Urgent call for mass immunization against coronavirus in Bangladesh

Abstract

Bangladesh showed initial success in the mass inoculation drive. However, the program was going through an alarming situation when the serum institute of India halted the shipments. Now the authority is administering US Moderna vaccines, Chinese Sinopharm vaccines, and Pfizer vaccines. Mass immunization is the only way for Bangladesh besides the present COVID-19 responses. Therefore, Bangladesh can utilize its previous experience in the roll-out of mass vaccination. The country can search for all available alternatives of COVID-19 vaccines besides maintaining diplomatic consistency with the existing sources for early vaccination of its population. The authority can try to get the committed vaccines from the COVAX program. Also, the country needs to maintain diplomatic relations with other global alliances that are promising support to poor and developing countries for the COVID-19 vaccine. The government can also consider direct purchases from vaccine manufacturers.

In Southeast Asia, India and China have started their vaccine diplomacy for forming new allies and influencing their existing friends. India was in a better position over China in vaccine politics because China had made huge inroads among neighboring countries at the early stage of the ongoing pandemic. India wanted to polish its credentials as a responsible global stakeholder while China was busy improving its reputation. India approached COVID-19 vaccine development and allocation as a matter of their pride. ¹ Also, the country has a long track record of vaccine manufacturing and launched a neighborhood-first policy for COVID-19 vaccine distribution. Serum Institute of India (SII) is manufacturing the Oxford-AstraZeneca vaccine known as COVISHIELD. In addition, India approved COVAXIN of Bharat Biotech for emergency use. But the second wave of the COVID-19 pandemic has changed the game. The double mutant variant has taken a drastic turn in India by record-breaking new cases and deaths. ² On the other hand, the pandemic is mostly under control in China. Also, the doubt about the effectiveness of the Chinese vaccine has disappeared after the approval from WHO. The COVID-19 vaccine of China might help to increase its global market share. ³ Another vaccine manufacturing rival to China is Russia, which has shown greater transparency in clinical trials of their vaccine, Sputnik V, and got comparatively higher confidence. However, together with Australia, India, and Japan, the USA launched a new initiative known as Quad for joint production of up to 1.2 billion doses of the vaccines against COVID-19 globally. This vaccine alliance will ensure expanded manufacturing facilities as well as coordinate with the COVAX facility to supply more vaccines to the Indo-Pacific region and the world. ⁴ As of September 24, 2021, the Quad initiative has delivered nearly 79 million doses in the Indo-Pacific region. ⁵ Moreover, Japan is committed to supporting its regional partners for $3.3 billion as an emergency support loan for COVID-19 vaccine purchase. Also, the government of Australia is committed to delivering $212 million in grant aid to purchase vaccine doses for Southeast Asia and the Pacific region. ⁵ However, Bangladesh has joined China's Belt to get immediate access to COVID-19 vaccines and also is set to join the US-led initiative for economic cooperation in the Indo-Pacific region. ⁶

Despite being a developing country, Bangladesh still managed to bag over 10 million doses of Oxford-AstraZeneca COVID-19 vaccine purchased from SII. Bangladesh has begun a nationwide COVID-19 vaccination drive in early February 2021. ⁷ Long diplomatic consistency of Bangladesh with the neighborhood countries helped to early access of quality vaccines. As of September 27, 2021, Bangladesh has administered more than 48 million vaccine doses to its citizens. ⁷ Bangladesh showed initial success in the mass inoculation drive. But the program was going through an alarming situation when SII halted the shipments. India paused the export of vaccines as the second wave of COVID-19 devastated the country with a sudden upsurge in infection rate and mortality. ⁸ Following a two-month break, the country has resumed mass registration for COVID-19 vaccination from July 7, 2021, in the wake of an alarming spike in the global pandemic. ⁸ Moreover, Bangladesh approved seven COVID-19 vaccines (Moderna, Pfizer/BioNTech, Sputnik V, Johnson & Johnson, Oxford/AstraZeneca, Sinopharm, and Sinovac) for use. At this time, US Moderna vaccines, Chinese Sinopharm vaccines, and Pfizer vaccines are being administered to people. Now Bangladesh government has taken several initiatives to mass inoculation of its population. The country launched the Surokkha app for easy registration for COVID-19 vaccination. Also, walk-in vaccination centers are providing their services. The authority reduced the age limit to 18 years for getting the COVID-19 vaccine. Moreover, the COVID-19 vaccine and its administrations are free in Bangladesh. However, 10.38% of the population is fully vaccinated in the country and 20.5% of the population has received at least one dose. ⁹

Moreover, Bangladesh is going through the massive third wave of the COVID-19 pandemic.^10,11 On May 8, 2021, Bangladesh reported the delta variant among its citizens and the pandemic situation worsened after the community transmission of this double mutated delta variant. ¹² Now the “Delta Plus” COVID-19 variant is thought to be the next potential variant of concern based on the mutation history. ¹³ Also, Bangladesh reported mucormycosis or black fungus infection in post-COVID-19 patients.^14,15 Moreover, the economic, social, and psychological burdens of COVID-19 are tremendous for a lower-middle-income country like Bangladesh.^16–20 The country recorded 1,559,452 COVID-19 cases and 27,614 related deaths as of October 5, 2021. ⁷ Therefore, mass immunization is the only way for Bangladesh besides the present COVID-19 responses. So, the country should search for all available alternative options for COVID-19 vaccines besides maintaining diplomatic consistency with the existing sources. The authority should try to get the committed vaccines from the COVAX program. Also, the country needs to maintain diplomatic relations with other global alliances that are promising support to poor and developing countries for the COVID-19 vaccine. The government can also consider direct purchases from vaccine manufacturers. The most important thing is that the authority should consider Chinese and Russian vaccines for their effectiveness, cost, and distribution profile. The government might decide to produce both vaccines locally through product development partnerships, or the government can purchase them directly from the manufacturers. Local pharmaceutical companies can be given permission and encouraged to import quality vaccines for Bangladesh.

Author biography

Md. Rabiul Islam, M. Pharm, MBA, Ph.D., is working as Assistant Professor at the Department of Pharmacy, University of Asia Pacific, Bangladesh. Before his academic journey, he served ten years for Sanofi Bangladesh Limited. His research interests are in psychiatric epidemiology, public health, and infectious diseases.