With Pfizer-BioNtech Covid-19 vaccine all set to arrive in Nepal, authorities are mulling over giving the jabs to people with their immunity compromised.

These include patients of cancer, renal failure and heart disease, among others, officials at the Ministry of Health and Population said.

“Due to limited doses of the vaccine offered to us by the COVAX facility, we are thinking of administering them to those taking immunosuppressants or those who are immunocompromised,” an official at the Health Ministry told the Post, asking not to be named. “We think that the vaccine will be sufficient only for the said group.”

After confirmation that COVAX would deliver the Pfizer-BioNtech vaccine to Nepal, authorities have started the preparations for storing and rolling out the vaccine by preparing guidelines for immunisation workers.

“A kind of understanding has been forged in an expert panel discussion to provide the Pfizer-BioNtech Covid-19 vaccine to the immunocompromised,” Dr Shyam Raj Upreti, coordinator of the Covid-19 Vaccine Advisory Committee, told the Post. “But the Health Ministry will take the final decision regarding the priority group.”

COVAX, a UN-backed vaccine-sharing scheme, has confirmed that it is delivering over 100,000 doses of Pfizer-BioNtech to Nepal, officials at the Health Ministry said.

The facility has committed around 13 million doses of Covid-19 vaccines, which will be sufficient for 20 percent of the Nepali population.

So far, the facility has supplied 3,497,490 doses of vaccine (1,534,850 doses of single-shot Johnson and Johnson vaccine, 1,614,740 doses of AstraZeneca vaccine, and 348,000 doses of AstraZeneca vaccine manufactured in the brand name Covishield).

Pfizer-BioNtech will be the first mRNA-based Covid-19 vaccine to be used in Nepal. The vaccine developed jointly by the US-based Pfizer and the German firm Biontech uses a copy of a molecule called messenger RNA(mRNA) to produce an immune response.

It is said that the Pfizer-BioNtech vaccine was 95 percent effective at preventing laboratory-confirmed infection with the coronavirus.

According to the US Centers for Disease Control and Prevention, the Pfizer-BioNTech vaccine was also highly effective at preventing laboratory-confirmed Covid-19 infection in adolescents between 12-15 years old, and the immune response in these adolescents was at least as strong as the immune response in people 16-25 years old in clinical trials.

“Evidence shows mRNA Covid-19 vaccines offer similar protection in real-world conditions as they have in clinical trial settings—reducing the risk of Covid-19, including severe illness by 90 percent or more, among people who are fully vaccinated,” the US Centers for Disease Control and Prevention said on its website.

The vaccine needs to be stored in minus 70 degrees Celsius, which is not supported by Nepal’s existing vaccine storage facilities.

The Covax facility has provided us with four ultra cold freezers to store the Pfizer-BioNtech Covid-19 vaccine. The four freezers can store over 100,000 doses, according to Upendra Dhungana, chief of the Logistic Management Section under the Department of Health Services.

Officials at the Health Ministry said they are working to clinch a deal with the vaccine manufacturing company (Pfizer-BioNTech) to purchase 6 million doses of the vaccine.

After a request by the Department of Health Services, the Department of Drug Administration, which is the national regulatory body of the drugs market, has given emergency use authorisation for the Pfizer-BioNtech Covid-19 vaccine. Normally, the vaccine manufacturer makes such a request.

Meanwhile, the department has also provided emergency use authorisation to the Moderna vaccine.

“Yes, we have provided emergency use approval to the Moderna vaccine at the request of the Department of Health Services,” said Narayan Dhakal, director general at the department.

Eight Covid-19 vaccines have got emergency use approval in Nepal in total. Earlier, the department had given emergency use authorisation to Covishield, developed by the University of Oxford and the pharmaceutical giant AstraZeneca, AstraZeneca’s vaccine manufactured in Japan and Europe, COVAXIN, developed by an Indian firm, Sputnik V developed by a Russian company, Vero Cell of China’s Sinopharm, Sinovac, and Johnson and Johnson vaccines.

“Two other Chinese vaccines have applied for emergency use authorisation,” said Dhakal. “We have been reviewing their documents.”

The Department has also given import approval for clinical trials to two vaccines.

Meanwhile, the Health Ministry said it has already started the supply of Vero Cell vaccine across the country upon delivery from China on Friday.

“The vaccine will be rolled out from Monday,” Dahal, chief of the National Immunisation Programme, told the Post. “Vaccines have already reached some provinces and are on the way to others.”

He said second doses will be administered to those who have already taken the first, and the first to those who have not taken a jab yet.

China’s Sinopharm delivered 4.4 million vaccine doses on Friday. It is part of the 6 million doses the government purchased of late. So far the government has bought 10 million doses of Vero Cell vaccine from China, under a non-disclosure agreement.

China has also provided 1.8 million Vero Cell doses in grants and has pledged to provide an additional 1.6 million doses but the delivery has yet to be scheduled.

Nepal so far has received a total of 17,755,590 doses of Covid-19 vaccines. Of them, 4,422,740 doses were AstraZeneca type, 11,800,000 doses were Vero Cell, and 1,534,850 doses were the Janssen vaccine produced by Johnson & Johnson.

Of the 4,422,740 doses of the AstraZeneca type vaccine, 2,448,000 were Covishield, manufactured in India. India had provided 1.1 million doses to Nepal under grant assistance. Of the 2 million doses of the Covishield vaccine Nepal purchased from the Serum Institute of India in February, only 1 million doses have been delivered.

Besides this, Covax had supplied 348,000 doses of the Covishield vaccine.

Bhutan supplied 230,000 doses, Japan provided 1,614,740 doses and the United Kingdom 130,000 doses of the AstraZeneca type vaccine to Nepal.

China has so far supplied 11,800,000 doses of the Vero Cell vaccine.

Apart from this, the United States had supplied 1,534,850 doses of the single-shot Janssen vaccine.

The government has already paid for 4 million doses of Moderna’s Covid-19 vaccine through the World Bank to the US manufacturer, and delivery is expected by mid-February.