„To vaccinate quickly and effectively we need sufficient vaccine stock and flexibility in adjusting the vaccination process. Removing barriers, including through effective communication, through the possibilities of combining doses, by increasing vaccination capacities, would allow us to achieve collective immunity already this year...”
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Vaccination campaigns against COVID-19 are in full swing in several countries. The speed of campaigns and the coverage of the population is very different, including in countries with sufficient stock of vaccines.
What is the secret to success in vaccination campaigns in the countries, advanced in the process?
Sufficient stocks of vaccines – the purpose excuses the means
The fact that vaccination is the most effective tool for ensuring herd immunity was known as early as the summer of 2020. Some countries have started to develop their own vaccines. Other countries have invested in vaccine development projects in the third countries. There were also countries like Moldova, which did not develop their own vaccine, did not invest in vaccines in the third countries, and are now in the process of seeking affordable solutions to ensure the immunization process of the population.
Ensuring sufficient vaccine stocks can now be carried out through several channels, including humanitarian aid and procurement.
Humanitarian aid can come from international bodies, various partners and various countries.
Procurement can be done directly from the manufacturer or through collective procurement platforms, such as COVAX.
There are countries that vaccinate all with one vaccine, and there are countries that offer a wide spectrum of vaccines currently available in the world.
The main goal of Moldova is to have a sufficient stock of vaccines here in the country in the near future.
Vaccination process – the key to the success of the campaign
The speed of the vaccination process is slow in Moldova. Attempts are made to justify this by limited stock of vaccines, by reluctance in society, by insufficient communication. All these elements are present and important.
The key to this slow movement, however, is in the original organizational concept.
Vaccination of doctors in the first stage was planned at work, which is good at first sight. But if we look at the figures, out of about 60,000 health care workers we have vaccinated less than 20% in 2 weeks, although we have enough vaccine to vaccinate 60% of our health care staff. The maximum reached daily vaccination capacity was 2000 daily doses. At this speed we're going to get vaccinated for four or five years.
Stage two of vaccination is also on the shoulders of primary medical staff. We have no chance of doing it faster than the first, because primary medicine is responsible for the treatment of the infected and is overloaded now.
What would be the solution? A simple one – to allocate a team dedicated exclusively to vaccination. It could be the Army's military service, or the Exceptional Situations service. It is important that these people work with only one purpose – to vaccinate at least 20,000 people every day.
Turkey has vaccinated 10 million people in 2 months, or 150-160 thousand people daily. Romania vaccinates 45-50 thousand people daily. We also can do it! It's important to know what we want.
We need more flexibility and discipline
To increase the speed of vaccination we need more flexibility and discipline.
To have flexibility it would be good to be able to combine different vaccines, for example. These options are now under investigation. Initially most vaccines were investigated in combination of two doses of vaccine from the same manufacturer. Now it's being investigated, what if we combine the first dose from Pfizer and the second dose from Astra Zeneca, or the first dose from Astra Zeneca and the second dose from Sputnik-V. The results of these studies will be available in the summer. Their concept is not an innovative one. Combining different types of vaccines to achieve stronger and safer immunity has been used in other diseases.
Such practices in our country have been used before permanently. For example, in one year, children received diphtheria vaccine, manufactured in Russia. The next year it was a diphtheria vaccine, made in India. More recently, it was the diphtheria vaccine manufactured in Bulgaria. There are children who have received three doses of vaccine from three different manufacturers. And there are no adverse consequences to these processes. This concept is now also being investigated for vaccination against COVID-19.
Until the decisions come about the possible combination of vaccines from various manufacturers, we now have here in Moldova another question.
Is it allowed to combine a dose of Astra Zeneca vaccine produced in the UK with another dose of Astra Zeneca vaccine, produced in South Korea?
The researchers' answer would be – YES. And this can easily be confirmed by the quality parameters mentioned in the quality certificate, issued by the manufacturer. The Astra Zeneca vaccine is produced after a unique technological process at all plants involved in the production cycle, regardless of geographical location. The quality parameters of the vaccine are identical in all batches, regardless of the manufacturing location. So, if the first dose of vaccine administered was from Astra Zeneca, South Korea, the second dose of vaccine may be from Astra Zeneca, Italy, or Astra Zeneca, UK. It's the same vaccine. The vaccination rate in Moldova can increase significantly if we eliminate this now-imposed artificial barrier.
To vaccinate quickly and effectively we need sufficient vaccine stock and flexibility in adjusting the vaccination process. Removing barriers, including through effective communication, through the possibilities of combining doses, by increasing vaccination capacities, would allow us to achieve collective immunity already this year.
