The country's plan to vaccinate around 80 percent population over the next two years was thrown in disarray following news that India reportedly slapped a ban on the export of the vaccine manufactured by the Serum Institute. The Business Standard reached out to two experts on what a possible delay could do to our Covid-19 pandemic management-
'We should have kept some phase-2 vaccines in the pipeline'
If we want to vaccinate 70-80 per cent people with the purpose of achieving herd immunity, we have to complete the process in one year. As far as I know, the available vaccines in the market give protection for one year. The people who are making decisions and planning these should consider this fact.
We cannot say the plan to vaccinate 80 per cent people is at risk now. It is too early to comment on the issue. But collecting the vaccine is the most important part of the planning.
We were supposed to source vaccines from other sources, and the government is doing that as well.
We should have kept some phase-2 vaccines in the pipeline of the procurement plan too. There is still time, within the next six months, some more vaccine will be available. Those vaccines will have some additional benefits, for example, some will work on a single dose. Some of the vaccine can be preserved at a temperature of 2-8 degrees, and even in room temperature. Some of the vaccines which can be kept in room temperature for one month to one year will be available within one year.
We do not need to be anxious about vaccines right now. A good plan is important to make the future secure. We need to buy two to three types of vaccines for vaccinating the whole population.
For the time being, we can say that if we vaccinate 70 to 80 per cent people, we will be able to achieve herd immunity.
MRNA vaccine will have to be kept in temperatures -20 to -80 degrees Celsius. The rest of the vaccines, including inactivated, protein-based can be kept in temperatures between 2-8 degree Celsius. There is no big obstacle to procurement of vaccines.
As for risks of using vaccines that have sped through in the trial phase, there is nothing in the world that does not have side effects, including water. You have to consider the risk and benefit ratio. How many people are suffering side effects? There is no medicine in the history of the medicine which does not have side effects.
Vaccines should also not be considered a replacement for masks. We all have to maintain the health guidelines. We will have to use masks for the next five years, or at least three years.
We will get the scope of talking to people without masks at least three years later. No vaccine will ensure that reality over the next three years.
Md Sayedur Rahman, chairman department of pharmacology, BSMMU.
'When people without expertise take decisions, mistakes happen repeatedly'
Bangladesh is an overpopulated country. If the government tries to vaccinate 80 percent of the population, that would mean vaccines have to reach over 13 crore people. That is very tough to attain in two years.
The uncertainty surrounding the arrival of vaccines had been anticipated. Such warning from the National Immunization Technical Advisory Groups (NITAG) was made earlier. Actually, the uncertainty was triggered from a scientific perspective as well. There is always a risk about whether a vaccine will be approved or not. In which case, we should not have depended on a single vaccine simply because it might even have not been approved at the trial phase. Dependence on a single source of vaccine is always risky.
There were recommendations about collecting vaccines from multiple sources. Of course, Bangladesh could have done that. We have missed many options so far. For example, the Chinese vaccine company Sinovac Biotech wanted to launch a human trial in Bangladesh. If their proposal had been approved, Bangladesh would have had access to the vaccines like Indonesia did.
If policymakers are not farsighted and do not consider the recommendations of public health professionals, problems like such uncertainties will be created on a regular basis. This happened earlier when the pandemic initially hit, and now it is happening on the vaccine issue. This is really unfortunate.
The proposal for human trial by the Chinese venture should have been approved. We should always be encouraging such scientific endeavours. Access to scientific research is a prerequisite for technological advancement. Why do you think some countries invest in Mars exploration? Even if that does not work out, the outcome of that research work could be applied to many other projects.
Like that, the human trial would have helped enrich our knowledge. Our researchers' quality would have been enriched. We could have learned whether the vaccines are effective on the people of country, or not. And finally, we would have had a better chance of getting the vaccines because the vaccine producer would be morally bound to provide us with the required doses. Conservatism against research work actually hinders progress.
There is a plan to vaccinate around 1.5 crore people in the first six months in Bangladesh. The main objective of vaccination is not to build herd immunity initially, rather to protect the people who are on the frontline and most vulnerable. These are medical service providers, security personnel, media workers and politicians. We need to protect the vulnerable people like senior citizens. Herd immunity will be achieved in phases.
There is new information that scientists are developing a second-generation vaccine that could be preserved under 2 to 3 degree Celsius, or even in room temperature. We need to be open to all the options.
If the responsibility of monitoring and recommendation on vaccination falls upon NITAG, it would be easier for the government to deal with this. But when administrative people who do not have experience or expertise in the field take the decisions, then mistakes happen repeatedly. In the time of pandemic, this has been proven again.
Dr Be-Nazir Ahmed, Member, National Immunization Technical Advisory Groups.