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COVID-19 VACCINE DISCOVERIES: How soon will it be available in Nigeria?

-By Ibrahim Suleiman PhD

Hopes were raised following the recent report on Pfizer’s vaccine effectiveness in preventing novel Corona Virus Disease (COVID-19) symptoms. The vaccine candidate was reported to possess about 90% efficacy in the ongoing phase 3 trials and showed no serious safety concern. The company plan to produce 50 million doses in 2020 and 1.3 billion doses of its vaccine, in partnership with the German company BioNTech, by the end of 2021. This is a major victory in the fight against a pandemic that has killed over 1 million people, negatively impacted the world’s economy, and upended daily life.

Even though a Nigerian Physician-scientist, an associate professor of Medicine and Infectious disease, Dr. Onyema Ogbuagbu, is at the centre of the Pfizer-led research. The question in the minds of many developing nations is if the vaccine will be made available and accessible to the rest of the world. Rachel Silverman, of the nonprofit Centre for Global Development in Washington, D.C. said “For most people in low- and middle-income countries, this vaccine is not likely to be available, at least, by the end of next year.”

Even if Pfizer could manufacture more doses, most low- and middle-income countries probably won’t be able to meet the vaccine’s logistics requirement for its maintenance, storage, and transportation at extraordinarily low temperatures (minus 80 degrees Celsius). It was noted that the Pfizer vaccine requires a special ultra-cold freezer that even a lot of hospitals and clinics in the U.S. currently don’t have.

In addition, Pfizer’s COVID-19 vaccine requires two doses, creating significant challenges for a global vaccination campaign and overwhelming logistical challenges of achieving a two-dose regimen, thereby making it more difficult to supply low- and middle-income countries. More than 80% of Pfizer’s vaccine supply deals are placed through advance purchase agreements by extremely rich countries such as the U.S., U.K., Canada, and Japan. So far, over 1.1 billion doses are already claimed by these rich governments, which represent only 14% of the global population.
Moderna’s shot was recently reported to be 95% effective against COVID-19 symptoms. Interestingly, it has a better storage requirement (relative to Pfizer) of -20 degree Celsius. In Nigeria, the Pfizer and Moderna vaccines storage requirements will make a large vaccination campaign unrealistic. Thus the Pfizer and Moderna shot will not likely be an immediate solution in Nigeria and most African countries.

Apart from Pfizer’s vaccine, many other COVID-19 vaccines are currently being developed using the same technology as that of Pfizer’s vaccine, by targeting the spike protein of the SARS-CoV-2 virus. A recent report from Oxford University research (in collaboration with AstraZeneca) revealed a 90% effective vaccine product with improved storage and transportation logistics requirements. Their vaccine can be stored in normal refrigerated temperatures (2-8 degree Celsius) and the price of the vaccine is expected to be about 85% cheaper than Pfizer’s and Moderna’s vaccines. Prof Sarah Gilbert, the lead scientist that discovered the Oxford vaccine said, “we’re a University, we’re not in it to make money”. This statement further confirms the pledge made by Oxford University and AstraZeneca to make their vaccine available on a non-profit basis “in perpetuity” to low and middle-income countries. This will increase the accessibility of the vaccines to countries such as Nigeria.

Other potential vaccines such as the one from Johnson & Johnson’s is formulated in a one- and two-dose regimen, and is expected to be stable at refrigerated temperatures of 2 to 8 degrees Celsius. When the company started its phase 3 trial in September 2020, the company said the candidate vaccine is “compatible with standard vaccine distribution channels and would not require new infrastructure to get it to the people who need it.” The report of Johnson & Johnson’s vaccine efficacy will be released in the early months of 2021. If proven effective, their vaccine may turn out to be more compatible with Nigeria’s existing vaccination campaign logistics, thus saving the country extra unbudgeted expenditures by adopting cold chain management using existing infrastructure. This means Nigeria may not have access to the COVID-19 vaccine until mid or late 2021.

Few other pharmaceutical companies that are currently developing COVID-19 vaccines include the Sanofi, GSK, and CureVac. Interestingly CureVac’s mRNA candidate doesn’t have any hefty storage requirements. The vaccine is stable for at least three months at refrigerated temperatures and up to 24 hours at room temperatures. In an effort to increase the affordability of these vaccines to developing nations, World Trade Organization (WTO) proposed the waiver of intellectual property rights needed for the manufacturing of COVID-19 vaccines, a proposal that was vehemently rejected by concerned rich countries. The waiver would have made the vaccine access cheaper for developing nations. Interestingly the G-20 pledged to pay for vaccine distribution to developing nations that can’t afford it. Access to these vaccines will help curb the spread of COVID-19 in Nigeria. The spread of the virus in Nigeria continues to record significant increases as the latest statistics provided by the Nigeria Centre for Disease Control revealed that Nigeria now has 66,228 confirmed cases as of 21st of November 2020.

In an earlier testing, common side effects of the vaccines included sore arms, fever, chills, and fatigue, but nothing severe. While the preliminary results for most of these vaccines are good, several key questions remain unanswered, including: How long does the protection last? Does the vaccine prevent severe disease and complications? Can vaccinated people still carry and spread the virus? How well does the vaccine work in older adults? Elderly people are at higher risk from COVID-19, but their immune systems often do not respond as well to vaccines. Does it work better or worse in different ethnic groups? Answers to these questions are too early to answer. Rather answers may be unveiled at a later time.

The role played by a US-based graduate of the University of Calabar, Dr. Ogbuagbu, in the discovery and development of Pfizer’s vaccine further confirms that Nigeria has all the necessary potentials and Human resources it needs to develop its own vaccine, the problem lies with the system and its current priorities. The federal government and the private sector may need to re-strategize on local content development in the pharmaceutical sector. This will help in addressing availability, accessibility, the economic burden of obtaining vaccine from foreign countries, and racial variations in responses to vaccines by developing and testing vaccines locally. It is high time Nigeria become the true “giant of Africa” in the medicare and health sector.