Why Uganda is opting for AstraZeneca

Wednesday February 17 2021
news04pix

A vial containing the Covid-19 vaccine by AstraZeneca at the Robert Bosch Hospital in Stuttgart, Germany. PHOTO AFP

By Tonny Abet

The AstraZeneca vaccine being purchased by government has 63 per cent efficacy in preventing Covid-19 illness, the World Health Organisation (WHO) revealed on Monday.

“The AstraZeneca/Oxford product is a viral vectored vaccine. AstraZeneca has been found to have 63.09 per cent efficacy and is suitable for low and middle-income countries due to easy storage requirements,” WHO said in a statement, adding the vaccine has been listed for emergency use.

This efficacy is, however, 30 per cent below the Pfizer and Moderna vaccines, which are being used in other countries, including Rwanda.

Pfizer and Moderna vaccines have efficacy of 95 per cent and 94 per cent, respectively at preventing Covid-19 illness, according to the US Centers for Disease Control (CDC) and Prevention.

We were unable to establish a ranking by WHO of the efficacy of the Moderna and Pfizer vaccines and neither does CDC have an efficacy ranking for AstraZeneca jabs, meaning different criteria were likely used by the two agencies to rank the vaccines.

Asked why government has settled for the AstraZeneca vaccine despite the comparably low efficacy, Dr Alfred Driwale, the programme manager of Uganda National Expanded Programme on Immunisation (UNEPI) at the Ministry of Health, said they made a number of considerations.

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“What we are interested in with this [AstraZeneca] vaccine is to reduce the severe form of Covid-19 and reduce deaths. Up to 80 per cent of people who get infected with the coronavirus either have no symptoms or have mild disease,” said.

He added: “Those who are going to have severe diseases which warrant admission, and those who may die, will be the remaining 20 per cent. But if 63 per cent of the 20 per cent are protected, then we are going to have only about 10 per cent admitted if we vaccinate the population.”

The country’s immunisation boss said hospitals will be decongested and the economy will be able to reopen fully. 
Dr Driwale also  said the country does not have cold-chain storage facilities to keep and distribute Pfizer and Moderna vaccine at ultra-low temperatures.

“...The Pfizer requires minus (-) 80-degree centigrade storage condition and we can’t meet that requirement for the whole country because it becomes too expensive. The vaccine itself is also very expensive,” he said.

He added: “The Moderna and Pfizer vaccines are more than $20 per (Shs73,000) dose. That is why the Cabinet advised that it is not technology we should go for. And when they wanted to give it to us, we said no, we will go for AstraZeneca [vaccine] and that is why we have been patiently waiting for it.” 

Dr Driwale said they would considerably vary the interval of the injections to improve the effectiveness.

“There is also another study which indicated that if you increase the interval of injection, its (the vaccine) efficacy goes to over 70 per cent. ... So, we will extend the interval of injection from one month to two months,” he said.

AstraZeneca should be given to people of 18 years and above, according to WHO. This means that 55 per cent of Ugandans - Uganda National Bureau of Statistics data indicates are between 0 and 17 years - will not be eligible to receive Covid-19 vaccine.

The BBC  last week reported that South Africa had opted for Johnson & Johnson and Pfizer vaccines after it suspended the use of AstraZeneca vaccine due to low effectiveness on the country’s new 501.V2 variant of the coronavirus.

The East African reported on Monday that Rwanda started inoculating its citizens with an initial 1,000 doses of the Moderna.

Dr Jane Ruth Aceng, the Health minister, however, said Uganda does not have the South Africa variants and AstraZeneca gives a good degree of protection to the people. 

“... therefore, when we weigh the risks and benefits, it is obviously good that Uganda should still go ahead and use the AstraZeneca vaccine so that we can protect our vulnerable people. Obviously, Uganda will continue carrying out research to find out whether we have these variants in the country or not,” she said last week.


The vaccine
Arrangements

The government is set to procure 18 million doses of AstraZeneca at $7 (Shs25,620) per dose or $14 (51,240) per person (each person gets two jabs of the vaccine), according to the previous Cabinet report.
Parliament has approved the budget of $5 million (Shs18.3 billion) down payment by the government to Serum Institute of India, the manufacturer of AstraZeneca.
 

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