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The challenges the new government faces in vaccinating 9 million people in 100 days

Published on May 25, 2021

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The SARS-CoV-2 pandemic changed the priorities of purchases in the foreign market in the last year. When infections spread throughout the world, nations intensified negotiations to stock up on medical and biosafety supplies, such as masks, gloves, rapid virus detection tests, among other items that, during those most critical months and until now, China produces by millions, one of the main producers of protective clothing and the country where the health crisis originated.

Currently, nations negotiate millions of doses of vaccines after the authorization of the World Health Organization (WHO) to initiate emergency vaccination with certain drugs that reached high levels of efficacy in clinical trials.

Ecuador has applied 1,727,805 doses, of these, 1,299,730 correspond to the first and 428,075 to the second dose, according to the records of the Ministry of Public Health on the Plan Vacunarse web portal , with a cut-off to May 22nd.

The Lenín Moreno government has handed over this and many other plans to the Guillermo Lasso regime, which has said it will vaccinate 9 million people in the first 100 days of work.

The immunologist Hernán Urgilez points out that the incoming government must overcome the difficult circumstances with which the commercialization of these drugs abroad is developing.

“The government’s ability to negotiate is important. At the moment there is no way to think of saying if the vaccine is worth $3, because I can pay the $3. For example, Israel negotiated paying a little more than it costs, that is, they have the economic capacity to offer something more,” says the specialist, who considers the negotiation stage as a race against time.

“The faster we vaccinate, we cover 50%, 60% of the population, logically we will have herd antibodies and we will have the entire population protected and the economic condition will vary.”

Among the actions carried out by the incoming government to obtain the doses is the approach to Moscow. The country’s new Vice President, Alfredo Borrero, said last week that they requested about 10 million doses of the Sputnik vaccine, a vaccine that was recently approved by the National Agency for Health Regulation, Control and Surveillance (Arcsa), to be used in the country.

“Let’s wait and we are going to put a candle to the saint of the impossible that by mid-June we have Sputnik vaccines in Ecuador with the requested doses.”

A few days ago, Lasso reported, instead, that Ecuador will receive 200,000 doses from China as an expression of congratulations for the electoral victory. Doses that, according to an outgoing government official, are due to arrive between May 25th and 26th, 2021.

The effectiveness of the plan drawn up by the incoming administration will depend, according to epidemiologist Diego Vásquez, on massive immunization.

“The government can lend the [extra] doses to other countries. If in June it has from one million to three million doses, there we can vaccinate en masse. I think they are vaccinating 50,000 a day, it is not enough to be an effective vaccination. Effective vaccination is when we vaccinate from 120,000 to 200,000 a day, “says the professor at the Catholic University of Santiago de Guayaquil (UCSG).

According to the web portal of the vaccination plan of President Lasso, the vaccination of about 90,000 people per day is expected. That comes to 43 people a day in the 2,100 health centers in the country.

Regarding the application of vaccines, Borrero said that the electoral roll will be used to summon citizens, probably in the places where they voted in the last election, on weekends, as a complementary measure to the vaccination points that will be kept open from Monday to Friday.

There will also be brigades, he said, who will go to areas furthest from urban centers.

Borrero emphasized that the vaccination plan they project to carry out is technical and not political, and that it was outlined by a commission of health experts.

Paúl Cárdenas is a researcher at the Institute of Microbiology of the San Francisco de Quito University (USFQ). The scientist, who has complained on Twitter that his hospital colleagues are “prohibited” from sending samples of patients with COVID-19, important for genomic surveillance of SARS-CoV-2 variants, says that the liaison between the Government and the universities to analyze the emergency situation and make decisions is most important.

“We have been asked many times about the situation, what we think, but we feel that what we tell them has not been taken into account when making decisions. The decisions are made by politicians. More science is needed in politics and not more politics in science,” laments Cárdenas.

As an academy we have made the best effort to carry out genomic surveillance in Ecuador, today colleagues from public hospitals are prohibited from sending us samples. The samples belong to the patients. Hopefully with @XimenaGarzon11 things change #SinCienciaNoHayFuturo

– Paúl Cárdenas (@paulcarald) May 21,2021

For example, the researcher points out that there is a diagnostic problem in the health system.

“Not only in public health, but also in the private part, related to the access to the costs of having an analysis in a private laboratory. It is difficult to lower costs further. Importing laboratory reagents is super expensive,” says Cárdenas, who adds that there is no certainty to calculate the number of people who have been infected in the country.

“The number of tests we have done per 100,000 inhabitants, I think we are the second worst country in the world by the number of tests we do. So, you can’t handle a pandemic if we don’t make a proper diagnosis.”

Immunologist Hernán Urgilez also refers to the importance of carrying out a pharmacovigilance of the people who have received the vaccine to know the effects, the duration of immunity, among other variables.

Meanwhile, the specialist says that the incoming government should include in its health policies the recovery of the vaccine production plant that worked in the defunct Leopoldo Izquieta Pérez National Institute of Hygiene and Tropical Medicine, which would be of much use if patents are released of SARS-CoV-2 drugs.

“We produced vaccines against diphtheria, tetanus, rabies, pentavalent, BCG. If we return to the subject, it would be important because we do not know how many booster doses will come for the COVID-19 vaccine, for the variants that exist. It is important that the country make an investment of this nature,” emphasized Urgilez.

These specialists also recommend that health authorities develop a powerful communication campaign to combat misinformation about vaccines and thus reduce absenteeism in immunization sessions.

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