Opinion: "Moldova Risks Failing the Vaccination Process"

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Semion ALBU Against the background population’s strong mistrust in vaccination, Chisinau decided to purchase a large batch of the Chinese CoronaVac drug - despite the fact that recently China itself admitted its vaccines’ insufficient effectiveness Along with Ukraine, Moldova remains a vaccination outsider on the European continent. To date, only about 65 thousand people (less than 3 percent of the country's inhabitants) have gotten the first COVID-19 vaccine. For comparison, there are 3.64 million of them in the neighboring Romania whilst 1.38 million have completed the full vaccination course (more than 7 percent of the population). When the whole world was actively joining the "vaccine race", reserving a maximum possible drugs amount from the world's leading manufacturers, Moldovan officials continued sitting idly by. As a result, nothing has been done to ensure access to quality vaccines this year. It is not clear where exactly the reasons for such a negligent behavior lie. Either due to political battles, it was simply not up to this, or the epidemiological situation improvement between the second and third waves led to a false sense of complacency. Therefore, Chisinau continued cooling heels, apparently counting on the peak of the pandemic to end and on humanitarian supplies within the COVAX platform framework. Leaving it to chance did not work - the third wave unexpectedly caught the country, and we confidently entered the world tops in terms of new infections and deaths number from coronavirus. Now a state of emergency is acting on the territory of the republic. The issue of citizens’ massive immunization has become acute again - but the catch is that there is an acute vaccines shortage. At the moment, a little more than 70 thousand doses have been received from Romania and about 40 thousand more - through the COVAX mechanism. In the coming months, Moldova should receive a humanitarian cargo from Russia with 182 thousand doses of Sputnik V and a batch of 100 thousand doses of Pfizer via the same WHO platform. According to Maia Sandu, the latter is expected by the end of July. All this is of course better than nothing, but on a national scale it is a drop in the bucket. To develop herd immunity, which would make it possible abolishing all quarantine restrictions, at least 70 percent of the population must be vaccinated. Taking into account the number of people living in Moldova, we are talking about millions of doses that are needed. Looking at the wave of coronavirus covering the republic again, in addition to waiting for humanitarian handouts, authorities finally began to discuss the possibility of a massive commercial vaccines purchase. Last month, during leadership joint meetings between the government and parliament, it was decided to purchase a million doses. After some bureaucratic delays, the Center for Public Procurement in Healthcare initiated two procedures: negotiations without prior publication of a notice of participation and an open tender. Invitations were sent to major COVID-19 vaccine manufacturers from various countries. The tender for 400 thousand doses of coronavirus vaccines purchases failed: not a single company applied to participate in the competition. Perhaps it was due to a low price for the lot (according to terms, about $ 10 per dose was offered) or tight deadlines (according to the contract, the winning company was obliged to deliver 80% of the purchased vaccine doses to Moldova within a month). However, on the same day, the Ministry of Health announced concluding a four hundred thousand vaccines volume contract with the Sinovac Chinese company. The news of this purchase did not clearly inspire the population, as can be seen from at least a cursory reaction review on social networks. Well, no surprise. The Chinese drug structure called CoronaVac differs from the American, the Russian and the British ones. It is not made according to modern technologies (based on protein or RNA), but according to the old technology - from an inactivated natural virus. Its main advantage is “sparing” storage conditions whilst its disadvantage is low efficiency. According to research results, it was only 50.65%, that is, half of those vaccinated can get sick even after vaccination. It is curious that one of the conditions for concluding a contract with a Chinese manufacturer is cost confidentiality. Apparently, Sinovac sells its vaccine not at a fixed price, but at a price that can be negotiated. For example, according to some reports, one vaccine dose costs Thailand $ 5, Indonesia $ 17, and the Philippines almost $ 38. One might wonder what price were Moldovan negotiators able to achieve and is a corruption component to end the transaction. The large Chinese vaccine purchase looks quite unjustified from all the sides. The scientific community suggests it is not very effective against new strains and as already known, the British version of the crown has already taken root in our territory. Beijing itself recently officially recognized the Chinese drugs provide an insufficient protection level. This, in particular, said the director of the Chinese Center for Disease Control Gao Fu. Now they are considering in the Celestial Empire the possibility of mixing vaccines to increase their effectiveness, or giving three injections instead of two. But these are all untested theories so far. It should also be noted that CoronaVac is still in the WHO approval stage and, as you might guess, has no recommendations in the EU and the USA. In addition, the manufacturer ability to supply the entire volume in the near future remains questionable. For example, the neighboring Ukraine signed a contract in December with Cinovac for almost 2 million doses, and it has not yet been fulfilled (only 215 thousand have been imported). Another important point is the attitude of the Moldovan population towards vaccination. According to polls, only half of our citizens agree in principle to be vaccinated, while most of them agree to do this only with Sputnik V and Pfizer. We have recently observed the situation when many doctors refused to be AstraZeneca (Vaxzervia) vaccinated. At the same time, authorities are now buying a vaccine, the effectiveness and reputation of which is much lower than that of the British-Swedish drug, not to mention the low confidence in vaccines from China in principle. There is no doubt the opposition will be criticize this purchase (and fairly though) and is to sow even more doubts among the republic’s residents. The faction of the Party Platform DA has already sent an appeal to the Speaker of Parliament Zinaida Greceanii with a request to hold parliamentary hearings on the deal with Cinovac. So far, vaccination in Moldova is voluntary. And there is an opinion that there are very few people who want to be Chinese drug vaccinated. Especially when the forthcoming humanitarian supplies of the most popular Sputnik V and Pfizer vaccines - even though the volumes are small, everyone will be hoping to get them. Given the difficult epidemiological situation, the need to reanimate the economy, and poor forecasts (scientists claim that new virus strains may make most of the current vaccines ineffective next year) Chisinau will sooner or later face a difficult choice. You will either have to use administrative levers and make vaccination voluntary-compulsory (or even mandatory), or put up with the downtime of the batch received, which will most likely be out of people’s need. It is clear that, given the global shortage, the choice of available drugs is small, and Moldova needs them right now. But this does not mean that budgetary funds should be spent to purchase a vaccine that the manufacturing country itself does not speak very flatteringly about. Thus, it is possible to discourage an even larger number of our citizens from vaccination (many of whom already did not want to undergo it) and thus, completely bury the prospects for a large-scale coronavirus population immunization.