Science, economics of covid-19 vaccines

BY: Dr Okoe Boye (MD, MPH, MBA)
Covid-19 vaccine
Covid-19 vaccine

The world was minding its business until about a year ago, first quarter of 2020, when the WHO declared COVID-19 a pandemic, coming with it disruptions to business, shocks to global and local economies and restrictions to movement of human and vehicular traffic.

Many countries adopted general and specific infection prevention protocols in a bid to manage the pandemic. Ghana recorded its first case of COVID-19 in the first week of March 2022.

The country announced protocols including screening for high temperature, cough and other chest symptoms.

Travellers coming from high-risk COVID_19 countries were barred while those coming from low-risk countries had to go through a quarantine before mixing with the local population.

Later, the border protocols changed with closure of the International Airport, lockdowns in Greater Accra and the greater Kumasi Metropolitan areas, all in response to rising COVID-19 cases.

Covid-related deaths started mounting steadily, with hospitalisation of COVID-19- related cases putting pressure on our health systems.

The number of active cases rose over some weeks then declined before the Christmas season of 2020. Then cases started to rise again with attendant increased rate in hospitalisation and deaths. This see-saw or wavy nature of the pandemic was to be expected until the arrival of vaccines.

 The development and the deployment of vaccines signal the last phase of every pandemic.

The vaccines help to achieve lower infection rates with time as well as lower hospitalisation and deaths from COVID-19.

It is unlikely to get a deterioration of the situation when vaccines are progressively deployed.

In very special circumstances, another wave of infections can occur when people relax on the protocols or when city or country managers remove restriction prematurely in the face of improving situation with covid cases.

The cost of COVID-19 to human lives and the global economy calls for a coordinated, equitable and expeditious deployment of vaccines globally; first to people at higher riskof COVID-19 infection such as health workers, secondly to the elderly with or without underlying conditions and lastly to the rest of the population.

Billions of dollars were invested in the COVID-19 Vaccine “Ghana will have to find about $12 million for the procurement of 28 million vaccines (assuming 12 million doses come from COVAX, to make a total of 40 million doses).

Science, economics of covid-19 vaccines development of the COVID-19 vaccines, and hence the expeditious manner in which vaccines have been developed.

Most of the vaccines are being sold for virtually no profit margins, with big pharmaceutical companies focusing on rolling out vaccines at costs that will sustain production for all of humanity.

The Biontech vaccine from Pfizer is selling at about 25US dollars for one dose, Moderna Vaccine also from the USA is selling at about 20 USD for one dose.

You need two doses for a complete vaccination cover so it costs an average of 50 USD per person for these vaccines produced in the USA.

Cost of VaCCines The AstraZeneca vaccine produced in the European Union and developed by a collaboration between AstraZeneca and Oxford University sells at about 4USD per dose.

The Russian-developed Sputnik vaccines sells at 10 USD per dose. Again you will need two doses of either of these two for sufficient cover.

This means Ghana will need about 40 million doses of, for instance, the AstraZeneca vaccines to cover the targeted 20 million Ghanaians.

 Given that Ghana is expected to get 20 per cent of its population needs from the covax facility (A WHO supported platform for procurement and distribution of vaccines to low to middle income countries), Ghana will have to find about $12 million for the procurement of 28 million vaccines (assuming 12 million doses come from COVAX, to make a total of 40 million doses).

If we should go for the Sputnik option, we will be requiring some $280 million for 28 million Sputnik vaccines at a unit price of $10.

 Then comes the operational cost per person and with the Ghana Health Service putting it at about $2.5 per person, Ghana should be finding some $50 million for the operational cost of the vaccine deployment programme in addition to the cost of the vaccines.

One realises that vaccinating an entire population is not cheap, even more expensive is the option of not vaccinating at all.

Besides the economic costs nationally in the form of reduced revenue to the state and individual businesses, there is also the economic cost of increased expenditure in the health sector for theprocurement of these vaccines and their operational expenses as well.

 Other recurrent expenditures such as free testing costs and free hospital care for those admitted to public hospitals continue to be made in pursuit of saving lives and livelihoods.

Indeed, we are not in normal times and that is the more reason why the whole world must accelerate the vaccination campaign so we can get back to our normal lives.

Ghana government started vaccinating its citizens against the COVID-19 disease some few weeks ago. As a physician that consults at the Lekma Hospital, I joined the queue on the first day of the national exercise of deploying the vaccines.

I belong to the first group of citizens eligible to take the vaccine due to my health worker status.

 Other genre of citizens such as the elderly ( 60+ years) and those with underlying conditions joined the queue on the first day.

So far the vaccination programme has covered close to half a million Ghanaians. Unfortunately, there are still those who keep asking the question- should I wait for sometime to see what happens to those going for the vaccines or just go for the vaccine now?

The AstraZeneca vaccine has gone through all the three necessary clinical trials that must be conducted before giving it to people in any country.

