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6 shots per patient, Rs 30,000 applicator gun complicate govt talks for ZyCov-D vaccine

World's first DNA vaccine, ZyCov-D is a 3-dose vaccine (administered in 2 injections each time) which requires a special needle-free applicator.

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New Delhi: Two unresolved issues have cropped up during the ongoing price talks between the Government of India and pharmaceutical company Zydus Cadila for its Covid vaccine ZyCov-D.

First, unlike the vaccines currently in use, ZyCov-D needs three doses to be administered for full efficacy, and second, a special applicator has to be used for the vaccine that costs Rs 30,000.

ZyCov-D — the world’s first DNA vaccine — is a three-dose vaccine that will be given on day zero, day 28 and day 56. Each dose consists of two shots that are supposed to be administered on each arm, and thus, a person has to be injected with a total of six shots of this vaccine to be fully vaccinated.

This means that even if the vaccine is available for the same price as the ones currently in use, the total cost of the vaccination will be about 33 per cent higher.

The vaccine also uses a needle-free applicator or a jet injector, which pressurises liquid medication into a narrow stream that is capable of penetrating skin.

The injector has two parts — an applicator that costs Rs 90 and has to be replaced after every person, and a gun that costs Rs 30,000. The gun has to be replaced after 20,000 shots, which means that it can be used on 10,000 people since each vaccine dose consists of two shots.

According to government sources, both the central government and Zydus have to reach a middle point in the ongoing price talks.

“We are awaiting the NTAGI (National Technical Advisory Group on Immunisation) recommendation on its (ZyCov-D) use but there are two obvious issues. One is that it is a three-dose vaccine. That does not mean we will not use it but we just have to reach a middle point (in price talks with Zydus). The second is that the applicator will also be provided by Zydus. One applicator (gun) can vaccinate 10,000 people but that price will also be factored into the final figure,” a top government source told ThePrint.

The vaccine’s jet injectors are manufactured by a company called Pharmajet, but the government is not looking at procuring the devices from the manufacturer at present, clarified the source.

“For now at least the applicators will be supplied by Zydus,” he said. As reported by ThePrint, India has already started training vaccinators in using the device.

“The gun is imported and the applicator is manufactured in the country. Eventually the gun too will be manufactured indigenously and that will change the situation considerably,” a senior health ministry official told ThePrint.

According to the US Centers for Disease Control (CDC), there are many advantages of using jet injectors instead of a needle for inoculation since they “prevent needle-stick injuries to health-care providers and can overcome improper, unsterile reuse”.

ThePrint reached Zydus via phone calls and email for a response but did not receive a response till the time of publishing this report.

Also read: Covid led to biggest decrease in life expectancy since World War II, Oxford study finds

‘Price of Zycov D a clear issue’

According to another official, the issues that emerged during the talks “are not sticking points but they do make the negotiations a little complicated”.

In the Covid briefing last week, Niti Aayog member (health) Dr V.K. Paul had also admitted that the price of the vaccine is a clear issue.

“Zydus Cadila DNA vaccine for practical implementation in vaccination programme, all preparations on. We are constantly talking to them and the price is clearly an issue. We will make a decision soon and with all preparations it should become a part of the national vaccination programme. We are looking forward to receiving the recommendations of NTAGI on the benefits and the target group. Work is in progress,” Paul had said.

Also read: Novavax vaccine shows 89.7% efficacy against Covid, UK clinical trial results show

Prices of other vaccines not a benchmark

According to senior officials, the government would like to keep the price band of vaccines at the current level but admitted that it was unrealistic to expect all vaccines to cost the same.

Different vaccines are based on different technologies, and the conditions in which they are manufactured are also different and in the case of ZyCov-D, even the mode of administration is different, the officials added.

“All of these in a sense are proprietary items, so the principle of going with the lowest bidder cannot be applied — all are single bidder. We are already procuring vaccines at two different prices so there is no harm in the third also coming at a different price. You have to also keep in mind that there is no other DNA vaccine in the world,” said a senior official in the health ministry.

The Government of India currently procures Serum Institute of India’s Covishield at Rs 205 per dose and Bharat Biotech’s Covaxin at Rs 215 per dose. The vaccines are administered using special syringes that are 0.5 ml in size and usually cost around Rs 2.

Top sources in the ministry also said that the first 1 crore doses of ZyCov-D are likely to be available next month.

Meanwhile, sources in NTAGI noted that the Covid working group is in favour of starting vaccinations in children with comorbidities. ZyCov-D can be administered to children as young as 12 years old but the government maintains that no decision on the matter has been taken yet.

Also read: Pregnant women vaccinated with mRNA shots pass protection to babies, study finds


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