COVID-19 vaccine update - VPI/DCD 10 January 2021 - Humanitarian Response

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COVID-19 vaccine update - VPI/DCD 10 January 2021 - Humanitarian Response
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       COVID-19 vaccine update

    VPI/DCD
     10 January 2021

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COVID-19 vaccine update - VPI/DCD 10 January 2021 - Humanitarian Response
Regulatory timeline of key phase lll vaccine candidates

   By end of 2020

By end of Feb 2021

From Mar ‘21/No info

                                             Medicines & Healthcare products Regulatory Agency (UK)

   11/01/2021    |   Title of the presentation                                                        2
COVID-19 vaccine update - VPI/DCD 10 January 2021 - Humanitarian Response
COVID-19 vaccine deployment in EMR: Countries that
started vaccination and those with bilateral agreement,
8 Jan 2021

            Vaccination started

            Bilateral agreement exists

                                                          3
COVID-19 vaccine update - VPI/DCD 10 January 2021 - Humanitarian Response
COVID-19 vaccine deployment in EMR:
          Date of initiation and number of persons vaccinated

                                                                                              Start date   Total vaccination

                       UAE                                                                     05-Jan         1,020,349 (as of 9 Jan)
                       Saudi Arabia                                                            06-Jan          130,000 (as of 7 Jan)
                       Bahrain                                                                 23-Dec            84,157 (as of 9 Jan)
                       Oman                                                                    29-Dec            14,980 (as of 9 Jan)
                       Kuwait                                                                  28-Dec          2,500 (as of 29 Dec)
                       Qatar                                                                     NA                              NA
Source:   Coronavirus (COVID-19) Vaccinations - Statistics and Research - Our World in Data

                                                                                                                                        4
COVID-19 vaccine update - VPI/DCD 10 January 2021 - Humanitarian Response
COVID-19 vaccine deployment in EMR: Vaccination doses
  administered per 100 population, 9 Jan 2021

                                                UAE                                                                                                     9.5

                                           Bahrain                                                                  5,67

                                  Saudi Arabia                    0.38

                                             Oman                 0.36

                                            Kuwait            0.05

                                                          0                  1                2   3        4           5          6         7   8   9         10
                                                                                                      Vaccination dose per 100 population

Source:   Coronavirus (COVID-19) Vaccinations - Statistics and Research - Our World in Data
COVID-19 vaccine update - VPI/DCD 10 January 2021 - Humanitarian Response
Vaccines in COVAX facility portfolio

                                       170 million doses

                                       500 million doses

                                       200 million doses

                                       1100 million doses

                                          Total: 1.97 billion doses secured

                                                                              6
Open invitation sent by GAVI CEO on 6 Jan 2021 to all COVAX
facility participants for potential early rollout of limited
quantities of Pfizer BioNTech vaccine as 1st wave

•   Limited number of doses made available through dose sharing from
    the European Union (Pfizer BioNtech not yet part of COVAX)

Objectives:

     • Maximize public health impact with limited doses
       (e.g., target centralized HCWs)

     • Ensure continuity for countries (e.g., subsequent deliveries of
       same vaccines, in meaningful volumes within a reasonable
       timeframe)

     • Gain critical learnings for full-scale up

     • Ensure no doses go idle, with timely delivery
Early 1st wave of Pfizer BioNTech vaccine
Requirements
✓   Express an interest in mRNA vaccines
✓   Plan to vaccinate before May 2021
✓   Willingness to use more than 1 type of vaccine in the national response1
✓   Agree to use standard labels2 and rely on WHO EUL or EUA3 to grant national regulatory authorization
✓   Have necessary indemnity & liability frameworks in place, including agreement with Pfizer

Minister of Health or other authorizing authority need to confirm that:
✓ The above conditions for using the Pfizer vaccine can be fully met in January 2021
✓ Essential elements of an early rollout plan are in place

Timeline
❑ 18 Jan 2021: Participants to confirm interest to COVAX facility with minimum criteria met
❑ 29 Jan 2021: Final selection and notification of country names

                       1. through the Vaccine Request Form (VRF) for AMC participants, the VIF for self-financing participants, or a subsequent communication
                       2. Without additional inserts or a language other than Spanish, French, Arabic, English, Chinese or Russian
                       3. or equivalent by a Stringent Regulatory Authority
                                                                                                                                                          8
WHO interim recommendation for the use of mRNA
BNT162b2 (Pfizer-BioNTech) (1/2)
SAGE meeting, 5 Jan 2021

•   BNT162b2 (Pfizer vaccine) has an efficacy of 95% against symptomatic
    SARS-CoV-2 infection
•   No data on impact on transmission or viral shedding
•   Vaccination recommended for persons aged 16 years and above
•   Two doses given intramuscularly with an interval of 21–28 days
     • Need for flexibility in the schedule
     • Current data support an extension up to 42 days (6 weeks)
•   The same product should be used for both doses.
     • No studies on interchangeability with other vaccines against COVID-19

