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Home Coronavirus

What you must know about Covid-19 vaccination – Pt I

February 23, 2021

Ghana became the fifth country in Africa (after Algeria, Guinea, Tunisia and Gabon) and the 31st in the world to approve the use of Russia’ Sputnik V vaccine for emergency use.

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But the Sputnik V vaccine may not be the only one likely to be used, as the Food and Drugs Authority has also given emergency authorization for use of the Oxford AstraZeneca vaccine as well.

The two manufacturing entities at a point last year went to a partnership to test if a combination of their two vaccines which were based on a similar approach would give a better protection against the virus.

AstraZeneca and Sputnik V are based on a modified version of a common cold virus that is altered to carry genetic instructions for making the coronavirus spike protein and cause an immune response to protect against Covid-19.

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And that is not the only two similarities the two vaccines share; they have faced their fair share of controversies, scepticism, and resistance albeit with successes chalked up within the same period.

SPUTNIK V

  • In August of 2020, when Russia had registered for emergency use of the vaccine, it had yet to go through the third stage of clinical trials. Around the same time however, the country had inoculated some 100 thousand people which included one of President Putin’s daughters.
  • That and several reports subsequent, including fears that politicians rather than scientists were taking charge in communicating the efficacy of the vaccine almost marred the fortunes of the vaccine
  • But sceptics would be swayed when the highly respected The Lancet reported their interim results from a phase 3 trial that showed a consistent strong protective effect across all participant age group
  • The Sputnik V vaccine became the first registered vaccine against Covid-19. This was despite its announcement of being potentially efficacious came after announcements by Pfizer and Moderna.
  • To be stored in a temperature of between 2 and 8 degrees Celsius
  • The vaccine though earlier claimed to have a 95% efficacy, has since be generally accepted to have an efficacy of 92%.
  • The vaccine currently is the only to use two varying serotypes (vectors or carriers) of the SAR-Cove-2 disease. This means the second dose of the vaccine uses a different material from the first jab unlike is the case of other vaccines approved so far; expect Johnson and Johnson’s which is one dose.
  • The phase 3 trial report on some 20 thousand persons 18 years and older showed immunity required to prevent the disease which arose within 18 days of the first dose.
  • The vaccine was seen as effective in persons 60 years and older as well

ASTRAZENECA

  • The vaccine is made through a collaboration between the University of Oxford and its British-Swedish pharmaceutical company partner, AstraZeneca.
  • According to the WHO, the vaccine has an efficacy of 63.09% against symptomatic SARS-CoV-2 infection. The Lancet said initial trials showed an 82.4% efficacy after two standard doses three months apart with the efficacy lower when the doses were closer
  • The vaccine is recommended by the WHO for persons 18 years and above and is a recommended two intramuscular doses with an interval of 8-12 weeks
  • Though the vaccine is also recommended for persons 65 years and older, it was not used in Germany, France and Austria for person 65 years and above because of claims there is limited data on how well it protects the persons over 65years.
  • South Africa which was one of Africa’s earliest recipients of the vaccine discontinued used after initial trials found it provided minimal protection against mild and moderate forms of the South African variant of the Covid-19 disease.
  • The WHO has however recommended its use even if there are variants in a country
  • It can be stored in a normal fridge temperature between 2-8 degrees Celsius.

WHAT DOES THE ADOPTION OF THESE VACCINES MEAN FOR GHANA’S INOCULATION PLAN?

The country is set to receive its first set of vaccines by the end of the month of February.

 An earlier draft plan submitted for review had targeted to inoculate some 74 percent of the population, meaning the country was looking forward to vaccinate almost everyone in Ghana except pregnant women and children under 5 years.

But with the known age threshold of these two vaccines, it means the country’s plan has drastically changed for a good reason. It would mean person 18 years and above would be the ones now to get inoculated. But at the public engagement on the country’s covid-19 vaccination roll out plan, Dr. Kwame Ampnsah-Achiano, the Programme Manager of the extended programme on immunization, explains children and pregnant women would be included as more data becomes available on these groups.

That will bring the initial target percentage drastically down as the Ghana Statistical Service suggest a majority of Ghanaians are 25 years and younger. But the virus largely has had a devastating effect on person older and person with comorbidities. It is the hope of the country to see a drastic impact should the vaccination exercise go as planned.

The plan is to, by the second phase which would see the vaccination of frontline workers and key sectors of the society, see some 20 million persons receiving a jab.

The president has indicated work already is under way to get some 17.6 million vaccine doses in the country by June ending.

Under the COVAX initiative, the country would benefit some six million doses which would be 20% of the estimated population which now stands at some 30 million people.

WHAT IS THE INOCULATION PLAN?

If all works to plan and the country should have its first batch of six million vaccines, it would kick start vaccination probably way ahead of its earlier mid-April plan.

The exercise would be a mixed bag of strategies that would culminate in three phases of vaccination roll out. These strategies are themed under target groups, delivery and hotspots; these then inform the phases.

For target groups, the population has been categorised into several facets, such as health workers, persons with underlying health conditions, security personnel, persons over 60 years judiciary, Media etc

There are approaches to the country’s delivery strategy that would see some areas or groups have two or all three applied to them. These are static or fixed delivery sites which would be hospital and all health facilities in general private and government; mobile or outreach facilities and campouts which will see vaccinators move into areas hard to reach for days to weeks to vaccinate.

The third categorization is on hot spots. The country has also been divided into levels of spread of the virus. With the hardest and worse hit areas which according to current data are Accra, Greater Kumasi and Western region.

PHASE ONE

This will likely commence in March and would see the following group of people vaccinated:

Health care workers, frontline security personnel, persons with underlying medical conditions, persons 60 year and above and frontline members of the executive, judiciary and legislature.

These groups apart from health workers who will have their vaccination at a fixed facility would see a mixed bag of delivery strategy to get them inoculated.

PHASE TWO      

This group which will be the next batch of persons who will get their jabs as more vaccines keeps trickling in will cover persons who work in the media, teachers, students in the senior high and tertiary, farmers, person in the food supply chain, commercial transport operators, waste management, electricity supply services, airport services etc

PHASE THREE

This will be all other persons 18 years and above who do not fall in the first two groupings.

These phases could see sub strategies that would see a target group or phase see a more detailed implementation approach adopting all the available themed approaches for effective coverage. The implementation institutions however have advised nothing is cast in stone and could see modifications as the implementation progresses.

By Cyril Dogbe

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