The COVAX facility, the United Nations-backed international Covid-19 vaccine sharing scheme, is most likely to provide vaccines for children between five and 11 years old in Nepal.

Officials at the Ministry of Health and Population said that they have been asked to wait for a few days for an official confirmation for the supply of the vaccine for the said age group.

“They had sent a message last week too asking us to wait for a couple of days for official confirmation,” an official at the Health Ministry told the Post, asking not to be named as he is not authorised to speak to the media. “They have told us they are seriously considering the possibility of providing vaccines to children between five and 11 years in Nepal.”

The government has decided to inoculate children between five and 11 years with Covid-19 vaccine with the vaccination drive taking off in April. However, no deal to purchase the vaccine has been reached so far.

“Officials at the Global Alliance for Vaccine and Immunisation have assured us about the possibility of supplying vaccines for children between five and 11 years,” Dr Bibek Kumar Lal, director at the Family Welfare Division, told the Post. “We do not have to procure vaccine syringes and diluent if the Covax facility provides us the vaccine.”

Nepal has yet to vaccinate children between five and 11 years against Covid-19. As the Covid-19 infection rate has dropped significantly of late, the process to procure vaccines for the said age group has not gained momentum.

Officials at the Department of Health Services; however, claim that they have already forwarded a proposal for procuring the vaccine to the Health Ministry, which has sent the proposal to the Cabinet.

“The file has been sent to Cabinet for the approval of terms and conditions of the proposal to procure vaccines for children between five and 11 years,” said Dr Surendra Chaurasia, chief of the Logistic Management Section under the Department of Health Services. “Once the Cabinet okays the proposal, a deal to purchase the vaccine will be signed.”

The government is planning to procure 8.4 million doses of the Pfizer-BioNTech vaccine to inoculate children between five and 11 years old.

To purchase Covid vaccines, the government also signed an agreement for a concessional loan of $18 million with the World Bank on Friday.

There are two types of Pfizer-BioNTech Covid vaccines for children—one is for those between five to 11 years, and another for those aged 12 and above.

Nepal has already used Pfizer vaccines on its people—on those with comorbidities and on children between 12 and 17 years.

The Department of Health Services has also sought emergency use authorisation for the Pfizer-BioNTech vaccine for children in Nepal with the Department of Drug Administration.

Lal said that his office has requested officials at the Global Alliance for Vaccine and Immunisation to inform about the possibility of supplying vaccine doses at the earliest as the government cannot stop the already started process to procure the vaccine.

“Government procedures take time so we cannot stop the process even if there is the possibility of Covax supplying us with the needed vaccines,” said Lal. “If we get the confirmation about vaccine supply from COVAX and a tentative date, we can stop the process to purchase vaccine doses right away. That will be a huge relief to the government.”

However, if the COVAX facility is unable to supply all the required doses, the government will go ahead and purchase the required doses to inoculate all the children between five and 11 years, according to Lal.

The Pfizer-BioNTech vaccine is the only jab recommended by the World Health Organisation for use in children of the said age group.

The American Association of Pediatrics has recommended administering 10 microgram doses in a gap of 21 days to children between five and 11 years. The dose, 0.2ml, is one-third of what is administered to adolescents and adults.

The vaccine vial for children in the said age bracket comes with an orange cap while the other vial is purple-capped.

Each vial with 10 doses needs 1.3 millilitres (ml) of diluent under Pfizer’s preliminary plan. The vaccines can be stored for six months in an ultra-cold freezer or 10 weeks in a normal refrigerator, under Pfizer’s proposal.

The US Food and Drug Administration in October authorised emergency use of the Pfizer-BioNTech Covid-19 vaccine for children between five and 11 years. Several countries have already started administering the vaccine to children of the said age group.

But if some reports are anything to go by, there could be a setback.

According to a large data collected by US’ New York state health officials, the Pfizer-BioNTech Covid-19 vaccine is less effective in children aged between five and 11 than in adolescents and adults.

In the study released recently, six New York state public health scientists analysed cases and hospitalisation rates from December 13, 2021 to January 30, 2022 among 852,384 fully vaccinated children aged 12 and 17 years and 365,502 fully vaccinated children aged five and 11 years.

Vaccine effectiveness against testing positive declined from 66 percent to 51 percent among children aged 12 and 17 years. In the younger group, effectiveness dropped from 68 percent to 12 percent.

The study was carried out during the Omicron variant surge but was made public at a time of rapidly dropping cases and hospitalisations in New York and elsewhere.

Health Ministry officials said that they will not stop the process to procure the vaccine unless the World Health Organisation’s Strategic Advisory Group of Experts on Immunisation recommends otherwise, as there is no other vaccine for children of a smaller age group.

Experts say that vaccination is the only proven intervention to lessen the severity and deaths from Covid-19 infection, now and in future.

Meanwhile, the Health Ministry said that the COVAX facility will supply 1.5 million doses of Pfizer-BioNTech vaccine for people above 18 years on March 25 and 28. The doses are part of 9.2 million doses promised by the facility. Officials said that the facility will supply 1.5 million doses by October.

Likewise, the government has planned to send a plane to China on March 25 and 27 to bring four million doses of Sinovac-CoronaVac Covid-19 vaccine offered by the northern neighbour in grant.

Nepal so far has received 47,882,800 doses of Covid-19 vaccines— AstraZeneca, Vero Cell, Moderna, Janssen and Pfizer-BioNTech.

As of Monday, 18748,545 people or 64.2 percent of the total population have been fully vaccinated.