                           https://apps.who.int/iris/bitstream/handle/10665/338484/WHO-2019-nCoV-vaccines-SAGE_recommendation-BNT162b2-2021.1-eng.pdf
WHO interim recommendation for the use of
mRNA BNT162b2 (Pfizer-BioNTech) (2/2)
Vaccination of specific populations

•   BNT162b2 is not a live vaccine, the mRNA does not enter the nucleus and is rapidly degraded
•   Animal studies show no toxicity to the fetus, but no data on safety in pregnant women exist
•   SAGE recommends not to use BNT162b2 in pregnancy until more data are available, except
    where the benefit outweighs risks, such as health workers at high risk of exposure or women with
    significant comorbidities
•   Vaccination can be offered to breastfeeding women if part of risk group, and WHO does not
    recommend discontinuation of breastfeeding after vaccination
•   Vaccination can be offered to people living with HIV in accordance to the prioritization roadmap
Summary
Vaccine roll out started, more to come soon…..

•   COVID-19 vaccine becoming available in the region, mostly through bilateral agreements
•   Some countries of the region provided emergency authorizations for Sinopharm vaccine ahead of WHO and
    stringent NRAs
•   COVAX facility secured almost 2 billion doses as initially targeted and more are under negotiation
•   COVAX facility is exploring interest and readiness for early rollout with Pfizer vaccine as 1st wave
•   More vaccine expected to be gradually available by the 2nd half of 2021
•   WHO approved Pfizer-BioNTech vaccine under EUL and made interim recommendations for use of this
    vaccine
•   More vaccines are under review of WHO – recommendations will be made soon the product is approved
    under EUL

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COVID-19 vaccine use in EMR,
5 Jan 2021

COVID-19 vaccine     Vaccination started     Bilateral agreement signed but              Probable bilateral
                                                  vaccination not started               agreement/donation
Pfizer BioNTech     Bahrain, Kuwait,       Egypt (20 million doses)            Lebanon (MoH statement through
                    Oman, Qatar, Saudi     Tunisia (2 million doses)           media)
                    Arabia, UAE                                                Jordan (procuring UCC equipment)
AstraZeneca                                Egypt (30 million doses)
                                           Morocco*
Sinopharm           UAE                    Morocco*                            Egypt (donation from UAE)

              *Morocco is procuring total 65 million doses of vaccine from two manufacturers (AstraZeneca and Sinopharm)

                                                                              UCC: Ultra cold chain for mRNA vaccine
Approval of COVID-19 vaccines by National
Regulatory Authorities (NRAs) and WHO
(Emergency Use Listing, EUL) – 5 Jan 2021
COVID-19                 Regulatory approval in EMR countries              Approved by other NRAs         WHO EUL
vaccine            Emergency         Emergency use         Conditional
               approval/Tempora    authorization (EUA)      approval
                ry authorization
Pfizer         Iraq                Bahrain, Jordan,      Saudi Arabia     UK MHRA, US FDA           Yes
BioNTech                           Kuwait, Oman,                          Health Canada
                                   Qatar, UAE                             TGA-Australia
Moderna                                                                   US FDA                    Under review
                                                                          Health Canada
AstraZeneca    Morocco                                                    UK MHRA, India            Under review
Sinopharm      Egypt               Bahrain, UAE,                          China
                                   Jordan*
Sputnik V                                                                 Russia                    Under review
              *Jordan- Sinopharm vaccine dossier is submitted and under review for EUA
COVAX Facility: Co-convened by CEPI, GAVI and WHO

                     • The Coalition for Epidemic Preparedness Innovations (CEPI)
                     • Supporting vaccine research and development from the lab to the production
                       facility

                     • Pulling procurement and incentivizing manufacturing expansion to secure rapid
                       supply of safe and efficacious vaccines for countries and territories

                     • Providing normative guidance on vaccine policies, safety, regulation, and
                       allocation

 Goal: Ending the acute phase of the global pandemic by the end of 2021, through fair
 and equitable allocation of safe and effective doses of vaccines
 Aim: 2 billion doses of COVID vaccine fairly and equitably distributed by end 2021
The path to COVID-19 vaccine delivery from COVAX facility

                                                           Approve
                                                           candidates
                                                           based on SRA,
                                                           WHO PQ / EUL

 CONFIRMATION OF                        REGULATORY                             ALLOCATION                   VACCINE DISPATCH
  PARTICIPATION                        AUTHORIZATION                                                                                                 VACCINES
                                                                                                                                                     DELIVERED

Dec 2020 – Jan 2021                Jan 2021
Sign Terms and Conditions          •   Monitor readiness using
                                       VIRAT/VRAF 2.0
Complete Vaccine Request and
                                       Countries develop National                                                       Feb - Mar 2021
express preferences on vaccines    •
                                       Vaccine Deployment Plan             Feb 2021                                     •   Country regulatory approval
Request TA & CCE support and
cost-sharing                                                               •    NDVP reviewed by regional               •   Indemnification and liability
                                                                                review committee                            agreement

            COUNTRY PREPARATION FOR VACCINE

            FINANCING                                                      READINESS                        READINESS
                                                                             CHECK                            CHECK

            Speed, Scale, Access                                                                                                                            15
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