On the basis of the Global Alliance for Vaccines and Immunisation (GAVI), the COVAX Facility was established as a mechanism for global access to COVID-19 vaccines. The aim of the COVAX Facility is to ensure a safe, rapid and equitable distribution of the vaccines. It provides aid to developing countries, like Georgia, to introduce COVID-19 vaccines.
The negotiations on the introduction of the vaccines are in progress both with the COVAX Facility and directly with the vaccine-producing companies. As a part of its cooperation with the COVAX Facility, Georgia has already made an advance payment which allows the country to select the vaccine on its own. Amiran Gamkrelidze, Head of the National Centre for Disease Control, says that the coronavirus vaccine will be available for the wider public from spring 2021. On 8 January 2021, the Minister of Health of Georgia, Ekaterine Tikaradze, stated that the COVAX Facility may allocate a certain amount of the vaccines for Georgia in February which will be distributed to the people in risk groups.
The respective authorities of a country approve the vaccines based on research vis-à-vis their safety and efficacy in the fight against COVID-19. For instance, vaccines and other medications are approved by the Food and Drug Administration in the USA and by the European Medicines Agency (EMA) in the European Union.
Three vaccine producers have successfully completed clinical trial phases for the COVID-19 vaccine in Europe and the USA. These producers are Pfizer-BioNtech, Moderna and AstraZeneca. At the beginning of December 2020, Pfizer-BioNtech’s vaccine was the first one authorised for mass vaccination and the USA’s FDA soon also approved Moderna’s vaccine. Pfizer-BioNtech’s vaccine needs to be stored at a temperature of -70 degrees (and even lower) Celsius whilst Moderna’s vaccine can be stored at a temperature of -20 Celsius. The latter is also easier to transport.
At the end of December 2020, the UK also approved a vaccine produced in collaboration with Oxford University and the AstraZeneca pharmaceutical company. The approval of the AstraZeneca vaccine is important since it is relatively cheaper with simpler transportation and storage requirements. It does not need an especially low temperature for storage.
In regard to efficacy of the vaccines, those of Pfizer-BioNtech and Moderna are around 95% whilst those of Oxford University and AstraZeneca are nearly 70%. Of note is that a vaccine is considered to be effective if its efficacy is over 50%.
What Do We Know About the Chinese Vaccines?
On 31 December 2020, China approved Sinopharm’s COVID-19 vaccine for general use on the population. As stated by the Sinopharm pharmaceutical company, third phase trials demonstrated that the vaccine’s efficacy is 79%. Prior to that statement, the United Arab Emirates said at the beginning of December 2020 that the vaccine’s efficacy was 86%. The UAE was the first country outside China which approved Sinopharm’s vaccine for emergency use in September. Health professionals have certain questions in regard to the efficacy of the Chinese vaccine since the final results of its clinical trials have not yet been published.
This vaccine is the one of the five vaccines produced in China with four of them having emergency authorisation. China started to administer COVID-19 vaccines to health workers and high-risk group people in July simultaneously with their final trials.
Sinopharm also has another vaccine although the company has not indicated which of its vaccines were approved for general use. One of the COVID-19 vaccines in China was produced by the biopharmaceutical company Sinovac. The company’s trial results in Turkey demonstrated that the vaccine’s efficacy is 91.25% although a research study in Brazil indicated that its efficacy is only 50%.
Of note is that neither the FDA nor the EMA has authorised the Chinese vaccine for general or emergency use.
Which Vaccine Does Georgia Plan to Introduce?
On 10 January 2020, the General Director of the Infectious Diseases and AIDS Centre of Georgia, Tengiz Tsertsvadze, stated: “Two vaccines are under discussion to be introduced to Georgia – AstraZeneca’s and one of the Chinese vaccines. China has five vaccines and this is one of them. I would like to say that the ranking of the Chinese vaccine is globally quite high.” Mr Tsertsvadze further clarified: “Those two vaccines which are most widely used in the USA, Germany and England; that is, Pfizer and Moderna, are not suitable or advantageous for us since they require very complicated logistics. They have to be stored and transported at temperatures of -80 and -20 Celsius. This is not affordable for countries like us.”
In contrast to Tengiz Tsertsvadze’s statement, the first Deputy Minister of Health, Tamar Gabunia, stated on 11 January 2021: “At this stage, Georgia considers only those vaccines which have authorisation from strict regulatory authorities or are pre-qualified by the WHO for a vaccination programme. The Chinese vaccine has not been approved by any of the strict regulatory authorities or by the WHO. Currently, we only discuss the introduction of the Pfizer, Moderna and AstraZeneca vaccines.” Ms Gabunia also clarified: “If we had a vaccine today, we have the technological capacity in three cities – Tbilisi, Kutaisi and Batumi – to use refrigerators with temperatures of -80 Celsius where those vaccines can be stored. This is not a problem and these refrigerators are not that expensive to be unaffordable to purchase in short notice and we have also started probing in that regard.” On the same day, the Deputy Head of the National Centre for Disease Control, Paata Imnadze, also made a statement, arguing that with the current refrigeration capacity “Georgia is able to receive 200,000 doses of the vaccine as early as today.”
Speaking on the same issue in December 2020, the Head of the National Centre for Disease Control, Amiran Gamkrelidze, stated that the coronavirus vaccination in Georgia would commence in a few months in spring. Mr Gamkrelidze added that the country may need technological equipment prior to the vaccination process. In addition, personal training will also be required for the Pfizer-BioNtech and Moderna vaccines.
Amiran Gamkrelidze also clarified: “The country currently has a -2 to -8 Celsius ‘cold chain’ system and nothing additional is needed in order to introduce AstraZeneca’s vaccine which does not require an extremely low storage temperature. In addition, speaking about Moderna’s vaccine which requires a temperature of -20 Celsius, there are refrigerators in municipalities and the vaccine can also be introduced. Pfizer’s vaccine requires a storage temperature of -70 to -80 Celsius and there are approximately 40 such refrigerators in the country which are currently loaded with various test kits. There is a possibility to empty some of them and there are plans to purchase a few more.”
According to the WHO’s survey carried out in Georgia at the end of November 2020, only 47% of the surveyed population expressed a readiness to receive the COVID-19 vaccine shot. The Deputy Minister of Health offered her remarks on the survey results and stated that trust towards the vaccine is a serious problem. Ms Gabunia stated: “To increase trust towards the vaccine in Georgia will require a very large-scale information campaign.” In this light, contradictory statements from authoritative individuals involved in coronavirus management further complicate the already faulty public attitude vis-à-vis the vaccination.
On 12 January 2021, the Minister of Health, Ekaterine Tikaradze, stated during her meeting with the US Ambassador to Georgia: “In the nearest future, it will be possible to vaccine the population with Pfizer’s vaccine.”
Editor’s Remark: The initial version of the article did not include Ekaterine Tikaradze’s latest statement since the Minister made this statement a few hours after the publication of the article.