Citing low recall rate, Nepal may not request immediate supply of doses from Pfizer

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July 12, 2022

KATHMANDU – The Ministry of Health and Population said it was undecided whether to resume the Pfizer-BioNTech vaccine supply from the Covax facility. The supply has been interrupted since April this year, given the slow absorption of boosters by the general public and the country’s limited capacity to store vaccines.

There has been no significant increase in vaccine consumption – the first two doses and the booster – and millions of doses are in stock. Requests to resume the supply of additional doses will not be made anytime soon, ministry officials said.

“We do not know when we will request the resumption of the supply of additional doses of the Pfizer-BioNTech vaccine,” said Dr. Surendra Chaurasia, chief of the logistics management section of the Ministry of Health Services. “We will not seek more vaccines until the doses we already have run out.”

The government had asked the COVAX facility to stop shipping the Pfizer-BioNTech vaccine earlier in April, citing storage issues. The facility, the United Nations-backed international vaccine-sharing program, had pledged to provide 9.2 million doses of vaccine and had through March provided 1.5 million doses. The supply of the remaining doses remains on hold at the request of the Nepalese government.

Pfizer-BioNTech doses, which are stored at minus 80 degrees Celsius in ultracold freezers, can be stored at normal temperatures (2 to 8 degrees Celsius) for up to 31 days. If not used within 31 days of deployment, vaccine doses should be discarded.

The Department of Health can only store around two million doses at minus 80 degrees at the moment.

The administration of the booster shot has not increased despite an increase in Covid cases in recent times.

According to the Health Ministry, 121 people tested positive for coronavirus on Sunday, including 104 out of 1,700 polymerase chain reaction tests and 17 out of 1,345 antigen tests.

The number of people testing positive for the coronavirus jumped to 642 in a week, with the infection rate tripling in a week.

Public health experts say the true number of infections could be higher than reported by the Department of Health, as the rate of testing has fallen in several ways, with only those traveling abroad opting for a test .

“Covid-19 infection has increased significantly in recent times,” Dr. Shrawan Kumar Mishra, head of the Provincial National Health Laboratory in Madhesh province, told The Post by phone from Janakpur. “Three people working in our own lab have tested positive.”

Stressing the importance of vaccines in the fight against Covid and citing Nepal’s own experience with the pandemic, doctors say vaccines prevent severity, hospitalizations and deaths, although they cannot prevent reinfection. Doctors insist on the need to administer booster doses to avoid a new health disaster.

“The number of people infected could be higher than the number currently expected,” said Dr. Rajiv Shrestha, an infectious disease expert at Dhulikhel Hospital. “But the cases of infected patients becoming serious and requiring hospital care have not increased due to the high vaccination coverage rate in earlier phases.”

So far, 20,359,274 people, or 69.7% of the total population, have been fully immunized against Covid. The Ministry of Health said that 87.3% of the population over 12 had been fully vaccinated.

Doctors say the rise and fall in the number of new cases will continue given the nature of the pandemic; therefore, administration of vaccine doses is important as a preventive measure.

“Covid-19 vaccines do not prevent infection or re-infection,” said Dr Shyam Raj Upreti, former director general of the Department of Health Services. “But they save us hospitalization and are useful in the fight against the virus.”

Of the 7.356 million doses of Covid-19 vaccines in stock, four million doses are the Sinovac-CoronaVac vaccine, 1.8 million doses are pediatric doses of the Pfizer-BioNTech vaccine; 700,000 doses are Pfizer-BioNTech adult vaccines; and 384,000 doses are doses of Covishield. Some of the vaccine doses, including that of Covishield, are nearing their expiration date, officials said.

The Ministry of Health had decided to administer boosters to eligible people who had received the second doses of Covid vaccines three months ago, but there was no significant increase in consumption.

Department of Health officials assume the term “booster dose” may have confused the general public, so they are considering whether to call it the “third” dose instead.

“The word booster seems to have confused the public. This may be the reason for the slow uptake of vaccines,” said Sagar Dahal, head of the national immunization program. “We would like to ask everyone who is eligible to take the third dose if they took the second dose at least three months ago. The third dose is necessary because it prevents us from becoming seriously ill.

Nepal has so far received 57,883,970 doses of Covid vaccines from different brands – AstraZeneca, Vero Cell, Moderna, Janssen, Sinovac-CoronaVac and Pfizer-BioNTech – including pediatric doses.

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