Pakistan approves Chinese donated Sinopharm CNBG’s COVID19 Vaccine for front line workers

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Pakistan approves Chinese donated
Sinopharm CNBG’s COVID19
Vaccine for front line workers
Prof. Mulazim Hussain Bukhari, Syeda Ailia Zahar Bukhari,
Department of Pathology, Azra Naheed Medical College,
Superior University Lahore.

The Corona epidemic shook the world last year so far it has infected and killed millions of people all over the world which includes a large number of healthcare professionals as well who were looking after these patients. With the availability of vaccine and its approval by various regulatory bodies, vaccination of healthcare workers and those at high risk of infection are being administered this vaccine. The vaccination of healthcare workers has also started in Pakistan with the donation of vaccine by Peoples Republic of China, a great all time friend of Pakistan. The first consignment of vaccine reached Pakistan in February and more consignments are expected to follow in the days to come. There are four vaccines approved in Pakistan for emergency use, AstraZenica, CanSino, Spunik V and Sinopharm CNBG’s Covid-19 vaccine. Pakistan has also allocated $250 million for purchase of the vaccine besides having arrangements with COVAX through WHO for supply of vaccine.


Prof. Mulazim Hussain Bukhari

Sinopharm has taken the mature inactivated vaccine R&D route, which is technically safe. In terms of accessibility, inactivated vaccines have their own advantages and are convenient for storage and transportation. The vaccines of Pfizer and Moderna are both innovative mRNA vaccines which have not been used in large-scale population. With the human body as a vaccine factory, mRNA vaccines can also stimulate the body to produce antibodies by translating antigens and cause immunity.

The Sinoform Covid vaccine from China is made from the remains of the virus after it has been killed in the laboratory. When it will enters the body, it will develop immunity by teaching the immune system to make antibodies against the original SARS-CoV-2 virus, by attaching its surface proteins (Spike) present on its surface.

Development of the Sinopharm
CNBG’s COVID19 Vaccine

The vaccine made by the Sinopharm Beijing Institute of Biological, is called BBIBP-CorV was developed from original SARS-CoV-2 from one of the Chines, hospital, it had the capacity to proliferate rapidly in monkey kidney cells filled in bioreactor tanks. It was passed through following steps. One of the original SARS-CoV-2 was cultured by placing it in the kidney cells of Vero monkeys, called Vero cells. Each Vero cell acted like a micro-factory to produce the SARS-CoV-2 to get a pure stock. After cultivation, these viruses are isolated by purification in the labs to remove the Vero cells remnants. In the third step it was treated with Beta Propiolactone (BPL).

Their Supernatant was separated and each of them was treated with Beta Propiolactone (BPL). The RNAs of the SARS-CoV-2 were inactivated by this chemicals BPL, and leaving only the spikes studding on the surface without making a full virus. The immunogenicity was retained to identify the human immune system to identify. The BPL disabled the SARS-CoV-2 by bonding to their genes. The BPL made it like a decoy duck, so when they will be injected in human, they will be captured by human innate cells and then will be targeted by humoral cells to develop the immunity. The inactivated coronaviruses could no longer replicate. But their proteins, including spike, remained intact. The remnants of the SARS-CoV-2, were filtered through 0.22 micron mesh to get purified killed stock. Finally, a complete vaccine was made by adding adjuvant alum which will enhance and boost the immune system to make the antibodies against S Proteins. Inactivated viruses vaccines technique is not a new modality but have been used for a long time in polio vaccine, rabies and Hepatitis-A vaccine

Administration of
vaccine and its dose

The vaccine is given by injection into a deltoid muscle. In two doses. Because the vaccine is given by inactivating the virus, its response in the human body is relatively weak, so two injections are needed in 20-28 days. When injected, some of the inactivated viruses will be taken up by innate immune system cells called an antigen-presenting cells (APCs).

The APCs will destroy this inactivated SARS-CoV-2 into pieces to display its fragments on their surfaces, to present them to naive helper T cells. Through IL12, will recruit other immune cells (CD8+) cytotoxic cell and through IL-4 will recruit other immune cells (B-Cells) antibody producing cells. Some of the broken corona fragments may be taken by B cells directly to activate plasma cells to respond to the vaccine. Figure-1.


