Editor’s Note: This story was originally published on Jan. 15 and was updated with the latest information on Jan. 21.
It has been almost one month since the United States, the United Kingdom, Israel, and other countries started vaccinating their populations against the novel coronavirus.
Meanwhile, Ukraine is at a standstill, expecting to receive the first batch of vaccines in February at the earliest.
Ukrainian authorities plan to first vaccinate high-risk groups who comprise half of its population or 21 million people. To meet this goal, the country needs 42 million doses — two shots for every person.
Right now, it’s not clear how it will be done. Two main obstacles are money and the slow pace of negotiations.
Ukraine’s government has negotiated the supply of only 9.9 million doses for the time being, enough to vaccinate 5 million people. The country has allocated funds to buy roughly 5.2 million more doses in 2021. The World Bank is expected to give Ukraine money for about 5 million doses more.
This will leave Ukraine with 10 million vaccinated citizens out of 21 million in the high-risk group. The 21 million group includes both those with underlying conditions and essential workers, like doctors and police officers.
Nor has the government been successful in clearly communicating what they are doing to get Ukrainians vaccinated. The Ministry of Health turned down the Kyiv Post’s request for comment, saying negotiations on vaccine supply are strictly confidential and no additional details can be disclosed.
The Kyiv Post answers the most vital questions about nationwide vaccination, putting together all available open-source information.
Where is Ukraine getting the vaccine from?
At least 1.9 million doses will come from China. On Dec. 30, 2020, the Ministry of Health announced that it signed a $34.5 million contract with Chinese biopharmaceutical company Sinovac Biotech for the supply of vaccines.
Ukraine will also get 8 million doses for free from the global coronavirus vaccine alliance, COVAX. First, the ministry said Ukraine would receive 8 million doses but later fixed their mistake.
It’s not clear what type of vaccine Kyiv will get — that is up to COVAX to decide. It may be AstraZeneca (U.K.), Sinovac Biotech (China), or Pfizer-BioNTech (U.S.).
However, a portion of it — 210,000 out of the promised 8 million doses — will be Pfizer-produced vaccine, according to several lawmakers who cited the words of Health Minister Maksym Stepanov at a closed-door meeting on Jan. 16.
What is the difference between the vaccines?
Simply put, the Pfizer/BioNTech and Moderna vaccines are the best because they have shown best results in clinical trials.
Pfizer’s effectiveness is 95% and Moderna’s is 94.1%. Both are authorized by the U.S. Food and Drug Administration. However, only Pfizer’s was validated by the World Health Organization.
Both are impressively effective at preventing symptomatic cases of COVID-19, the most severe infections and deaths.
Pfizer/BioNTech and Moderna use RNA or mRNA technology, a cutting edge approach to making vaccines.
A woman wearing a medical mask is featured walking in the crowd in central Kyiv on Jan. 4, 2020. (Kostyantyn Chernichkin)
RNA vaccines mimic infection using a genetic sequence of the virus. When introduced into the body, it instructs cells to make protein to counteract it, preparing the immune system to fight off the real virus.
There are other good vaccines but they proved to be less effective than the RNA versions.
The British AstraZeneca’s vaccine is a more traditional vector vaccine. It uses a weakened version of a common cold virus that prompts the immune system to make antibodies and attack coronavirus infection.
While it’s approved in the U.K., the FDA is still waiting for data from American trials. Confusing data from the trials indicated that AstraZeneca’s vaccine could be 70% effective on average.
Russia made its own vaccine, Sputnik, which is 91.4% effective, according to the vaccine producers, the Gamaleya Research Institute. However, the Sputnik vaccine drew warnings from scientists as it was launched before the large-scale clinical trials took place.
Available vaccines also include the Chinese version made by Sinovac Biotech, which Ukraine has ordered.
Is the Chinese vaccine that Ukraine’s buying any good?
It’s fine but less effective than the leading vaccines.
Sinovac Biotech’s vaccine is deactivated. It works by exposing the immune system to dead viral particles without risking a serious infection.
