Coronavirus: as rich countries turn to big-name booster shots from Pfizer, AstraZeneca, the poor are left with lesser-known rivals like Abdala, Soberana 2
- With supply of high-profile brands limited in many poorer countries due to hoarding by the developed world, some are embracing more obscure shots, including those that are yet to receive World Health Organization approval
- Vietnam and Iran are buying Cuba’s Abdala and Soberana 2 shots, while India’s Covaxin has got the nod in the Philippines. Meanwhile, an Indian-made world-first DNA vaccine looks promising to some
“Unfortunately, countries are likely to explore any option that might be available, but would be well advised to take their cue from the WHO SAGE recommendations on which vaccines are recommended following adequate interrogation of the evidence supporting the safety and efficacy of the vaccines,” said Shabir Madhi, a professor of Vaccinology at the University of the Witwatersrand in Johannesburg, South Africa.
“It’s not about where the vaccines are manufactured, but the scientific evidence of their safety and efficacy. Unfortunately, some vaccines are being deployed without having the necessary data to support their widespread use, based on limited studies that are undertaken.”
The Abdala jab is one of five indigenous vaccines in use or under development in the Latin American country, all of which are yet to receive WHO approval.
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Cuban authorities have said Abdala has been shown to be more than 92 per cent effective in local trials, but data from the studies has yet to be published in peer-reviewed international journals.
Indian Health Minister Mansukh Mandaviya told local media last week he expected overall domestic vaccine production to exceed one billion doses in the last quarter of 2021, “more than enough to meet domestic demand”.
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Before restricting exports, India, home to the world’s largest vaccine-maker, the Serum Institute of India, donated or sold more than 65 million doses to dozens of countries, with the lion’s share being the locally manufactured version of AstraZeneca, Covishield.
India’s three domestically approved jabs include locally developed Covaxin, developed by state-run Bharat Biotech, which has yet to receive approval from the WHO.
Bharat Biotech has said it expects to manufacture 35 million doses of the vaccine in September and 55 million doses next month, with plans to produce 100 million doses each month by the end of the year.
Covaxin, which has been reported by its maker as showing 77.8 per cent efficacy in Phase 3 trials, has accounted for about 12 per cent of the vaccines administered in India, which has supplied at least one dose to 65 per cent of its 944 million adults.
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Last month, Indian regulators granted emergency authorisation for the world’s first DNA vaccine, Zydus Cadila, which works by introducing a small piece of the virus’ genetic code in DNA molecules called plasmids.
Another locally developed jab, Corbevax, developed by Hyderabad-based Biological E, is in the final phase of clinical trials, with expectations it could be ready for use by December.
India also manufactures well-known non-locally developed vaccines including the Johnson & Johnson and Sputnik V jabs.
Shahid Jameel, a virologist and visiting professor at Ashoka University in Hyderabad, India, said boosters at this stage of the pandemic made “little scientific sense” and would further strain supplies of mainline vaccines.
“Covid-19 has shown the acute need for distributed manufacturing for better access and equity,” Jameel said.
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Jameel saw promise in emerging and non-mainline vaccines, particularly DNA vaccines.
“For me the genetic vaccines stand out,” he said. “That is the future. Now that the immunogenicity of DNA is getting better with needle-free intradermal vaccination technology, we should pay more attention to these. DNA is easier to make and more stable than RNA.”
Jerome Kim, director general of the International Vaccine Institute in Seoul, South Korea, said it was important vaccines went through the necessary approval processes and it remained unclear how less-studied vaccines would respond to boosters in the future.
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“The problem with boosters is that it isn’t a simple matter of giving a matched or mismatched third dose,” Kim said. “There are some things that are ‘rules of thumb’ and others that are derived empirically by testing.”
“The Cuban vaccine hasn’t reported real efficacy data yet,” Kim added. “Sputnik has yet to be approved by the WHO for emergency use. How would we use them? The beauty of the current process is that each vaccine is theoretically receiving the same level of review through WHO. Hopefully it isn’t too political a process but one driven by science.”