Coronavirus: Thai doctors want Pfizer vaccines amid doubts over Sinovac’s efficacy against Delta variant
- Thailand’s ‘Fed-up Doctors’ group is demanding the country switch to mRNA vaccines amid reports that even medics double vaccinated with the Chinese-made jab are being infected with the Delta variant of the coronavirus
- Health care workers have been angered by a leaked memo showing experts fear giving doctors Pfizer jabs donated by the United States could undermine confidence in Sinovac
For the past five years, Wipa, a doctor in her 20s, has had to adjust to a gruelling shift pattern of 36 hours on, eight hours off, for three to five days a week.
“Our focus is now on the Covid-19 patients who take most of the doctors’ time. We will run out of a few things soon: oxygen, medicines and negative pressure rooms,” said Wipa.
Like other frontline medical workers, Wipa has grown used to battling the pandemic with limited resources and does not begrudge the long hours she is putting in.
“If we give [Pfizer jabs] to the [frontline medical workers] it would mean we accept that Sinovac cannot prevent [the Delta variant], which would make it harder for us to find excuses for ourselves,” the memo read.
Wipa said the memo had left her “very saddened and disappointed”.
“I know there were many senior medical professors in the meeting. They owe doctors like me an answer,” she said.
Wipa belongs to the group Mor Mai Ton (“Fed-up Doctors’), which petitioned in April for the Health Minister Anutin to resign, and is now demanding Thailand switch to using vaccines that, like Pfizer’s, use mRNA technology. (Sinovac uses an inactivated form of the Covid-19 virus, while AstraZeneca is considered a viral vector-based vaccine).
Wipa, like many of her colleagues, has already received two shots of the Sinovac vaccine; inoculations of the elderly and health care workers began in February.
But she had been hoping to get a booster shot of the Pfizer vaccine after hearing reports of rising coronavirus infections among health workers who like her had already received two shots of Sinovac.
On Sunday, a Reuters report quoting health ministry data from April to July said that 618 medical personnel, out of 677,348 who had received two doses of Sinovac, became infected including a nurse who died and another medical worker who is in a critical condition.
The following day, though it did not reference the report, the health ministry said it was now advising that the Sinovac vaccine should be used only as a first dose and that the locally made AstraZeneca shot be administered as the second.
That advice came despite no major studies having been made into the efficacy of a combined Sinovac-AstraZeneca regimen, leading some observers to paint the measure as one born out of waning confidence in Sinovac – and increasing desperation at how the Delta variant has turned on its head a health system that as recently as 2019 was ranked among the world’s best by the US magazine CEOWorld.
With the government having ordered a two-week lockdown in several provinces including Bangkok from July 12 public morale has been made worse by a steady stream of distressing news. In recent weeks local media has run images of people queuing overnight in the rain just to get a Covid-19 swab test and reported that scores of people are dying before they can get treatment. Temples around Bangkok have reported their crematoria being overwhelmed to the point of collapse.
Lack of data
Research released in June by Public Health England, based on analysis of 14,019 cases of the Delta variant in Britain, found the Pfizer and AstraZeneca vaccines were 96 per cent and 92 per cent effective, respectively, against hospitalisation after two doses.
Real-world effectiveness results from Chile, published in the New England Journal of Medicine on Wednesday, showed that the Sinovac vaccine was 65.9 per cent effective against Covid-19, 87.5 per cent effective at preventing hospitalisation and 86.3 per cent effective at preventing death. However, those figures did not include a breakdown of how well the vaccine stood up to the Delta variant.
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Some doctors have defended Thailand’s move to mix and match vaccines as a necessary measure amid a shortage of vaccines. The country has set a target of vaccinating 50 million of its 66 million population by the end of the year. So far, about 12.9 million have been inoculated, with its programme having been hampered by delayed deliveries of the AstraZeneca vaccine.
AstraZeneca had been expected to deliver around 10 million doses each month from June onwards, but has fallen behind. Nakorn Premsri, head of the National Vaccine Institute, has said the target was missed because of AstraZeneca’s export deals with other countries.
AstraZeneca had originally been pitched as the workhorse for Thailand’s inoculation programme but due to its problems Sinovac instead has provided the bulk of the country’s shots, with 10.5 million doses imported as of June 23. On July 6, the government approved a budget of 6 billion baht (US$183 million) to procure a further 10.9 million Sinovac doses.
Despite the supply issues, some doctors have criticised the government’s reliance on Sinovac.
Santi Kijwattanapaibul, a doctor and a member of the Public Health Association of Thailand, said the government had been “stubborn” in continuing to import the Sinovac vaccine despite “unclear scientific data”.
Sinovac had “failed to gain the confidence of the people because of its lower efficacy” Santi said, adding that “infections among doctors could have been easily preventable but the government let it happen”.
Santi said the decision to mix and match Sinovac and AstraZeneca shots was not “a straightforward act by the government” and that the lack of transparency would only fuel the public’s mistrust.
“When the lesser efficacy of a vaccine is defended by further supporting its use it is not just a scientific issue, but an ethical one,” Santi said.
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It is not only Sinovac that is struggling with public mistrust. The delivery problems of AstraZeneca mean it too has come in for heavy criticism, while the government has come under fire for the sort of excessive bureaucracy some blame for its failure to join the World Health Organization-backed vaccine-sharing initiative Covax Facility.
Government bureaucracy is also being blamed for the equipment and supply shortages affecting hospitals such as the one Wipa works at in Pathum Thani.
The health ministry has responded in recent days by loosening regulations on the use of antigen test kits, with Nimit Tienupdom, a board member of the National Health Security Office, vowing the kits would be made free and available to all.
But doctors like Santi and Wipa remain unimpressed, saying the government has done too little too late.
They said cases had risen to the point where it had become challenging to separate patients from their home or community as a means to control further infections.
Santi said the two-week lockdown was too short and that at least two months of containment would be needed to have an impact.
“Covid-19 started last year, but no contingency was put in place in terms of medical devices or anything,” he added.
Wipa, who is a member of Mor Mai Ton, warned that the actual infection rates could be two or three times higher than the current ineffective testing regime suggested and that shortages of oxygen and medicine would begin to bite by the end of July.
“We have to shout and be loud about what is best for our society,” Wipa said. “But I run out of things to say because so far I don’t see how Thailand will get out of this pandemic. I don’t know if those high up see the same things I see.”