Nigeria may not receive second batch of COVID-19 vaccine until September

More reasons have emerged why Nigeria and so many other developing countries may not get their second batches of COVID-19 vaccines under the COVAX facility until September.

A reliable source at the National Primary Health Care Development Agency (NPHCDA) told The Guardian yesterday: “We are expecting to get the next batch of COVID-19 vaccines in August. But with what is happening in India, I don’t think that will be possible. Most of the vaccines, call it AstraZeneca or Johnson & Johnson, are all mass-produced in India. Also, most of the vaccines under COVAX facility are coming from India. India has also banned all exports of vaccines and essential drugs and medical equipment.”

Also, the Executive Director, United Nations Children Fund (UNICEF), Henrietta Fore, in a statement, recently, as G7 countries gear up for June summit, said: “… Among the global consequences of the situation in India, a global hub for vaccine production is a severe reduction in vaccines available to COVAX. Soaring domestic demand has meant that 140 million doses intended for distribution to low- and middle-income countries through the end of May cannot be accessed by COVAX. Another 50 million doses are likely to be missed in June. This, added to vaccine nationalism, limited production capacity and lack of funding, is why the roll-out of COVID vaccines is so behind schedule.”

COVID-19 Vaccines Global Access, abbreviated as COVAX, is a worldwide initiative aimed at equitable access to COVID-19 vaccines directed by Gavi, the Vaccine Alliance (formerly the Global Alliance for Vaccines and Immunisation, or GAVI), the Coalition for Epidemic Preparedness Innovations (CEPI), and the World Health Organization (WHO).

The Serum Institute of India (SII), the largest single supplier to the COVAX scheme, has made none of its planned shipments since exports were suspended in March.

UNICEF buys and distributes vaccines for COVAX. It is urging leaders of G7 nations and European Union (EU) states to share their doses. They are due to meet in the United Kingdom (UK) next month.

The Group of Seven (G7) is an intergovernmental organisation consisting of Canada, France, Germany, Italy, Japan, the United Kingdom and the United States. The heads of government of the member states, as well as the representatives of the European Union, meet at the annual G7 Summit.

According to the statement, G7 leaders will be meeting next month with a potential emergency stopgap measure readily available. New data analysis provided by Airfinity, the life sciences research facility, and commissioned by the UK National Committee for UNICEF, indicates that G7 nations and ‘Team Europe’ group of European Union Member States could donate around 153 million vaccine doses if they shared just 20 per cent of their available supply over June, July and August. Critically, they could do so while still meeting their commitments to vaccinate their own populations.

The UNICEF Chief said while some G7 members have greater supply than others, and some have further advanced domestic rollouts, an immediate collective commitment to pool excess supply and share the burden of responsibility could buttress vulnerable countries against becoming the next global hotspot.

However, Fore said the COVAX Facility will deliver its 65 millionth dose in the coming days and it should have been at least its 170 millionths. By the time G7 leaders gather in the UK next month, and as a deadly second wave of COVID-19 will likely continue to sweep across India and many of its South Asian neighbours, the shortfall will near 190 million doses.

UNICEF noted: “We have issued repeated warnings of the risks of letting down our guard and leaving low- and middle-income countries without equitable access to vaccines, diagnostics and therapeutics. We are concerned that the deadly spike in India is a precursor to what will happen if those warnings remain unheeded. While the situation in India is tragic, it is not unique. Cases are exploding and health systems are struggling in countries near – like Nepal, Sri Lanka and Maldives – and far, like Argentina and Brazil. The cost for children and families will be incalculable.

“The longer the virus continues to spread unchecked, the higher the risk of more deadly or contagious variants emerging.

“The clearest pathway out of this pandemic is a global, equitable distribution of vaccines, diagnostics and therapeutics. COVAX, led by the WHO, Gavi and CEPI, with UNICEF as implementing partner, represents such a pathway. But COVAX is undersupplied.”

Fore said, ultimately, the global vaccination race will be won when Member States make sustainable plans to fully fund and supply the COVAX Advance Market Commitment, while supporting the expansion of vaccine manufacturing capacity, including through proactive Intellectual Property licensing and technological transfer. “These measures are critical, but they won’t change anything overnight. Sharing immediately available excess doses is a minimum, essential and emergency stop-gap measure, and it is needed right now,” she said.

