 2 trials.) Yet deliveries of the vaccine – 25 million doses – will already be made as follows: “50,000 doses in February, then 950,000 in March, then one million, two million, three million every month (thereafter).”

He was so certain of these, whereas the Chinese firm hasn’t yet finished its clinical trials in Brazil and Turkey, whose results have to be submitted to the FDA. Moreover, China itself has yet to issue its own EUA for general use and export of the vaccine by the first week of February.

The FDA announced Thursday it had granted its first EUA to Pfizer-BioNTech COVID-19 vaccine, “after a thorough review of currently available data by medical and regulatory experts.” (FDA chief Eric Domingo pointed out that the vaccine would not be available commercially, since EUA is not a marketing authorization or a certificate of product registration.) Pending FDA approval are EUA applications by AstraZeneca and Russia’s Gamaleya Institute.

Could the FDA conduct a similarly “thorough review” of the data yet to be submitted by Sinovac before it grants the EUA to CoronaVac by February 20, as Galvez had announced?

Said to be the second most expensive OVID-19 vaccine (next to Pfizer-BioNTech’s), Sinovac’s efficacy has been shown to be only 50.4 percent in its last-stage trial in Brazil. Galvez justified the government’s buying it because he said the Chinese firm, upon the intercession by China’s ambassador, was giving the “best price” vis-à-vis those of US pharmaceutical firms Pfizer and Moderna.

Calls have been raised for the government to reconsider the Sinovac deal, including by Senators Francis Pangilinan and Panfilo Lacson. “Sinovac with just over 50 percent efficacy is six times more expensive than AstraZeneca, which in contrast shows 70 percent efficacy,” Pangilinan pointed out, urging the cancellation of the purchase deal.

Questioning the government’s pronouncement that only the Sinovac vaccine is available for Filipinos from February to June, Lacson asked: “Can somebody explain why preference is given to the second most expensive vaccine (at P3,629 for two doses), has lower efficacy, a record of suspended clinical trials… over other vaccines that cost much less, are more efficacious and about to be granted their EUAs?”

Malacañang has brushed aside these questions and objections to Sinovac. However, Duterte has been quoted as qualifying, “We can give (the vaccine) first to those who want it, and we can tone down the orders if there are too many.”

All together, the government targets to procure this year 148 million doses of various vaccines, purportedly to inoculate 50-70 million Filipinos in order to achieve so-called herd immunity.

Galvez said a deal with AstraZeneca was to have been signed last Thursday for 20 million doses of the British vaccine. (Earlier, a private sector-financed purchase of 2.6 million doses of the vaccine was signed, under which half of the doses will be used by business firms for their employees, with the other half donated to the government’s vaccination program.) He also announced that in the next few days conclusive final agreements with other vaccine producers are expected to be signed.

The Senate, sitting as a committee of the whole, yesterday resumed its inquiry on the government’s national vaccination plan. It was set to hear from, among others, representatives of Pfizer, United Laboratories and Zuellig Pharma, as well as from LGU executives and officials of the nation’s doctors’, nurses’ and medical technologists’ organizations.

Also, the House of Representative is weighing in on the vaccination program. Its committee on health has set a hearing on Monday, supposedly intent on ensuring that the P72.5-billion funding under the 2021 national budget would be used to procure the most effective and safest vaccine against COVID-19.

A lot more needs to be disclosed and clarified on plans/decisions made towards ensuring a well-organized national inoculation program, aimed at stopping (or at least minimizing) the spread of COVID-19 infections – now nearing 500,000 cases with almost 10,000 deaths.

Meantime, the government needs to take into account the World Health Organization’s warning that the second year of the coronavirus may be tougher than the first, given how the virus has been resurging with two variants more rapidly spreading – the UK strain in 50 countries, that from South Africa, in 30 territories. One case infection of the UK strain has been detected and is being monitored in a Quezon City quarantine facility.

And don’t forget: what’s the bottom line on the “smuggled” Sinopharm vaccine’s use in the unauthorized inoculation, in September and October, of presidential guards and at least one Cabinet member?

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