Which vaccine?

Being in my 70s, with underlying health issues typical for my age, I have decided that the one thing I should resolutely avoid at this time is to be hospitalized for COVID-19. I have seen enough of what oxygen deficit does to a person’s breathing to dread this condition, far more than pain itself. This — and being intubated and kept alive with a ventilator — is what I most fear about this disease.

Accordingly, I will have myself immunized against COVID as soon as the vaccine of my choice becomes publicly available. Based on my own reading as a nonexpert in this field, my preference would be Moderna, Pfizer, Sputnik V, Novavax, AstraZeneca, and Sinopharm, in that order. This ranking is mainly based on reported safety and efficacy ratings in clinical trials.

But, given the current scarcity of vaccines, particularly of the early ones with completed phase 3 trials and 90-plus percent efficacy, I would seriously consider getting inoculated with any available vaccine with lower efficacy (e.g., 50-plus percent)—if the alternative is to wait indefinitely for the preferred brands. Here, my first choice would be the Johnson & Johnson vaccine.

This would still be a lot better than having no protection at all from moderate or severe COVID-19. While there is no published information that these vaccines actually prevent infection, it is enough that they offer a shield against developing a serious form of the disease.

I would however guard against being inoculated with a vaccine that has not been cleared for importation. I would firmly avoid using smuggled vaccines, even if these were being offered by people I know and implicitly trust. For there’s nothing in the world today that cannot be faked. Without the help of experts from the medical science community, we would have no way of knowing what we are actually getting.

That said, the global outlook on the supply of vaccines does not look very encouraging at this point. According to Bloomberg News, vaccine rollout has begun only in 77 countries, and leading the pack is tiny Israel, where 68.5 percent of the population has received at least one jab of the vaccine.

At present, around 6 million doses are being administered daily around the world, albeit unevenly. At this rate, Bloomberg estimates it will take 5.3 years to cover 75 percent of the world’s population. The period could be shorter once more vaccines from other companies become available. Or it could take longer—if there is significant public resistance to getting vaccinated in some countries, which, ironically, may rise once the threat from COVID-19 subsides as a result of widespread immunization.

The three most popular COVID-19 vaccines in use right now are those produced by Pfizer-BioNTech, Moderna, and AstraZeneca-Oxford. So far, only these three have received emergency use authorization in much of the world. Four other vaccines have been authorized for emergency use in some countries since late last year even while their clinical trials were still ongoing. These are: China’s Sinovac, CanSino, and Sinopharm, and Gamaleya’s Sputnik V from Russia.

Two other vaccines from the United States—Novavax and Johnson & Johnson—have recently completed their clinical trials and may soon get clearance for public use from US authorities. Novavax has reported 89 percent efficacy, which is quite close to the standard earlier set by the Pfizer and Moderna vaccines. But it is the Johnson & Johnson vaccine that is drawing much interest in the developing world despite its lower reported 66 percent efficacy because, unlike the other vaccines that require two doses, this particular vaccine is administered with a single dose.

Of the vaccines made outside the West, Gamaleya’s Sputnik V has recently received favorable reviews in reputable media outlets like the New Yorker magazine. The Russian vaccine was developed in a laboratory that has had extensive experience in producing vaccines against Ebola and MERS. In its Feb. 8, 2021 issue, the New Yorker reports: “Sputnik V—like several other COVID-19 vaccines, developed by Oxford University and AstraZeneca, in the United Kingdom; CanSino Biologics, in China; and Johnson & Johnson, in the United States—is what is known as a vector vaccine. This type of vaccine is much newer than the attenuated or inactivated kind [e.g., Sinovac] but has a longer track record than the mRNA variety [used by Moderna and Pfizer].”

By April 2020, while the rest of the world was busy looking for SARS-CoV-2 testing kits and dwindling supplies of PPE, Gamaleya’s scientists had produced a vaccine that they felt confident enough to administer to themselves and to their families. With 92 percent reported efficacy against COVID-19, Sputnik V has, unfortunately, been available only in very limited quantities.

It is a sad testimony to the absence in our country of a robust and consistent support for scientific research that we are nowhere near this caliber of scientific innovativeness. We remain dependent on technology and pharmaceuticals developed abroad, particularly in the West.

For all President Duterte’s early endorsement of the Chinese vaccine, it is obvious that we actually follow the lead of the US Food and Drug Administration, especially when it comes to COVID-19 vaccines. This is not a bad thing in itself. But, where time is of the essence, it could spell disaster. It means that instead of relying on our own local scientists’ professional judgment to guide us in acquiring a portfolio of vaccines at the soonest possible time, we wait until we are last in line.

public.lives@gmail.com