From Shortlisting Promising Candidates to Negotiations: How Singapore Acquired Its First Shipment of COVID-19 Vaccine



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SINGAPORE: When the first shipment of COVID-19 vaccines from Singapore from Pfizer-BioNTech landed at Changi Airport on Monday (December 21), relief on the runway was palpable.

Just hours earlier, fears of supply chain disruptions had emerged.

European countries had closed their borders to isolate Britain after reports of a more infectious variant of COVID-19 there represented a new wave of cases.

Fortunately, Singapore was prepared for such situations, the Economic Development Board (EDB) told CNA.

“To mitigate the risk of supply disruptions as a result of new waves of infection in other countries, we are working to ensure diversity in manufacturing locations across the portfolio of purchased vaccines,” EDB said.

Back-up air transport arrangements were also in place to guard against limited global air cargo capacity, he said.

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ASSEMBLING THE EQUIPMENT

The arrival of Singapore’s first COVID-19 vaccine has been long awaited, providing hope to end a global pandemic that has infected more than 77 million people and claimed 1.7 million lives. .

Even before COVID-19 cases rose to the thousands in Singapore, the search for suitable vaccine candidates had already begun.

In April, EDB President Dr. Beh Swan Gin established a Therapy and Vaccine Expert Panel (TxVax) led by Dr. Benjamin Seet, group deputy general manager (research in education) at the National Healthcare Group.

The panel consisted of 18 scientists and doctors from hospitals, A * STAR and the private sector.

Their mission was to find promising vaccine candidates around the world.

There have been around 160 candidates to date, and the panel narrowed it down to 35 after selecting the type of technology, track record and production schedule.

Once certain vaccines and therapies showed promise, the government set up a planning group to acquire them early, EDB said.

The multi-agency group consisted of members from EDB, the Ministry of Health, the hospital group, the Health Sciences Authority, and the Prime Minister’s Office.

He studied the TxVax panel analysis to shortlist promising candidates, spanning different vaccine technologies.

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ACQUISITION PROCESS

Three vaccines soon became viable: Moderna, Pfizer-BioNTech, and Sinovac. The first two vaccines use the new messenger RNA technology. Sinovac is a traditional inactivated virus vaccine.

MRNA vaccines teach our cells to produce a protein that triggers an immune response within our body. This is different from traditional vaccines that put a weakened or inactivated germ in our body.

The group entered into its first advance purchase agreement with Moderna in June, securing it with an advance. In August, he bought the Sinovac vaccine and held discussions with Pfizer-BioNTech.

Although Moderna appeared to be the pioneer, the US Food and Drug Administration gave its stamp of approval to the Pfizer-BioNTech vaccine earlier, on December 11.

Singapore followed suit, with Prime Minister Lee Hsien Loong announcing in a televised speech on December 15 that the Health Sciences Authority had approved the Pfizer-BioNTech vaccine.

The first shipment would arrive in late December, and other vaccines are expected to arrive in the coming months, Lee said at the time.

He also said that if all went according to plan, Singapore would have “enough vaccines for everyone” by the third quarter of next year.

READ: Pfizer-BioNTech, Moderna and Sinovac: A Look at Three Key COVID-19 Vaccines

Singapore’s path to vaccine procurement was fraught with uncertainty, as decisions had to be made during the early phases of clinical trials, EDB said.

“When we were about to negotiate the product, we had no idea if it was actually going to be licensed,” said EDB’s Dr. Lisa Ooi, vice president of health and wellness.

“It had to be accompanied by a risk-adjusted approach. For example, how much do we buy, when, what data will allow us to make certain decisions. So all the decisions were made in a very data-driven process where we go through the vaccine data. “

While EDB began by establishing extensive contact with vaccine manufacturers, the Ministry of Health negotiated and finalized commercial agreements.

“In the advance purchase agreement, you are trying to buy something before the products are actually available. It’s almost like buying a movie ticket even before the criticism comes in,” Dr. Seet said.

“Then we have to see how soon we can get it to Singapore. If we want to buy, is it available? Because it could actually be bought by bigger jurisdictions – the US, the EU, a lot of the bigger economies have bought. huge chunks, ”he added.

Once a candidate was identified, they were subject to independent approval by the HSA.

To date, Singapore has signed some 40 confidentiality agreements with pharmaceutical companies, giving it access to unpublished data. That allows authorities to make a more informed decision about vaccines.

READ: Singapore to begin Phase 3 of COVID-19 reopening on December 28

VACCINE SAFETY

The government has not disclosed how many doses of the Pfizer-BioNTech vaccine it ordered, but said it is the first time it has purchased large quantities of a drug before approval.

Dr. Seet explained: “We evaluate all vaccine technologies. But eventually we looked at RNA with much more interest, in particular because it was easier to manufacture and therefore we participated in clinical trials earlier and, in fact, it may be available globally in the large quantities needed. “

Associate Professor Tan Say Beng, executive director of the National Council for Medical Research, said the standard of clinical trials also gave Singapore the confidence to move forward.

“Globally, many agencies in countries are confident that the process was accomplished. You were not risking compromising the integrity of the study, so if you need 30,000 subjects, you will get 30,000 subjects. So there were no shortcuts to that point. view.”

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Singapore has allocated over S $ 1 billion to vaccination efforts, of which upfront payments have been made to at least three companies.

While it has not disclosed the true cost of each deal, authorities say Singapore’s economic strategies gave it an advantage during the talks.

“Singapore is really known as a leading biomedical center, so I think the region looks to Singapore for some thought leadership, be it regulatory, clinical science,” said EDB’s Senior Vice President and Director of Health and Wellness, Ms. Goh Wan Yee. .

“That position, plus the fact that many companies have significant bases in Singapore, puts us on a good basis to be able to negotiate and work with them despite our small market size,” he added.

To shore up the country’s pandemic response, EDB also worked with companies to establish vaccine production facilities here.

With the shipment now in Singapore, work will begin to vaccinate residents.

The government has said the vaccines will be voluntary, but has urged residents to get vaccinated.

Priority will be given to those most at risk, such as frontline and healthcare workers, and the elderly and vulnerable.

As the population is vaccinated, an ongoing review will continue to track the vaccine data.

“Since the drug is used in the population, not just in Singapore but around the world, the company has a requirement to track any adverse events it detects. It works closely with the regulator, HSA in this case, to make sure You have to monitor, have a log if you want, all the different side effects that you see, ”said Assoc Prof Tan.

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