Nepal now has enough vaccine doses in stock. It is estimated that around 13 million doses are at various storage facilities across the country. The country’s vaccination drive, however, has slowed down.

As the risk of spread of new variant of SARS-CoV-2, dubbed Omicron, has increased with the rise in the number of new cases across the world and in neighbouring India, public health experts have stressed the need to ramp up the vaccination campaign and to administer extended doses to the elderly who have received two shots.

Calls have also been growing to start administering booster doses. The government, however, has not taken any decision yet. Experts say officials must take a quick decision on expanding the vaccination coverage and launching booster doses also because the Omicron threat is knocking at the country’s door.

Here is what you need to know about Nepal’s vaccination status, planning about the extended doses and booster shots.

When did Nepal launch its vaccination campaign against Covid-19?

Nepal rolled out its Covid-19 vaccination campaign on January 27, a little over a year after the country confirmed its first coronavirus case on January 24, 2020. Nepal started vaccinating its people with the 1 million doses of Covishield, the AstraZeneca type of vaccine manufactured by the Serum Institute of India, that India had provided under grant assistance.

What types of vaccines has Nepal used so far?

Nepal so far has used AstraZeneca (including the Covishield shot manufactured in India), Vero Cell, Janssen, Moderna and Pfizer-BioNTech vaccines to inoculate its population.

How many doses has Nepal received so far and from where ?

As of December 24, Nepal has received 39,203,927 doses.

Of the total amount received, the COVAX facility, the United Nations-backed vaccine sharing scheme, has supplied 16,989,720 doses. Of them, 6,387,000 doses were Covishield and 2,474,840 doses AstraZeneca.

Likewise, the facility also supplied 3,711,500 doses of single-shot Janssen, 3,651,200 doses of Moderna and 765,180 doses of Pfizer-BioNTech.

Nepal has also received 18,551,487 doses of the Chinese Vero Cell vaccine. Of them, the government purchased 10 million doses through a non-disclosure agreement from the vaccine manufacturer Sinopharm. An additional 4,751,487 Vero Cell doses were bought through COVAX’s cost-sharing scheme. China has donated 3.8 million doses of Vero Cell so far.

The government has purchased 2 million doses of Covishield vaccine from the Serum Institute of India, which were delivered in February and in October and India provided 1.1 million doses in grant.

Bhutan, the Maldives and the United Kingdom have supplied 230,000 doses, 201,600 doses and 131,120 doses of AstraZeneca, respectively.

Of the total doses the country received so far, 18,551,487 are Vero Cell and 12,524,560 AstraZeneca type (Covishield included). The remaining are Janssen, Moderna and Pfizer-BioNTech.

Are more vaccines coming?

Shipments of 6 million doses of Pfizer-BioNTech and 4 million doses of Moderna, purchased using a loan from the World Bank, have not started yet.

Around 2 million doses of the Vero Cell vaccine purchased through the COVAX facility’s cost-sharing scheme are expected to be delivered in the coming days.

China has also pledged to provide 3 million doses of the Sinovac-CoronaVac Covid-19 vaccine to Nepal.

Officials say COVAX will also supply more doses.

How many people in Nepal need to be vaccinated?

Nepal needs to vaccinate 78 percent of the total population—or over 23,400,000 people.

How many people have been vaccinated so far?

As many as 19,922,164 people have received the first dose and of them 9,985,568 people (32.9 percent of total population) have been fully vaccinated as of Saturday.

What is the country’s current Covid-19 status?

After 167 new coronavirus cases were reported on Saturday, the nationwide infection tally has reached 923,183 [including antigen positive cases] since the start of the pandemic. Active cases stand at 4,978 throughout the country.

The Covid-19 death toll has reached 11,583.

What is the risk of spread of the Omicron variant in Nepal?

Omicron, a new iteration of the coronavirus first confirmed in South Africa in late November, has now spread to over 100 countries.

And with new cases rising in neighbouring India, public health experts have rung alarm bells in Nepal. They warned that the country is on the brink of an outbreak of the Omicron variant and the upcoming two weeks will be very crucial.

India has also been reporting a surge in Omicron cases. So far, the southern neighbour has recorded 415 cases of the coronavirus variant. Even the vaccinated people are found infected with the new virus variant in India.

Nepal also reported a new Omicron case on Thursday, weeks after two infections from the new variant were confirmed. The earlier two patients, however, had tested negative after a few days.

What do experts say about the role of vaccines against the Omicron variant?

Public health experts in Nepal say even if a vaccinated person gets infected with the Omicron variant, chances of them getting serious and dying from infection will be less if the infected person is fully vaccinated. They say it’s already late to start booster shots at least for the elderly population, those with compromised immunity and frontline health workers.

What is the government's preparation to start booster shots?

Although Minister for Health and Population Birodh Khatiwada has said that the government is waiting for permission of the World Health Organisation to start booster shots in Nepal, Health Ministry officials say that neither the United Nation’s health body has recommended booster shots yet, nor the government currently has any plan for the same.

They say that a third dose of the Covid-19 vaccine will be administered to the people with compromised immunity, and those above 60 years old who were administered with the Vero Cell vaccine.

The National Vaccine Advisory Committee has also recommended administering a third dose of Covid-19 vaccine to the people from the said groups.

“People are getting confused about booster shots and extended doses,'' an official at the Health Ministry said. “The Health Minister himself has been confusing people.”

What has the WHO said about the extended dose?

The UN health body has recommended administering an extended dose after two to six months of the completion of the second dose.

The WHO said that an additional dose may be needed as part of extended primary series for the target population where immune response rate following the standard primary series is deemed insufficient. The objective of an additional dose in the primary series is to optimize or enhance the immune response to establish a sufficient level of effectiveness against disease.

“In particular, immunocompromised individuals often fail to mount a protective immune response after standard primary series [two doses], but also older adults may respond poorly to standard primary series,” reads the WHO’s interim statement.