The recent announcement of Pfizer and BioNtech’s Covid-19 vaccine sent the world into a tizzy, including Pakistan. There is already talk of the pandemic coming to an end soon and life returning to normal. However, while this vaccine is good news it isn’t the magic cure-all that everyone is perceiving it to be. And, Pakistanis certainly shouldn’t be pinning their hopes on it. As Dr. Atta-ur-Rehman, Chairman of Prime Minister’s Taskforce on Science and Technology already said, “This vaccine is not suitable for Pakistan” and it is “too early to celebrate”.
For the time being everyone’s best bet at beating the virus is to continue to wear a mask and socially distance.
Although it may seem like Dr. Atta-ur-Rehman is needlessly raining on everyone’s parade, there are concrete reasons behind why we shouldn’t get our hopes up and subsequently abandon protective measures. Firstly, the vaccine and its effectiveness has been misunderstood and misreported by most of the media. The vaccine was reported to have an efficacy rate above 90 %, this should not be confused with an effectiveness of 90% as the two are different things. Its efficacy is how well it performed in a trial, under controlled conditions. Vaccine efficacy trials measure the treatment being tested against another control or placebo treatment that is known to be ineffective on the virus. The subjects used in these trials are also normally healthy individuals. Whereas, in order to ascertain the effectiveness of a vaccine it must be deployed in the world and its effects studied. For example, does it perform differently for people of various ages and ethnic backgrounds and how what is the duration of protection provided. At this point in time we do not know the actual effectiveness of the vaccine, only that it warded off symptomatic cases of Covid-19 in 90% of the volunteers that got the vaccine compared to the placebo.
This is not to say the vaccine is ineffective, it is not, only that the rate of its effectiveness is still unknown. There is still uncertainty over the vaccine’s effect on asymptomatic infection, this means that this vaccine might not categorically stop the transmission of Covid-19 even when deployed. Still, if it can prevent the spread of symptomatic infection it will go a long way towards preventing further loss of life.
Now coming to why it will likely be unsuitable to be deployed in Pakistan, there are two main factors. And, those are storage and cost.
Now coming to why it will likely be unsuitable to be deployed in Pakistan, there are two main factors. And, those are storage and cost. Both these factors stem from the fact that this vaccine is based on novel technology unlike any vaccine before. It is an mRNA vaccine, which uses synthetically made genetic code of the virus to teach the body how to fight an infection. Traditional vaccines use inactive or dead forms of a virus to prompt an immune response in the body. This mRNA vaccine tricks the body into producing solitary coronavirus proteins (the spike protein produced is an infectious protein but on its own it cannot assemble into the deadly coronavirus) by itself and then the immune system detects these proteins as threat and produces T-cells and antibodies in defence. Those T-cells and antibodies then are ready to fight off the actual coronavirus should the body come in contact with it. If approved it will be the first vaccine of its kind on the market. But this novel technology is delicate and needs be stored at -70 degrees celsius— just for a frame of reference the coldest winter in Antarctica was -89.6 degrees celsius. Pakistan does not possess the cold chain system requires to transport and store this vaccine. Also, there is also an ongoing shortage of dry ice, which is essential for the transport of the vaccine, in many parts of the world. If the vaccine is not kept at this below freezing temperature it will spoil and be ineffective. Given the native climate and lack of cold storage facilities at airports and hospitals Pakistan will face a monumental challenge in securing and distributing this vaccine.
To successfully deploy this vaccine in Pakistan the government would have to incur significant expenditure to upgrade cold storage facilities, plus the time lag required to set up an entire functioning cold chain. This expenditure would be in addition to the cost of buying the vaccine. Pfizer recently agreed to supply a 100 million doses of the vaccine to the U.S government for $39 (Rs. 6,179) for a two-shot course. At this price inoculating the Pakistani public will be almost prohibitively expensive for the government. Pakistan may have to consider other more traditional vaccines which will be easier to buy and store. China’s Sinovac will probably be Pakistan’s first alternative choice. It is a traditional vaccine that doesn’t need to stored at sub-zero temperatures. And although the quoted price ($60) of the Sinovac vaccine is higher than Pfizers’, Indonesia was able to reach a deal with them to supply it for $13.60 per dose. Pakistan and China are old allies thus there is a possibility that Pakistan can strike a similar deal to secure the Sinovac vaccine. If Pakistan is able to procure that vaccine for the same price as Indonesia it would cost Rs. 4, 309 for a two shot course. This would be more cost effective than Pfizer’s vaccine. Whatever vaccine Pakistan eventually ends up getting it will, in a best case scenario, be at the end of 2021. Thus, for the time being everyone’s best bet at beating the virus is to continue to wear a mask and socially distance.