The best vaccine is the one we get


Officially, Lebanon began vaccination campaigns against the Corona virus, in conjunction with the “first annual” anniversary of the virus entering the country. Before starting his new phase of confrontation, he was racing against time to formulate a national plan to achieve justice in distributing vaccines and reaching community immunity in a record time, exempting from the relentless death of the “harvest.” That plan was the first challenge that the National Corona Vaccine Committee faced, especially as it deals with vaccines that are used for the first time, not only in Lebanon, but in the world. This matter required the monitoring team to work “day and night”, according to what the head of the committee, Dr. Abd al-Rahman al-Bizri, said, to secure the terms of the plan, whose top priority was the launch of the electronic platform. Shortly before the arrival of the first batch of vaccines in February, an online platform was launched, which El-Bizri is proud to be “Made in Lebanon”. The importance of the latter is that it was the “backbone” of the plan, as it is the main nerve in the immunization process, in terms of providing the full data for the registrants and automatically dividing the stages.The first work was completed, and contrary to what happened about its embarrassing start, this was not the slightest obstacle to the workshop. According to Al-Bizri, the obstacle lies elsewhere: in the amount of vaccines that Lebanon receives, which are not sufficient until the current moment to confront the virus, as there is a big difference today between the “readiness of the Lebanese state” and the quantity of vaccines dispensed “on its own land” today. As for El-Bizri, there are three critical months, April, May and June, to resolve the actual outcome of “helping society out of the impasse”, which is contingent on “someone who introduces vaccines.” Today, only about 30,000 doses of the Pfizer vaccine enter Lebanon every week. And it is an insufficient amount, given the centers’ ability to vaccinate between 30 and 50 thousand per day and “comfortably”, Al-Bizri asserts. This challenge creates another challenge related to the number of doses, “as each person is supposed to receive two doses of the vaccine, and this forces us to calculate that with each distribution we have to give the center twice, once for the first dose and another for the second dose.” Hence, what is important at this critical stage is obtaining sufficient quantities of vaccines from several sources. Otherwise, the status quo does not tolerate “theorizing”. Therefore, the Lebanese state is working to diversify the sources, by concluding agreements with companies that produce vaccines other than Pfizer, which provide Lebanon with two million and 100,000 doses “that can be increased and at a faster rate,” according to Al-Bizri.

There is no preference for one vaccine over another based on the fact that every vaccine with efficacy rates exceeding 70% is excellent

Although the state has negotiated directly with Pfizer, it has another possibility to boost the quantities, which is via the Kovacs platform. For Al-Bizri, this is a “possibility on the table”, in addition to the third possibility, which is related to Pfizer’s ability to administer more vaccines. To countries “after increasing production lines.” To Pfizer, the country is negotiating with the British company, which produces the vaccine, AstraZeneca, in direct negotiation, and also through the Kovacs platform, through which it is expected to obtain approximately 340,000 doses. As for the remaining doses, which Al-Bizri estimates are two million doses, these are supposed to arrive through three channels: from the main AstraZeneca laboratory in Russia, from the laboratory in South Korea, and from India in a smaller quantity. As for the largest quantity, from the Russian laboratory, which is about one and a half million doses, being “the closest, because in the event of an epidemic, vaccines are often shipped from the nearest airport to the nearest airport.” However, the problem facing the country here is that the AstraZeneca factory in Russia had, just two weeks ago, “obtained a license stating that the product that will exit from Russia’s factory is the same as the one that leaves Britain”, and therefore this imposes an enforced delay. As for the South Korean laboratory, “they asked us two days ago via the Kovacs platform to give them approval, and we did.” And on the AstraZeneca line, there are also 500,000 doses of vaccines that will arrive, according to El-Bizri, under the heading of social benefits for the benefit of specific sectors. In addition, 50 thousand other vaccine doses will come from the India laboratory for the benefit of the Lebanese University. As for the Russian Sputnik vaccine line, that is another story, as the negotiations with the Russian side have two main obstacles: the first is imposed by the Russian, in terms of “its lack of readiness to give Lebanon due to internal pressure and requests reserved for other countries. As for the second obstacle, it is the “specificity” of the Russian vaccine, which assumes special handling with it, “because its conditions are complicated, as it needs a special temperature and has a short life in the normal refrigerator, and the specifications of the first dose differ from the second dose …” However, Al-Bizri says that the state has overcome the second obstacle, without being able to solve the first, since “all those who went to Russia have not yet come up with an answer.”
Dealing with the Chinese Sinopharm vaccine differs from the previous three vaccines, so now there is no final agreement with the Chinese state. Some circumstances have played a role in delaying this agreement. In addition to the logistical aspects that may accompany any agreement, there is another aspect related to the introduction of this vaccine by some and most of them politicians without the state’s knowledge, “We did not know to whom it was given and how”, and this made the scientific committee in the ministry. Dealing with him with a specific view ». In this context, Al-Bizri points out that several contacts took place between him and the Chinese ambassador in Lebanon and between the latter and the Minister of Public Health, Hamad Hassan, who informed him of Hassan that it is desirable that “there is a file for the scientific committee to review so that it can make a clear decision.” Al-Bizri added that they sent a file “and it was very nice,” and that this matter was accompanied by the Lebanese army’s request for 150,000 doses of the Chinese vaccine, which are being studied as well. However, Al-Bizri points out, “We have given approval for the vaccine within certain specifications in agreement with the Chinese side,” without going into details. Therefore, no accurate numbers of Sinopharma vaccine may arrive. What is clear today is the number of 200 thousand doses, of which 50 thousand were provided by China, in addition to the 150 thousand doses requested by the Lebanese army and another 50 thousand a donation that will be disbursed in coordination with the Ministry of Public Health, and a smaller donation from the Chinese army to the Lebanese Army. To these, there is Johnson & Johnson, with whom the state is negotiating directly to obtain the vaccine, as through the Kovacs platform, and “if the information is correct that MSD will show solidarity with Johnson on production lines, then there is a possibility that the quantity that we may get is greater.” .

