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COVID19: Cyprus must prepare for vaccine roll-out

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As big pharmaceuticals race against the clock to produce a COVID-19 vaccine, Cyprus health authorities need to start working on logistic challenges for an unprecedented vaccination action plan, argue experts.

Dr Christos Petrou, co-ordinator of the Pharmacy Program at the University of Nicosia, urged authorities to address serious logistic difficulties in importing vaccines that must be stored at extremely low temperatures while also determining which groups will get the vaccine first.

He sees the first batches arriving sometime in the first three months of next year, depending on when the vaccines are approved.

With trials well underway on a global scale involving tens of thousands of participants, Cyprus does have time to prepare, but it must be quick in drawing up plans.

Petrou is sceptical over the government’s capability to execute an effective vaccine roll-out plan, as they did not handle the distribution of flu vaccines very well.

“Authorities knew since February that a pandemic would most likely hit the country, and yet they took their time in ordering flu vaccines.

“That is why they were rushing in September to put in extra orders to cover increased needs as more people would need to be vaccinated to avoid the flu from coinciding with COVID-19.

“We have seen hundreds of thousands of vaccines imported by authorities just thrown in the bin due to bad planning.

“In 2009, some 700,000 flu vaccines were thrown away due to the lack of proper planning and communicating the need to the public to get vaccinated,” said Petrou.

Cyprus will need to find answers to the logistics headache caused by the fact that with the exemption of Moderna’s version, all vaccines will need storing in temperatures of minus 70 to 80 degrees Celsius.

“This presents huge logistic problems, as Cyprus’ health authorities will have to address the issue of how the vaccines will arrive on the island and where to be stored until they are used.

Vaccines can only survive a few days in regular refrigerating temperatures.”

Petrou argued that, even more pressing, Cyprus authorities have to come up with a plan on who will be vaccinated first.

He said Cyprus, unfortunately, has not come up with such a plan but seems to be content in copying other countries.

“This is doomed to fail. Each state will have to come up with its own vaccination scheme, according to the needs of its society and priorities to keep society running.

“Theoretically, the vaccine will be offered to vulnerable groups and then to health workers and teachers.”

However, as he said, Cyprus will need to take a look at its own needs, noting France’s example which included vaccinating people working at abattoirs, to spare the country from a meat shortage.

Meeting demand for vaccines, is a challenge on its own, one which pharmaceutical companies will be hard to push to meet, so governments will need to draw up their vaccination plans.

“This means that Cyprus will not get the 1 million vaccines the government has ordered at once.

“We are more likely to get some 200,000 doses of the first vaccine which gets approved some time at the beginning of next year.

“The health services should have already decided which group they are to vaccinate first.”

Petrou noted that three vaccines developed by Moderna, Pfizer, Astra Zeneca with the contribution of Oxford University are leading the race.

“We must make it clear that we should be looking at what is happening in Europe and not in the US where Moderna is reportedly close to receiving approval from the FDA.

“At the moment just two vaccines are under a rolling evaluation procedure, those developed by Pfizer and Astra Zeneca.”

He explained that once clinical trials are complete and all necessary data is collected, then the companies will file for a conditional license, which will speed up processes so that it can contribute to stopping the virus.

“The vaccine will still be under probation and monitored by the European Medicines Agency. People vaccinated will be monitored for some time to come.”

Vaccines will be safe

According to the latest available data from the World Health Organization, in various phases of Clinical Trials, 48 candidate vaccines are being tested.

Eleven of them are in the third phase, with different schedules each. Also, there are 164 in the pre-clinical trial phase.

Each vaccine employs different technologies, two of the vaccines taking the lead in the race are those of Moderna and Pfizer, which employ what is called a messenger RNA.

“This involves injecting the part of the genetic code that encodes the virus spike protein into the body to produce that protein and train the immune system to fight the virus.

“This is a completely new technical result of scientific and technological progress.

“It is important to emphasize that this technique does not affect the human genetic code.

“Messenger RNA simply carries the message to the cells to produce the virus protein once and for all to protect the body.”

The other vaccines employ harmless gland viruses, genetically modified to resemble the coronavirus, in a bid to trigger a response from the immune system.

Referring to the efficiency of vaccines, Petrou said that they are surprisingly high, with efficiency rates exceeding 90%.

Efficiency

Pfizer / BioNTech announced that their mid-term analysis looked at the first 94 confirmed cases of infections in volunteers who received either two doses of the vaccine or a placebo vaccine.

Less than 10% of infections were in participants who had received the vaccine while 90% of the infections were in volunteers who received the placebo vaccine.

The difference in volunteers who took the placebo was compared to those who received the vaccine and became infected.

“There is still more data to be collected related to whether the vaccine can actually stop people already infected with the coronavirus from developing severe symptoms of the disease.

“How well does each vaccine work on different groups, such as the elderly or vulnerable groups. According to Astra Zeneca, their vaccine seems to be more efficient for the elderly.”

Each vaccine approved and released will have different characteristics.

“Not all vaccines are used in the same way, nor will they have the same effectiveness in every age group or group of patients.

“Most Clinical Trials involve volunteers between the ages of 16-65. This will also need to be considered when drawing up a vaccination program,” said Petrou.

Even with vaccines and a good vaccination scheme, nobody can predict when the pandemic will be over.

Wearing face masks and sticking to protective measures such as social distancing will be a must for the months ahead.

“The news, however, is good, so let’s keep our cool and spring will arrive.

“Until we get through the winter ahead, we will have to continue protecting ourselves and our loved ones by wearing masks, keeping to social distancing and good hygiene.”