Its efficacy is questionable, ranging from 91.25% to 65.3% in trials in Turkey and Indonesia, respectively. In Brazil, researchers estimated its effectiveness at 78% in “mild to severe” cases.
However, the latest figures are less promising.
On Jan. 11, Brazilian researchers said that the effectiveness of Sinovac Biotech’s vaccine is just 50.4%. The new figure included infections that were mild or asymptomatic.
When this news broke, Stepanov tried to defend the country’s choice of the Chinese vaccine. He said that these figures are not final and Ukraine is waiting to see the final report on clinical trials from all participating countries.
“Even a vaccine with over 50% effectiveness is sufficient to confirm that it works and to get approval from most medical regulators in the world,” Stepanov said at a daily press briefing on Jan. 13.
The contract Ukraine signed with Sinovac Biotech stipulates that the vaccine must be at least 70% effective, he said.
“In case the company does not meet these standards and the effectiveness we agreed on, not less than 70% is not provided, the company will reimburse the money the state paid in full,” he added.
When will Ukraine start vaccination?
Ukraine will likely start vaccinating its population in February.
The first batch of Sinovac Biotech’s vaccine, 700,000 doses, is expected to arrive in February, according to the Ministry of Health.
But to be used, it has to be locally authorized.
Lekhim, a Ukrainian pharmaceutical company supplying the Sinovac vaccine to Ukraine, said that it plans to file the paperwork to get the vaccine registered in the country in early February.
In December, the Ukrainian parliament passed a law that shortens vaccine authorization to five days.
Ukraine expects to get the first portion of the vaccine coming from COVAX, 210,000 doses, in early February, according to Stepanov.
Who will get vaccinated first?
Doctors who treat COVID-19 patients will get the first shots. At the same time, the vaccine will go to soldiers in the Donbas, social workers and employees and residents of homes for the elderly.
“350,000 people are in the first priority group that will be vaccinated,” Stepanov said in an interview with the 24 TV channel on Jan. 12.
From left: Health Minister Maksym Stepanov, Finance Minister Serhiy Marchenko and Economy Minister Ihor Petrashko talk during a parliamentary session in Verkhovna Rada in Kyiv on Oct. 20, 2020. (Kostyantyn Chernichkin)
The second group in line includes Ukrainians who turned 60 and have medical conditions, employees of educational facilities and the staff of the State Emergency Service of Ukraine: the National Police, Armed Forces and other institutions that ensure the state security.
The second phase of vaccination is expected to start in late March and will cover 2.5 million people, Stepanov said at a closed-door meeting with lawmakers.
In the third stage are people between the ages of 18 and 59, who have medical conditions and professionals most exposed to coronavirus.
On Dec. 22, the Ministry of Health approved the plan for the nation’s immunization. According to it, 21 million Ukrainians in the risk group will get their shots by March 2022.
To get there, Ukraine is continuing negotiations with other vaccine producers. They started in May 2020, according to Stepanov.
On Dec. 30, the ministry announced that its negotiations with British-Swedish company AstraZeneca are in full swing.
Can the Ukrainian government afford to vaccinate everyone in Ukraine?
No. The government currently doesn’t have the money to vaccinate the 21 million in the risk group.
In December 2020, the government allocated Hr 1.3 billion ($46 million) for vaccine purchase. The ministry spent $34.5 million on Sinovac’s vaccine.
Additionally, Hr 2.6 billion ($91 million) was allocated to COVID-19 vaccination in the Health Ministry’s 2021 budget. This is enough to buy 5.2 million vaccines if the price of one dose remains $18, the price of a single dose from Sinovac.
However, on Jan. 21, the ministry announced that the Central Bank would give Ukraine Hr 2.5 billion ($89 million) to buy vaccines.
That way, Ukraine will be able to vaccinate 10 million out of the target 21 million people.
The Health Ministry said it needs Hr 15.1 billion ($539 million) to vaccinate everyone in the risk groups. For comparison, that is more than the Health Ministry spent on all the medications and medical equipment procurement in 2020, which was around $460 million.
The ministry said it is looking for additional funds for vaccination.
$18 a dose — isn’t that expensive?
