This is how vaccination will be for Colombians – Health

While in Europe the first doses of vaccines have already begun to be applied to stop the new coronavirus – which to date has caused 1.6 million deaths throughout the planet – Colombians wonder which biological they will receive and when.
Although the answers are not yet clear, it must be started by saying that for the purchase of vaccines the country opted mainly for the Covax strategy, a global alliance to promote early access and equitable distribution of these products for member countries.

(Read also: How is Colombia going in the race to access vaccines against covid-19?)

The mechanism, conceived as a large common bag, aims to add demand and access a larger portfolio of vaccines, thereby guaranteeing, at least in a first phase, vaccination for twenty percent of the world’s population. To date, more than 180 countries have joined, some as funders and others as beneficiaries.

Colombia joined in August and secured 20 million doses, for which it had close to 200 million dollarss, under the premise that the most advanced projects and others in earlier phases will deliver vaccines according to the production rate of their holders. However, it is not enough as high-income countries made sure to have the highest number of doses for their population from day one.

And they did it through two mechanisms: financing research and development, and signing early risk purchase agreements, thereby guaranteeing a large part of the laboratories’ production.

For this reason, according to health worker Elizabeth Beltrán, the distribution of vaccines, far from being equitable, shows enormous distances between some countries and others, and between countries and Covax. In fact, many governments, without prejudice to their adherence and trust in Covax, quickly understood that the strategy of access to the vaccine should be complemented and they initiated bilateral agreements with pharmaceutical companies. This explains why the production of the vaccines that are going forward is committed until 2021.

Colombia also understood this and, despite not having activated the private sector coalition for the acquisition of the vaccine that President Iván Duque enthusiastically announced in August, the Government began conversations with different producers and to date confidential agreements have been signed. with Pfizer, Astrazeneca, Janssen, Sinopharm, CanSino and Serum Institute of India, with no business closing.

What has been public is that, through Resolution 2327 of November 25, 2020, the Ministry of Finance authorized the use of more than 437,000 million pesos through the Emergency Mitigation Fund for the acquisition of 10 million of doses of Pfizer vaccines, priced at $ 12 per dose. While the weeks go by and the agreements are finalized, the countries of the region ensure their place in line and Colombia has not yet appeared with something concrete, except the participation in Covax.

Disturbing law

Meanwhile, with an urgent message from the Government, the so-called vaccine law (2064 of 2020) was approved, which declared of general interest the strategy for the immunization of the Colombian population against covid-19, provides the free vaccines for the entire population, tax benefits for those who donate resources for their acquisition and creates the council for the evaluation of the “adverse reactions” caused by the application of these products.

The law exempts pharmaceutical companies from liability for the negative effects of products while in emergency use. Although this aspect has generated controversy, to the point that Beltrán describes it as “a shameless cession to the laboratories that goes against the well-being of the people”, the truth is that this is an immovable condition of the negotiations with all pharmaceutical companies. , including those bidding through Covax.

Specifically, although in some countries there are several applications for the use of emergency vaccines, only Pfizer has obtained this license in the United Kingdom, Canada and the United States. In Colombia, this emergency framework is unknown and without it the agency Sanitary Invima does not have the tools to allow the entry of vaccines to the country, so the Government announced its expedition for the next few weeks.

Not before 2022

Fernando Ruiz, Minister of Health, announced that the vaccine will arrive in the first half of 2021 with the aim of vaccinating 15 million Colombians: 10 million through the Covax mechanism and 5 million for bilateral purchases.

The vaccination plan will be prioritized based on the greatest exposure and risk to covid-19, that is, health professionals, the elderly population and the population with comorbidities. The economically active population would then follow. The rest of the population will have to wait even until 2022, according to the response of the Ministry of Health to a right to petition by Congressman José Daniel López.

The great challenge is to have access to the first wave of vaccine supply with opportunity. Later, when the portfolio of biologics is expanded, with new developments that have sanitary authorization, and rich countries begin to have surpluses, it will be a question, through cooperation and binational agreements, to access a new batch of vaccines for the next group of people.

This will advance towards the immunity of 70 percent of the population, and the goal will be considered fulfilled.

Logistics must be added to the challenge of access. Vaccinating 15 million Colombians in a first wave, reaching 70% of the population in two or three years, is something that has never been done in the country, despite having the Expanded Immunization Plan, which is an example in the region and reaches the entire national geography. It should be considered that the vaccines that will be available, through Covax or bilateral agreements, are different from each other in their production technology.

Some are based on viral vectors whose production is easier to scale, as well as their distribution and storage. Others have innovated from mRNA and require extreme refrigeration conditions, such as Pfizer’s, which must be kept below –70ºC.

This implies that logistics and handling are not the same for all biologics. Some vaccines will be single-dose, others will require two doses with varying time intervals; others will require a dilution medium for application.

And, in this sense, for months the health systems and their technology providers have been evaluating the production and supply capacity of syringes, the availability of glass for ampoules, the means for dilution, and it is not something less if it is considered that 5,000 millions of people will need to be vaccinated in the next few years, something that has never been done.

The general feeling is that the country cannot be left behind and must promptly and responsibly secure a place in this line, without neglecting that all the requirements associated with this task on which they will depend, to a large extent, must be reviewed and met. the well-being of the people, the reactivation of the economy and the return to normality.

HEALTH UNIT

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