The Ministry of Health and Population said it is undecided about resuming the supply of Pfizer-BioNTech vaccine from the Covax facility. The supply has been halted since April this year, given the slow uptake of booster shots by the general public and the country’s limited capacity to store vaccines.

There has been no significant increase in the uptake of vaccines—the first two doses and booster—and millions of doses are in stock. Requests for the resumption of supply of additional doses will not be made anytime soon, officials at the ministry said.

“We don’t know when we will request for resumption of supply of additional doses of the Pfizer-BioNTech vaccine,” said Dr Surendra Chaurasia, the chief of the Logistic Management Section under the Department of Health Services. “We will not seek more vaccines until the doses we already have are used up.”

The government had requested the COVAX facility to halt shipment of the Pfizer-BioNTech vaccine earlier in April citing storage problems. The facility, the United Nations-backed international vaccine-sharing scheme, had committed to supply 9.2 million doses of the vaccine and had until March supplied 1.5 million doses. The supply of the rest of the doses remains on hold at the request of the Nepal government.

The Pfizer-BioNTech doses, which are being stored at minus 80 degrees Celsius in ultracold freezers, can be stored in normal temperatures (2 to 8 degrees Celsius) for up to 31 days. If not used within 31 days of the rollout, the vaccine doses must be discarded.

The Health Ministry can only store around two million doses at minus 80 degrees at the moment.

The administration of the booster shot has not increased despite an increase in Covid cases of late.

According to the Health Ministry, 121 people tested positive for the coronavirus on Sunday, including 104 in 1,700 polymerase chain reaction tests and 17 in 1,345 antigen tests.

The number of people testing positive for the coronavirus increased to 642 in one week with the infection rate increasing three-fold in a week.

Public health experts say that the actual number of infections could be higher than reported by the Health Ministry since the testing rate has decreased manifold with only those going abroad opting for a test.

“Covid-19 infection has increased significantly of late,” Dr Shrawan Kumar Mishra, the chief of the Provincial National Health Laboratory of the Madhesh Province, told the Post over the phone from Janakpur. “Three people working in our own laboratory have tested positive.”

Highlighting the importance of vaccines in the fight against Covid and citing Nepal’s own experience with the pandemic, doctors say that vaccines prevent severity, hospitalisations and deaths, even if they can't prevent reinfection. Doctors stress the need for administering booster doses to avoid another health catastrophe.

“The number of infected people could be more than the number currently projected,” said Dr Rajiv Shrestha, an infectious disease expert at Dhulikhel Hospital. “But instances of infected patients getting severe and seeking hospital care have not increased because of the high coverage rate of the vaccination in the previous phases.”

So far, 20,359,274 people or 69.7 percent of the total population have been fully immunised against Covid. The Health Ministry said that 87.3 percent of the population above 12 years old has been fully vaccinated.

Doctors say the rise and decline in the number of new cases will continue given the nature of the pandemic; therefore, the administration of the vaccine doses is important as a preemptive measure.

“Covid-19 vaccines do not prevent infection or reinfection,” said Dr Shyam Raj Upreti, former director general at the Department of Health Services. “But they save us from hospitalisation and are helpful in fighting the virus.”

Of the 7.356 million doses of Covid-19 vaccines in stock, four million doses are the Sinovac-CoronaVac vaccine, 1.8 million doses are pediatric doses of Pfizer-BioNTech vaccine; 700,000 doses are adult Pfizer-BioNTech vaccine; and 384,000 doses are Covishield doses. Some of the vaccine doses including that of Covishield are close to expiration, officials said.

The Health Ministry had decided to administer booster shots to eligible people who were administered with the second doses of Covid vaccines three months ago, but there has been no significant increase in the uptake.

Health Ministry officials surmise that the term ‘booster dose’ might have confused the general public, so they are mulling over whether to call it the ‘third’ dose instead.

“The word booster seems to have caused confusion in the public. This may be the reason behind the slow uptake of vaccines,” said Sagar Dahal, chief of the National Immunisation Programme. “We would like to request all eligible people to take the third dose if they have taken the second dose at least three months ago. The third dose is necessary as it saves us from getting severely ill."

Nepal has so far received 57,883,970 doses of Covid vaccines of various brands—AstraZeneca, Vero Cell, Moderna, Janssen, Sinovac-CoronaVac, and Pfizer-BioNTech—including paediatric doses.