Tens of thousands of participants took part in the phase three trials which were carried out to find out how effective the vaccines were in protecting the population against COVID-19 infection as well as COVID 19-related severe illness and death.

AstraZeneca has an efficacy of about 70 per cent. This efficacy only speaks to the protection the vaccine gives from contracting COVID-19.

 That is to say if 100 people get vaccinated, 70 of them will not get COVID-19 at all. The rest of the 30 can get COVID-19.

 Just ending here on the efficacy information leaves out two critical benefits that the vaccine provides; two benefits that have been established in clinical trials across different countries and have actually been confirmed in countries such as the UK where more than 21 million have been vaccinated.

Taking the vaccine protects you from severe and critical disease should you find yourself in the minority who can get COVID-19 despite vaccination.

 What it means is that you are saved from hospitalisation and more importantly COVID-19-related death with the vaccine.

AstraZeneca vaccines might have an average of 70 per cent efficacy against COVID-19 but its protection against severe illness from COVID-19 is over 85per cent, with protection from death nearing 99 per cent.

The Pfizer vaccine produced in the US may have an efficacy of 94 per cent similar to the Moderna vaccine but the good news is that both of them give you virtually the same result from AstraZeneca when it comes to preventing severe illness and death.

 The Johnson and Johnson vaccine that recently got Emergency Use Authorisation has an average efficacy of 70 per cent like the AstraZeneca vaccine.

 The phase three clinical trials done in South Africa with this Johnson and Johnson vaccine showed that rate of hospitalisation fell drastically in those who got the vaccine compared to those who didn't receive the vaccine.

No deaths were recorded in those who got the Johnson and Johnson vaccine.

This information from the studies on the Johnson and Johnson vaccine validates one truth[1]which is - it is smarter to get the vaccine, irrespective of which brand , when available than to wait.

I know that in Ghana 85 out of 100 people who get COVID-19 will have only mild to moderate disease and this statistics has undoubtedly emboldened some people to say "let me just wait and watch" , with the thinking that should they even get the virus, they will be part of the 85 per cent who do not experience severe disease.

 Transmission Chain A relative of mine got COVID-19 and experienced severe illness that could have killed him. He got it from a family member who only experienced mild symptoms when she had it.

The lesson is that should one avoid the vaccine with the thinking that he/she will be ok even in case of an infection, one can serve as a carrier who passes on the virus to other friends and family who might get severely ill and die.

So getting vaccinated doesn't only protect you, it protects those you relate to by breaking the transmission chain.

 I am vaccinated now so should I come across a COVID-19 positive person who brings the virus in contact with me, two things can happen; either my vaccine acquired immunity stops the virus from infecting me or the virus gets into my system but is unable to overwhelm me and land me at the hospital.

Since over 70 out of 100 who get the vaccine are protected from COVID-19 infection, those people serve as barriers that break the transmission chain.

When a virus gets to them, it ends there and doesn't get passed on to the next. So vaccination achieves a reduction in the transmission rates, infection rates, hospitalisation rates, mortality rates and eventually will bring the pandemic to a stop.

 The deployment of vaccines signals the beginning of the end of the pandemic.

What will make this end stage shorter and less fatal is continued adherence to the mask wearing and hand washing protocols since these protocols serve as an extra net catching the few viral strains that escape the wall of protection provided by the VACCINES.

Time-Table It is the objective of Ghana's government to complete this end stage of the pandemic by December 2021. Hopefully by this time, over 20 million Ghanaians will have been vaccinated and the transmission rate for COVID-19 will have neared zero.

 We have lost so many loved ones to COVID-19, over 700 cherished people as at the last count had died from COVID-19 related deaths.

 I know the roll out of the vaccine will save us many more deaths in this end stage but if we want to experience very low mortality or better still avoid any deaths at all , the mask wearing protocols must be

adhered to so that this last episode of the pandemic is made short and less deadly. It does not take AstraZeneca or Pfizer or Moderna in particular to achieve a COVID[1]19 pandemic free world.

 Any of the approved vaccines will protect you from the Pandemic, keep you away from the ICU , save you from death and significantly slow down infections rates till elimination of the disease is achieved nationally.

 PrediCTion I predict that this pandemic will end with this calendar year, 2021. This prediction can only be true if you take the vaccine and wear the mask.

 Let's help to make the prediction true because we can't afford to have our cinemas closed and our hospitality sector on its knees in 2022.

 We can't afford not to hug our loved ones in 2022.

 We need to slow down the virus so our economy can pick up quickly, we need to come together in adhering to the protocols so the restrictions to movement can be lifted sooner than later, we need to get every citizen jabbed with the vaccine if we want to see ourselves liberated from the cross covid has put on our heads.

 Europe and some parts of North America have started experiencing a third wave of infections. We have a duty to learn from their mistakes so we can preserve our gains.

We are going to win this war against the virus, yes we will. We've got to believe first so our energies can be harnessed and directed towards the path of victor