That is disputable but many believe this is quite pricey.
According to Nashi Groshi’s procurement watchdog, Ukraine paid $18 per dose to Sinovac Biotech for a vaccine that’s supposedly 50.4% effective while Moldova paid the same amount to Pfizer for a vaccine that’s 95% effective.
Will the vaccine be available commercially in Ukraine?
Yes.
Apart from the limited amount of free vaccines provided by the state, Ukrainians will have the option to buy vaccines for themselves independently.
Lekhim, a Ukrainian pharmaceutical company responsible for supplying 1.9 million doses of Chinese vaccine, signed another distribution contract with Sinovac.
On Jan 11, the company announced it would import 5 million doses of Sinovac Biotech’s vaccine for commercial use in April-May.
Lekhim is the exclusive supplier of the Chinese vaccine in Ukraine. It plans to launch mass production of this vaccine in Ukraine’s eastern city of Kharkiv in 2022.
It’s not clear how much the vaccine will cost for consumers who want to buy it in Ukraine.
It will become available by summer, according to Stepanov.
Will Ukrainians get ‘vaccine passports’?
This is unclear.
Introducing so-called vaccine passports to resume international travel is under wide global discussion. However, it is controversial amid concerns that it could discriminate against people who must not be vaccinated, such as pregnant women.
Such a passport would be a digital proof of vaccination or the absence of one. A trial of the application is about to start in Great Britain in January, according to the Daily Mail. The U.K. Department of Health, however, said there were “no plans” to introduce vaccine passports given that the government’s own science and research funding agency, Innovate UK, has already pumped £75,000 into the project.
The governments of Estonia, Hungary, Iceland, Spain, Denmark and Belgium have all hinted that they would support vaccination certifications.
Ukraine may be on board with certifications but not vaccine passports, according to Viktor Liashko, Ukraine’s Chief Sanitary Doctor.
According to him, Ukraine is considering launching an electronic database where all the vaccinations will be recorded.
“When mandatory vaccination passports are introduced at the international level, Ukrainian doctors will be able to promptly issue a certificate of vaccination,” Lyashko said on Jan. 20 during an interview with Ukraine24 TV channel.
The government will decide whether to introduce vaccination passports when it becomes clear whether the vaccinated person is fully prevented from spreading coronavirus disease after getting a shot, Lyashko said at a briefing on Jan. 12.
“According to the rules issuing such a document is allowed only if the vaccine is WHO-approved. As of now, only Pfizer has such authorization,” he added.
When will herd immunity emerge in Ukraine?
Not soon, according to Semen Yesylevskyy, biophysicist and leading researcher at the Institute of Physics of the National Academy of Sciences of Ukraine.
Yesylevskyy told the Kyiv Post that Ukraine faces two problems: the Health Ministry’s inability to properly organize vaccination and the public’s reluctance to get vaccinated.
Forty percent of Ukrainians do not want to get inoculated even if it is free, according to a survey by the Rating group in late November.
If the vaccine is just 50% effective like Sinovac’s, the people would be even less keen to get vaccinated, Yesylevskyy believes.
“If the authorities manage to vaccinate 99% of the population with, say, 50% effective vaccine it would be enough to forget about coronavirus,” the scientist said.
“But this will never happen. In Ukraine, we will be lucky if at least one-third of the population gets vaccinated. But if this vaccine is 50% effective it is unclear whether this will be enough for herd immunity to appear,” he continued.
So, what happens if Ukraine does not quickly vaccinate enough people?
In that case, at least 100,000 Ukrainians will die of coronavirus, Yesylevskyy believes.
“If 70-80% of the population contracts coronavirus, we will likely have an additional death toll of 100,000,” he said.
“If we look at it optimistically and suppose that the vaccination starts in March, we still have 1.5 months before it. And the vaccination is not immediate. It will last for a few months at least. Hence we will have four or five more months of the circulation of the virus,” he continued.
“And if the number of people contracting it remains the same as it is now, half of the population will get infected by summer.”
This means that many people will get a natural immunity and won’t require an urgent vaccination, but many other people will die.
