Pfizer, Moderna COVID-19 vaccines could possibly be available in India through COVAX route

India is eligible to get COVID-19 vaccines from COVAX for vaccinating about 20 percent of its population.

January 25, 2021 / 05:08 PM IST

With Pfizer signing the deal with COVAX, and Moderna in talks, the possibility of these two vaccines becoming available to the public in India and other low middle income countries (LMIC), may soon become reality.

COVAX is a global initiative coordinated by Gavi, the Vaccine Alliance, the Coalition for Epidemic Preparedness Innovations (CEPI) and the World Health Organization (WHO) to provide equal access to COVID-19 vaccines for 92 LMIC countries. India is eligible to get COVID-19 vaccines from COVAX for vaccinating about 20 percent of its population. India has begun the first wave of COVID-19 vaccinations to inoculate three crore healthcare and frontline workers, using Serum Institute of India's (SII) Covishield and Bharat Biotech's Covaxin.

Read here on the status check on COVID-19 vaccines in the pipeline for India over next six months

Pfizer and BioNTech on January 22 said they have signed an advanced purchase agreement with COVAX for up to 40 million doses of COVID-19 vaccine in 2021, subject to the execution of additional agreements under the COVAX structure.

Neither Pfizer nor COVAX have provided the procurement price details of the vaccine.

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COVID-19 Vaccine

Frequently Asked Questions

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How does a vaccine work?

A vaccine works by mimicking a natural infection. A vaccine not only induces immune response to protect people from any future COVID-19 infection, but also helps quickly build herd immunity to put an end to the pandemic. Herd immunity occurs when a sufficient percentage of a population becomes immune to a disease, making the spread of disease from person to person unlikely. The good news is that SARS-CoV-2 virus has been fairly stable, which increases the viability of a vaccine.

How many types of vaccines are there?

There are broadly four types of vaccine — one, a vaccine based on the whole virus (this could be either inactivated, or an attenuated [weakened] virus vaccine); two, a non-replicating viral vector vaccine that uses a benign virus as vector that carries the antigen of SARS-CoV; three, nucleic-acid vaccines that have genetic material like DNA and RNA of antigens like spike protein given to a person, helping human cells decode genetic material and produce the vaccine; and four, protein subunit vaccine wherein the recombinant proteins of SARS-COV-2 along with an adjuvant (booster) is given as a vaccine.

What does it take to develop a vaccine of this kind?

Vaccine development is a long, complex process. Unlike drugs that are given to people with a diseased, vaccines are given to healthy people and also vulnerable sections such as children, pregnant women and the elderly. So rigorous tests are compulsory. History says that the fastest time it took to develop a vaccine is five years, but it usually takes double or sometimes triple that time.

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Cold storage barrier

The Pfizer-BioNTech vaccine has already received emergency use listing from the WHO. Pfizer said it will work with the countries to put in place cold chain requirements for the rollout of the vaccines.

"As we prepare to provide these first doses, we will provide support so that countries can ensure that solid systems are in place for vaccine delivery, building on our recent innovations in packaging to manage cold chain requirements," Pfizer said in a statement

"Establishing the infrastructure needed to administer breakthrough mRNA vaccines in developing countries will not only help the world fight this pandemic but make us more prepared for the next one," the statement added.

Earlier this month, US biotech Moderna told Moneycontrol that it is still in discussions with COVAX, but is yet to sign an agreement.

"We are actively participating in discussions with multilateral organizations, such as COVAX. Moderna understands the important role that multilateral organizations will play in helping to expand access and protect populations around the world," Moderna said in an email statement.

Both Pfizer-BioNTech and Moderna COVID-19 vaccines are based on the messenger RNA platform and have efficacy rates of over 90 percent. While they are now available in the developed world, the high price tag and low cold storage temperature requirements have made the vaccines inaccessible to most low and middle income countries including India.

Also unlike AstraZeneca and Novavax who have tied up with SII, Johnson & Johnson with Biological E and Russia's RDIF with Dr Reddy's and Hetero for Sputnik V vaccine, to manufacture COVID-19 vaccines locally, Pfizer and Moderna haven't yet entered into any such tie-ups. Analysts say given the novelty of the mRNA, technology is possibly the reason for them not to enter.

COVAX has now become a gateway for the availability of these vaccines. The Pfizer vaccine was priced at $19.5 per dose, the Moderna charges $32-$37 per dose, according to a presentation by the government. Pfizer requires storage temperature of minus 70°C, Moderna needs to be preserved at temperatures between -25°C and -15°C.

SII the top supplier

COVAX now has agreements in place to access just over two billion doses of several promising vaccine candidates. But it expects at least 1.3 billion of these doses will be made available to the 92 economies eligible by the end of 2021. The rollout of the COVID-19 vaccines from COVAX to begin in Q1 2021.

The initial focus would be to protect health care and other frontline workers as well as some high-risk individuals. The aim of COVAX is to protect at least 20 percent of each participating population by the end of the year.

The major chunk of vaccine doses for COVAX will be coming from the Serum Institute of India (SII). COVAX has signed agreements to buy 200 million doses of AstraZeneca-Oxford University and Novavax vaccines from SII, with an option to secure additional doses based on requirement. Of these first 100 million doses, the majority are earmarked for delivery in the first quarter of the year, pending WHO Emergency Use Listing. The AstraZeneca-Oxford University vaccine requires 2-8°C and is priced at $3 per dose, making it the most affordable and convenient COVID-19 vaccine.

The WHO review process, which is currently underway, follows approval for restricted use in emergency situations by the Drugs Controller General of India earlier this month, and is a critical aspect of ensuring that any vaccine procured through COVAX is fully quality assured for international use.
Viswanath Pilla is a business journalist with 14 years of reporting experience. Based in Mumbai, Pilla covers pharma, healthcare and infrastructure sectors for Moneycontrol.
first published: Jan 25, 2021 05:08 pm

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