The vaccine can be administered to people 18 years and above but pregnant women and those breast feeding have to be careful. Hopefully this vaccine will provide protection for two years. It’s possible that the level of antibodies produced by BBIBP-CorV, may drop over the course of months. But the immune system also contains special cells called memory B and T cells which might retain information about the coronavirus for years or even decades. The main advantage of this BBIBP-CorV is that it can be kept in a standard refrigerator at 2-8 degrees Celsius. In the coming days numerous vaccines by various manufacturers will become available at varying prices.

According to the Sinopharm the vaccine’s effectiveness in preventing infection is 79.34 percent, or about 80 percent. That means four out of every five people will be able to avoid corona infection with its help, while 99 to 100 percent of people will be saved from a dangerous corona attack. Research on 31,000 people in the UAE in July 2020 has an impact rate of 86%.

Fifty countries, all over the world including Pakistan, have approved this vaccine. The Government of Pakistan has started the work of administering free vaccine in phases and in the first phase the first dose has been given to the frontlines workers in government hospitals. (Figure-2)


Safety profile: Every vaccine is safe because it goes through several stages before any is given to humans. Once approved from Phase I to Phase III, it is allowed for emergency use to save the humans from current pandemic. It had conducted the cross-neutralization tests with the many coronavirus strains from different sources around the world. According to the data, obtained at that time, this vaccine is broad-spectrum protection and has good cross-neutralization effect on strains from different regions of the world. The phase in the UAE, 50,000 volunteers in 125 countries from different parts of the world, should good protection. The new mutant strains in Britain and other places, and still are stepping up trials to obtain the protective results of the vaccine for them.

Contraindicated: People over the age of 60 should be careful while getting this vaccine, because still there is no data of any trial. It is also not advised for pregnant women, breastfeeding women. The women who get vaccinated should avoid getting pregnant for two months. People who have had coronary heart disease and have had taken monoclonal immunoglobulin or Convalescent plasma, have respiratory and heart disease. Those who have previously been allergic to a drug or substance and have had anaphylaxis must be careful in taking this vaccine.

Side Effects: The side effects of this vaccine are much less than the actual diseases, if we see the cost management of the vaccine, it is life is better than mild fever of mild body aches. Antibodies that target the spike protein can prevent the virus from entering cells. Other kinds of antibodies may block the virus by other means. In Pakistan, no death or serious or permanent disability has been reported from the vaccine so far. These side effects are temporary.

  1. Side effects of the injection site include temporary redness, swelling, itching, pain, and irritation.
  2. Physical effects include headaches, fever, malaise, arthralgia, tiredness, cough, vomiting, diarrhea and itching.
  3. Very few and occasional side effects like dizziness, loss of appetite, cough, Cold and constipation.
  4. Some unknown side effects include allergies, body aches, sore throat or stomach or eye pain, loss or excess of taste, palpitation, low or high blood pressure, neck or throat or abdominal pain. Sinopharm CNBG’s Covid-19 vaccine has been vaccinated more than 10 million doses, in about 50 countries, but has not received the serious adverse reaction report till now.

REFERENCES

  1. How the Sinopharm Vaccine Works. Antibodies that target the spike protein can prevent the virus from entering cells. Other kinds of antibodies may block the virus by other means.
  2. Reuters Staff (2020-11-19). “China Sinopharm’s coronavirus vaccine taken by about a million people in emergency use”. Reuters. Retrieved 2020-12-09.
  3. Pakistan’s allocation for vaccine purchase raised to $250m https://www.dawn.com/news/1595458. Dated 12.2.2021
  4. Sinopharm’s COVID-19 vaccine scores approval in China. Vaccine found to be 79% effective in top-line result. http://www.pmlive.com/pharma_news/sinopharms_covid-19_vaccine_scores_approval_in_china_1360725. Dated 12.2.2021
  5. Arab nations first to approve Chinese COVID vaccine — despite lack of public data. https://www.nature.com/articles/d41586-020-03563-z