Last Thursday it was announced that Ecuador closed an agreement with AstraZeneca for the acquisition of five million doses of the vaccine that it is developing with the University of Oxford.

According to the World Health Organization, worldwide there are eleven proposals for vaccines against COVID-19 that are in phase 3 clinical trials in several countries. This is one of the efforts underway to stop the spread of the virus, however, according to specialists, a return to normalcy is still far away.

Ecuador has been working with multiple international groups to ensure it has access to any group purchasing options and outside financial support for the vaccine. Ithas also begun negotiations with several pharmaceutical companies for the same purpose.

Worldwide interest in the vaccine for the coronavirus increased last week when Pfizer and BioNTech announced that the vaccine they are developing have been shown to have more than 90% efficient in the trials, however, in-depth details have not yet been provided and studies continue on volunteers who received it.

On Monday of this week, Biotech company Moderna also announced that its vaccine has been effective is preventing illness, including in severe cases, in 95% of its study patients.

The Vice Minister of Governance and Health Surveillance, Xavier Solórzano, announced that the country will invest up to $200 million for the acquisition of doses that will cover around 65% of the population.

“It is important to consider that it is a worthwhile investment, but, above all, beyond the economic, the probability of having a tool that saves lives is priceless because life is priceless, then the country and the government in a responsible and committed way it has made the decision to invest in those vaccines and analyze the country’s access to those doses of vaccines because we cannot be left out, “he said.

The research and development of a vaccine has accelerated dramatically, says Solórzano; before it took between 7 to 12 years for a vaccine to be developed and commercialized for humans. However, due to the pandemic, the process has been cut drastically short. But before the mass application of either of these vaccines, they will still need certain certifications from health regulatory entities.

Due to urgent need for these vaccines against COVID-19, emergency authorizations are being issued for their deployment to market, but they will continue to be investigated for a few years to track and adverse effects on the population.

Ecuador has secured several vaccine other agreements

Solórzano specified that Ecuador has already reached an agreement to participate in the Covax Facility mechanism, a global initiative that has a portfolio of vaccine options and promotes equitable access to all countries regardless of their financial situation.

Within the framework of this initiative, Ecuador has secured access to just over seven million doses that will be focused on health workers, public service personnel, and people who care for gerontological centers, among others. Solórzano added that if the vaccines are shown to be effective in the population over 60, they will also become a priority group along with those people with comorbidities.

Regarding AstraZeneca, Ecuador signed a contract on Thursday afternoon and made an advance payment to guarantee five million doses of their finalized version of the vaccine, which is in the Covax Facility portfolio.

In the case of Pfizer and BioNTech, the Ministry of Health reached an agreement in October to secure two million doses of the vaccine they have developed. Solórzano added that they have to sign a second binding document that establishes the delivery, logistics process and technical support to be provided.

The government has also held negotiations with Covaxx, a US company who will provide 2 million doses of their vaccine to Ecuador. The Covaxx vaccine is still in development and is slightly behind in development, but it is still important for Ecuador to obtain as it will be the first and possibly only) purely synthetic form of a COVID-19 vaccine.

Funding for the vaccine has been made available

“Fortunately, we had loans approved for the health sector from the Inter-American Development Bank and the World Bank, so what we have done is to reprogram the activities that were had within those projects, now giving priority to access to vaccines and from that we have had the support from both the IDB and the World Bank, “said Solórzano.

The Covax Facility operation will be carried out through the Vaccine Revolving Fund, a mechanism of the Pan American Health Organization that is used to purchase vaccines in the region. They will also oversee the distribution and delivery of the vaccines to the member countries.

Pfizer Vaccine and Refrigeration Systems

The Pan American Health Organization has warned that no health system in the world is yet fully prepared for the technical requirements of the Pfizer/BioNTech and Moderna vaccines, which require storage in a special cooling system at low temperatures.

Ecuador is also aware of this and has announced that Pfizer/BioNTech will provide technical, scientific and logistical support for the handling of the vaccine. It is anticipated that the same requirement will be asked of Moderna.

