Coronavirus vaccines have been introduced by their developers as a solution to the coronavirus pandemic that has killed thousands of people, and many countries are eagerly awaiting pharmaceutical companies to provide this information.
The Dominican Republic is no exception, and government authorities have already spoken out when they intend to receive the 10 million vaccinations they agreed with the pharmaceutical company AstraZeneca at the end of October last year.
The Minister of Public Health, Plutarco Arias, declared in November 2020 that the vaccines will be available in the country until next March, although he did not specify whether it is the total amount or a part.
“We may have the vaccines available in February, but the surest thing is that we will administer it in March,” the official said in an interview.
However, for the period indicated by Arias, only about 400,000 vaccinations would be ready, according to the aforementioned contract.
In that document, obtained in full by that means, AstraZeneca estimates that it will make the delivery in the first half of this year and will be sent gradually within that time period.
The first batch of vaccines would arrive on March 21, according to the preliminary delivery schedule; the second, of 800,000, will be delivered on April 21; a month later, AstraZeneca expects to send another expedition to the country with the same amount, and on June 21 the next will send another 700,000.
On July 21, it would reach an even higher amount, this time 1.9 million; 3.9 million vaccinations in mid-August and another 1.4 million in September 2021.
Subscriptions
One of the important aspects of the contract is that the pharmacist must give thirty days’ notice of the time when the vaccines are available, as well as the quantity that would be delivered.
They would be exported from the distribution center, located in Mexico. Once imported, the vaccines will become the responsibility of the Dominican government, which will also have to take responsibility for their useful life, with no possibility of return if they expire.
Price
Each dose will cost about $ 4 (about 232 Dominican pesos), although this price could increase by 20 percent. If this happens, then the state will take over the additional cost. In any case, the agreement stipulates that in no case will the price per dose exceed 6 USD (RD 349 USD).
The contract also contains the structure of the total payment for vaccines, which amounts to $ 40 million (more than 2,300 million pesos), in which three different payments will be made, when specific situations are met.
The first will be equal to 20 percent of the total agreed, or $ 8 million (approximately $ 464,612,690). It will then become one of the equivalent of 40% (RD $ 929,225,381) when the AstraZeneca vaccine is approved by one of these health agencies: the US Food and Drug Administration (FDA). Medicines and British Health Products (MHRA), the European Medicines Agency (EMA) or the Dominican health authorities.
The remaining amount will be delivered when AstraZeneca notifies the country of the date of first delivery of the vaccines.
The Dominican authorities have already paid 60% of the contract, as the first requirement was met when the National Congress approved the purchase agreement, while the second was concluded three weeks ago.
On Wednesday, December 30, the MHRA approved the AstraZeneca vaccine, with the aim of accelerating the vaccination process against COVID-19, a fight that has grown since the emergence of a new, more contagious strain.
Termination
The contract will be in effect until the delivery of AstraZeneca doses is completed or until the Dominican Government terminates the agreement prematurely.
This can only occur in two situations, the first being that the pharmaceutical company mentioned above abandons its efforts to develop and manufacture the vaccine or if it cannot be administered safely and effectively.
Under these conditions, either party can terminate the agreement, and the laboratory will undertake to return to the state, within 30 days of cancellation, “any part of the unused purchase price”, after deducting the expenses it has incurred. had during the term of the contract.
At the same time, the country must reimburse AstraZeneca for “all reasonably incurred and unpaid expenses”, in addition to expenses that cannot be canceled.
The Dominican Republic will not be able to claim any compensation, in terms of damages, for this cancellation.
The other case is for breach of one of the terms of the contract by AstraZeneca. If this happens, the government will have to notify the pharmacist of its intentions in writing, describing its reasons.
After that, the laboratory will not have more than thirty days for rectification and, even if the requests for continued termination, the payment method will remain in force.
What if there are defective vaccines?
In this case, the agreement specifies that any of the signatories may submit a sample of a dose that it considers defective, agreeing to send it to an independent laboratory so that it can be analyzed and determined whether it has been in that condition before. or after it has been performed.Delivery.
The cost of testing and evaluation will be borne by the Dominican State, unless the failure was caused by negligence or irregular conduct of AstraZeneca.
If it turns out that the error was the fault of the pharmaceutical company, the delivery will be canceled, changing the affected product for one in conditions that meet the established standards, arranging the delivery of the replacement package in an “accelerated” way. This is at no extra cost to the Dominican Republic.