The effectiveness of vaccines
Which vaccines are the best? Al-Bizri refuses to deal with vaccines on the basis of that classification, considering that “the best vaccine is the one we can get.” On the other hand, Al-Bizri affirms that it is not permissible to compare today between one vaccine and another, especially since “the groups on which the vaccine’s effectiveness was studied were different.” Based on here, and considering that most vaccines have received international approvals, “every vaccine with efficacy rates exceeding 70% is excellent,” and since “all vaccines have proven after their use after the first dose that they are able to provide high protection against severe disease, and this What is reassuring, especially in terms of its ability to alleviate the pressure on the health sector.

The Lebanese state dealt with the Chinese Sinopharma vaccine with caution and approved it within certain specifications

Do these vaccines enter Lebanon commercially, or not? This question imposes itself with the approval of the emergency use of vaccines and the Ministry of Public Health giving approval to companies that the vaccine can be imported, via the platform. However, before it is too late, El-Bizri returns to the laws according to which the Lebanese state has the right to price based on a set of criteria and based on the total cost of vaccines. Accordingly, no company has the right to announce prices outside the state, although this “does not mean that the state pricing at prices less than the costs incurred by the companies.” It should be noted here that “the two affordable vaccines are Sinopharm and AstraZeneca, since the latter, when work began on it, was intended not to profit.”

Work hurdles
In the first divisions of the centers, the national plan noted about 50 centers, based on taking into account that “the amount of vaccinations will increase with time.” However, in practice, there are about 28 centers operating today, distributed over the Lebanese regions, albeit in degrees. In this context, the demographic map highlights population density as well as hospitalization in Greater Beirut and its suburbs. Therefore, it is natural for there to be centers that are “the nerve of work”, which are concentrated in the major areas, without this eliminating other areas that need vaccination service. The plan showed that “there are centers in Lebanon that are large and tolerate much more vaccinations than were allocated to them, but we were governed by the priority given to them and by the amount of vaccines as well.” The problem of distributing vaccines also arose due to the low quantities of the vaccine. Nevertheless, Al-Bizri said, “We have adhered to the plan that divides the centers into three: large centers that give nearly 300 doses, medium centers give up to 200 doses, and three smaller ones give up to 100 doses,” provided that these centers are fed Twice a week (Monday and Wednesday). As for the other obstacle, it is, for example, in the precise specifications of some vaccines with regard to preservation. For example, the committee’s fear at the beginning was not from the “minus 70” temperature as much as the fear of power cuts!
Among the challenges we face today is the imbalance in registering between the regions on the platform, “It is due to two reasons, one of which is that people in some areas do not know how to register and have not found anyone to help them, and they are the majority, and the second is the reluctance of some people to register as it is a new vaccine.” . While the second reason can be skipped, the first is a “dilemma”. Therefore, Al-Bizri points out that “when work improves, we are supposed to send teams to the regions to communicate with institutions, administrations and governors to help with registration, as well as to encourage vaccinations.”

Sectoral initiatives
One of the positive things that importing vaccines may open up is the strengthening of community initiatives. In this context, the head of the Corona Vaccine National Committee, Dr. Abdel-Rahman Al-Bizri, refers to working to encourage the scientific committee, in line with the Ministry of Public Health, to have sectoral initiatives under the supervision of the online platform. These initiatives, some of which are beginning to appear, will support the primary campaign and provide relief to the sector itself through immunization. Al-Bizri points out that “when these vaccines are specified for any category and with state supervision, this would reduce the pressure on the amount of other vaccines.” It should be noted that these initiatives do not unilaterally communicate with the company, but rather through a tripartite agreement that the state undertakes, whereby it pledges directly with the company to the third party, who is part of the Lebanese community “which pays directly”. Among those initiatives, the initiative of the Lebanese University and Makhzoumi Foundation was for the benefit of its institutions, and partly for the benefit of the Ministry of Health and the Civil Aviation Directorate, and an initiative of one of the security institutions. In addition to these initiatives, the Lebanese-Palestinian Dialogue Committee initiative to secure 300,000 doses of vaccine for Palestinian refugees.

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