Solórzano said that Pfizer/BioNTech designed thermal boxes that will allow its vaccine to be transported and stored without the need for deep freezing. However, because of the time of year that the vaccine is being distributed, the country will also vaccinate against influenza at the same time that the coronavirus vaccine is administered, which will require a strengthening of the cold chain.

“We have also been working with a private sector committee that includes all the trusts that have been supporting the pandemic and we are planning to use the installed capacity that the private sector has, for example in the food industry, that is, supermarket chains and the flower industry that have these deep freeze freezers and we can use private sector support for storage, “he added.

The Minster announced that Pfizer also designed a delivery mechanism that will be handled by courier, which will send the doses to the points assigned by the Ministry of Health. The intent is to disperse the vaccines in partial deliveries, not all at once throughout the country.

“This greatly facilitates us also and also lowers the investment cost in these freezers, a few will probably be required, but thanks to this design of both the thermal box and the logistics it will facilitate the handling of this vaccine.”

Manufacturers have estimated that the doses for distribution could be available by the end of March, but the complete application of the vaccines would be, if all goes well, in the second quarter of 2021.

Most of world needs to be vaccinated to stop the virus

Approximately 70% of the world’s population will need to be immunized with one of the new vaccines to guarantee the end of the pandemic, says Soumya Swaminathan, the Chief Scientist of the World Health Organization.

Although it remains to be seen how effective the vaccines will be, Swaminathan and the Director of the WHO Department of Immunization, Kate O’Brien, estimate that that would be the ideal percentage, although the goal by 2021 is to reach 20%.

“No company [that is developing the vaccine] will be able to immediately have doses for everyone,” warned O’Brien, who indicated that it is therefore important that all laboratories continue their investigations even if one of them is ahead of the others.

In a meeting with Internet users last week to analyze the new and promising advances in vaccines that were been reported last week in the US and Russia, the two experts pointed out that the new technologies developed in the current fight against coronavirus “can help to better protect us from future pandemics.”

They were alluding to technologies such as Messenger RNA (mRNA), used in the vaccine candidates of Pfizer-BioNTech and Moderna, and that instead of the usual recourse to try to weaken a virus, it uses molecules that give instructions to the human body about how to build antibodies.

Swaminathan stressed that the news of 90% efficacy in the clinical studies of the German-American project Pfizer-BioNTech, are preliminary results and that “more data is needed” until it can be guaranteed that it can be licensed for production.

Even if the new vaccines become available to the general public, the WHO experts insisted that the first to be immunized must be health workers and people from risk groups, such as the elderly or patients with certain pathologies.

O’Brien noted that the first doses of the vaccines that may arrive in the next few months, when there will be greater demand than supply, should not be stored, and warned countries against creating large stocks of them.

“The correct and intelligent thing is to guarantee that they are given to those who need them most,” she said, adding that in those first weeks “a vaccine in the fridge is not going to benefit anyone.”

Asked about the distribution problems that vaccines developed with mRNA technology could entail, which need to be preserved at temperatures close to 80 degrees below zero, the experts indicated that this would be a challenge, but that there are already technologies being developed for this precise purpose.

They also stressed that there have previously been vaccines that required storage at such cold temperatures, such as Ebola, so storage and distribution chains have been tested on a limited basis in some parts of the world.

More than 200 laboratories around the world are researching vaccines against COVID-19, a disease of which there have been more than 55 million confirmed cases worldwide. Of these projects, about 40 are in clinical trials in humans.

Of these, a dozen vaccine candidates from countries such as China, the United States, Russia or the United Kingdom are in their last phase, in which tens of thousands of subjects have already been tested, and their results are being compared with those of others large test groups given a placebo.

O’Brien added that the WHO needs about $20 billion for its Covax platform, intended to fund some of the laboratories in exchange for equitable distribution of the vaccine in developing countries.

“Although it seems like a lot of money, what is lost every ten days in trade and tourism in the world now amounts to about $35 billion.”