But if the country proves to be guilty, then the same process will take place, with the government paying all the necessary expenses.
Likewise, the Dominican Republic will bear the costs if a scenario arises in which the inoculation of AstraZeneca must be withdrawn from the market, unless the reason was the fault of the laboratory.
Vaccine details
At the time of signing the contract, the AstraZeneca vaccine was designed for people over the age of 18, with a shelf life of approximately six months.
They will be applied intramuscularly in two doses, at a distance of 28 days between vaccinations, of 0.5 milliliters. They should be kept cold, between 2 and 8 degrees Celsius.
Vaccination
Although the contract with AstraZeneca was announced more than two months ago, the Government has not officially announced its vaccination plan for when the vaccine will arrive.
However, the vaccination program for citizens is already ready, according to Deputy Minister of Public Health Ivelisse Acosta, and that it would be applied as soon as the first doses of vaccines are available.
Similarly, the head of Public Health advanced some details about this plan last month, ensuring that the first to receive the doses will be “front-line” workers, such as doctors, nurses and the military.
After these people, those with comorbidities against the virus and those over 60 will be inoculated.
This is in line with the measures announced by the major powers that have been hit hard by COVID, such as the United States, the United Kingdom and China.
Arias indicated that there is logistics, including the refrigerators needed to host the vaccines, and stressed that the vaccination process could be extended until next October, but that, with the help of primary care centers and private medical centers, they will achieve the set goals.
Effectiveness
The effectiveness of the AstraZeneca vaccine (70%) triggered alarms in the Dominican Republic, as others scored higher.
Despite this, AstraZeneca CEO Pascal Soriot believes that his vaccine is effective against the new strain of coronavirus detected in the London region, which is already in the Dominican Republic, and is 70% more contagious than the original.
Critics of the purchase of this vaccine include the president of the Dominican College of Physicians (CMD), Waldo Ariel Suero, who said that the country should have bought Moderna and Pfizer-BioNTech, due to their greater effectiveness in those studies, both over 90 percent.
However, the AstraZeneca has some advantages, such as the price. Your modern rates are around $ 35 (2,035 Dominican pesos) for each dose, Pfizer has announced that theirs will cost about $ 20 (RD $ 1,163), while AstraZeneca will be only $ 4 (232 pesos) ).
In addition, there is the question that the handling of AstraZeneca is easier than the others, as it should be maintained only at a temperature between 2 and 8 degrees Celsius, with Moderna requires -20 ° C and from Pfizer-BioNTech, which should be maintained at – 70 degrees.
As for the doubts, the Minister of Public Health said that the level of effectiveness of the AstraZeneca vaccine was given more importance than he received, adding that the first dose will cover 70 percent and the second part will cover 90 percent. “It simply came to our notice then. We are talking about a first dose, of half a dose, will cover 70%, and the second part will cover 90% “, said Arias. “So the possibility of a vaccine covering 100% is not real, but 90 or 95% and this will happen with the first part of the vaccine we contracted.”
Another contract
Republican Vice President Raquel Peña announced last Friday that the government had agreed with Pfizer and BioNTech to buy 7.9 million doses of vaccine, saying they had made that decision to ensure Dominicans had access to a COVID vaccine. .
According to information shared by Peña, vaccinations will arrive in the country in the second quarter of 2021, once the BNT162b2 vaccine, the only one approved by the World Health Organization (WHO), receives transitional permission from the General Directorate for Medicines, Foods and Products (Digemaps) and its acquisition is approved by the National Congress.
Similarly, President Luis Abinader had reported that he expected to receive from Pfizer and BioNTech about 25,000 vaccines that would arrive as an “emergency shipment,” and he and the first vice president would be inoculated with them.
Although the delivery period could be in jeopardy, due to the production problems faced by the pharmaceutical company due to the high demand that exists for its product.
For example, Pfizer has already reported that it will take three to four weeks to deliver what was promised to European Union (EU) countries, with several countries on that continent criticizing the delay.
Austria has received 20% fewer vaccines than it expected this month, and Italy has even decided to sue developers for delay.
Canada was another country affected by the delay, as they temporarily reduced the number of vaccines sent to the North American country.
In fact, on the same day that the contract with Pfizer was announced, the pharmaceutical company explained that its deliveries will slow down at the end of this month or at the beginning of February, in order to bring changes to the production process and increase the pace in the coming weeks.
In a statement, they said there may be fluctuations in orders at their facilities in Belgium, saying that this will allow them to significantly increase the doses available for March.