The National Command and Operation Centre (NCOC) announced on Saturday that a special plane has left for China to collect a shipment of COVID-19 vaccines, in time for the launch of Pakistan’s first vaccination drive this coming week. Asad Umar, head of the NCOC and Federal Minister for Planning, Development, Reforms, and Special Initiatives had announced this week that “the system for vaccination is in place. Hundreds of vaccination centres in the country will be administering COVID vaccine.”

Soon after, it was announced that Pakistan has secured 17 million doses of AstraZeneca-Oxford vaccines through COVAX.

Pakistan plans to vaccinate at least 70% of its 220 million people free of cost.

Sindh will be the first province to start the coronavirus vaccination campaign on Wednesday, February 3, as announced by Provincial Minister Nasir Hussain Shah.

The special shipment due to arrive in Pakistan on Sunday will be delivering part of the 500,000 vaccine doses that China has promised to “gift” Pakistan. These vaccines have been developed by Chinese vaccine manufactuer Sinopharm, and will be administered to healthcare workers in Pakistan on a priority basis.

However, these are not the only vaccines to have been approved for usage by the Drug Regulatory Authority of Pakistan (DRAP). Here is a breakdown of the vaccines likely to be administered soon in Pakistan, and what is their current approval status.

China’s Sinopharm vaccine

Status: Approved by DRAP

The vaccine was developed by the Beijing Institute of Biological Products, a subsidiary of state-owned conglomerate Sinopharm. According to preliminary data from last-stage trials shared by the company in December, the vaccine is 79.3% effective.

This is a double-dose vaccine, and can be stored at 2C to 8C temperatures.

The first shipment carrying this vaccine will arrive in Pakistan on January 31. The vaccine will start being administered in Sindh from February 3.

UK’s AstraZeneca-Oxford vaccine

Status: Approved by DRAP

Developed by Oxford University and the Anglo-Swedish drug company AstraZeneca, this vaccine is to be sold to developing countries around the world at reasonable costs. DRAP approved its usage in Pakistan, and it was confirmed on January 30 that Pakistan has secured 17 million doses of the vaccine through the World Health Organisation (WHO)’s COVAX facility.

Up to 6.8 million doses of this vaccine are expected to arrive in Pakistan in the first quarter of the year, with the rest becoming available in the next quarter. The start of this distribution is expected in February 2021.

This is a double-dose vaccine and has an efficacy rate of 70%.

Russia’s Sputnik-V vaccine

Status: Approved by DRAP

Russia’s state-owned Sputnik-V company filed an application with DRAP in January, seeking permission for emergency use of its vaccine in Pakistan.

“It is a double-dose vaccine and will be administered by syringes,” an official from the Ministry of National Health Services (NHS) confirmed. It has not yet been announced when the vaccine will be administrated in Pakistan.

The vaccine has also been approved for usage in Hungary, Algeria, Bolivia, Serbia, and the United Arab Emirates (UAE), among other countries. Its efficacy rate is 92%.

China’s CanSinoBIO vaccine

Status: Undergoing Phase III trial

The Chinese vaccine made by pharmaceutical company CanSino Biologics is currently undergoing Phase III trials and has applied to the DRAP for emergency approval. The company has offered 20 million vaccine dosages to Pakistan.

The company has employed more than 18,000 volunteers for its trial in Pakistan, while it is also undergoing trials in Mexico, Russia, China, Argentia, and Chile.

This is a single-dose vaccine and its efficacy rate is yet unknown.

WHO’s COVAX/Pfizer-BioNTech vaccine

Status: Pending review at WHO

COVAX is the World Health Organization’s (WHO) global initiative to “ensure rapid and equitable access to COVID-19 vaccines for all countries, regardless of income level.” It will be distributing the Astra-Zeneca vaccine as well as vaccines produced by Germany’s BioNTech and US pharmaceutical company Pfizer to Pakistan.

The Pfizer-BioNTech vaccine has been approved for use in the United States (US), the United Kingdom (UK), the European Union (EU), and several other countries, as well as by the WHO. However, its distribution is still under review by WHO and it is unclear whether the vaccine will be provided to Pakistan. Its requirement to be stored in special refrigeraters at below -70C temperatures make its administration appear unlikely in Pakistan.

This vaccine has a 95% efficacy rate and is administered in double doses.

China’s Annui Zhefei Longcom vaccine

Status: Applied to DRAP for Phase III trial

Chinese firm Anhui Zheifi Longcom Biopharmaceuticals Company Limited has applied for Phase III clinical trial of its vaccine in Pakistan. The vaccine has been jointly developed by the company and the Institute of Microbiology under the Chinese Academy of Sciences.

Its approval status is yet unknown.

How will vaccines be administered?

The NCOC has developed an online portal, the National Immunisation Management System (NIMS), to track the COVID-19 vaccination process in Pakistan. Alongside NIMS, multiple Adult Vaccine Centres (AVC) have been set up across the country, which will be run by the National Vaccination and Administration Control Cell (NVACC). Coordination cells have also been established at provincial and district levels, the NCOC has said.

An 8-step innoculation process will be in place for Pakistani citizens. These steps are as follows:

(1) Citizens would have to text their CNIC number on 1166 or register at the NIMS website.

(2) Citizens would be informed of their designated Adult Vaccine Centre.

(3) Individuals may change their vaccine centre by texting 1166, or through the NIMS website.

(4) Upon the availability of the vaccine at the centre, citizens would be informed of their appointment via SMS along with an individual PIN code.

(5) On the appointed date, citizens must visit the centre with their CNIC and the individual PIN code.

(6) The staff at the centre will verify CNIC and the PIN code.

(7) After this, the vaccine will be administered and each citizen will be kept under observation, for monitoring vital signs and health, for 30 minutes.

(8) The government database will be updated in real-time to keep a record of citizens who have been vaccinated.

There is still considerable uncertainty regarding Pakistan’s vaccine rollout, with the inability to secure enough doses of the vaccine for its entire population being the biggest hurdle. However, with a number of manufacturers applying to DRAP for approval, and the latest developments in vaccine acquirement through COVAX, these facts may change soon.