According to UNICEF, shortfall numbers are based on delays related to shipments from the Serum Institute of India (SII) only. Other delays related to the original COVAX delivery schedule are expected to be made up, by the end of June. There is currently no timetable to resolve SII-related delays.

The Airfinity analysis is produced using data forecasts of vaccine supplies allocated to G7 members based on doses set to be readily available. The supply forecasts are based on existing deals between countries and manufacturers of approved vaccine candidates unless specified as included vaccine candidates currently undergoing Phase III trials. The aggregate figure of 153 million doses represents the total of available doses if all G7 members donate 20 per cent of their available supply in June, July and August 2021, minus Novovax (due to anticipated supply limitations affecting Novovax).

The Novavax COVID-19 vaccine, codenamed NVX-CoV2373, and also called SARS-CoV-2 rS protein nanoparticle with Matrix-M1 adjuvant, is a COVID-19 vaccine candidate developed by Novavax and the CEPI and is undergoing trials in India under the brand name Covovax.

According to the National Primary Health Care Development Agency (NPHCDA), Nigeria has used more than 87.8 per cent of its first batch of 1.92 million doses of AstraZeneca COVID-19 vaccines, which will expire in June.
However, countries in Africa are some of the most reliant on doses through the COVAX scheme.

But, like in many parts of the world, there has also been hesitancy around receiving the vaccine among some communities. Another major challenge is physically getting the doses into people’s arms – all that requires health workers to be specially trained and the vials to be transported to far-flung parts of countries where infrastructure can be limited.

Some nations are now facing the prospect of deciding whether to give second doses to the most vulnerable who have already been given one jab or continue vaccinating more people as planned in the hope that the next shipments turn up soon.

According to the WHO, nations including Rwanda, Senegal and Ghana are already using some of their last remaining doses.

Seven countries in Africa have used almost 100 per cent of their COVAX doses including Botswana, Ghana, Rwanda and Senegal. Kenya and Malawi have used nearly 90 per cent of their COVAX doses. Cabo Verde and the Gambia have used 60 per cent of their COVAX doses. 1.3 million doses have been redistributed from the Democratic Republic of Congo to other parts of Africa because the country will not be able to use them all before their expiry date in June.

Meanwhile, a recent risk assessment of the situation in India conducted by WHO found that resurgence and acceleration of COVID-19 transmission in India had several potential contributing factors, including an increase in the proportion of cases of Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2) variants with potentially increased transmissibility; several religious and political mass gathering events which increased social mixing; and, underuse of and reduced adherence to public health and social measures (PHSM). The exact contributions of each of these factors on increased transmission in India are not well understood.

Preliminary analyses conducted by WHO using sequences submitted to GISAID suggest that B.1.617.1 and B.1.617.2 have a substantially higher growth rate than other circulating variants in India, suggesting potential increased transmissibility compared. Too few sequences of B.1.617.3 have been detected to date to assess its relative transmissibility.

GISAID is a global science initiative and primary source established in 2008 that provides open access to genomic data of influenza viruses and the coronavirus responsible for the COVID-19 pandemic.

Meanwhile, a new study suggests that delaying the second dose of the Pfizer–BioNTech mRNA vaccine could boost antibody responses after the second inoculation more than threefold in those older than 80.

The authors said it is the first direct study of how such a delay affects coronavirus antibody levels and could inform vaccine-scheduling decisions in other countries. “This study further supports a growing body of evidence that the approach taken in the UK for delaying that second dose has really paid off,” Gayatri Amirthalingam, an epidemiologist at Public Health England in London and a co-author of the preprint, said during a press briefing.

Many COVID-19 vaccines are given in two doses: the first initiates an immune response, and the second; ‘booster’ shot strengthens it.

Clinical trials of the three vaccines used in the United Kingdom generally featured a three- to the four-week gap between doses.

But for some existing vaccines, a longer wait between first and second doses yields a stronger immune response. Delaying the COVID-19 booster shots could also expand partial immunity among a greater swathe of the population than could the shorter dosing schedule. On December 30, the United Kingdom announced that it would delay the second dose by up to 12 weeks after the first.