Political immunity: Moldova’s vaccine debate amidst severe jab scarcity
This is a translated and slightly adapted version of an article originally published in Romanian on March 2.
As Moldova records all-time highs in daily coronavirus cases and deaths, public trust in Covid vaccines continues to be low among Moldovans even as vaccine availability remains extremely limited. Meanwhile, politicians can’t help but exploit the vaccine issue for their own agendas, infusing some geopolitics into the mix.
Igor Dodon and the Russian vaccine
In August 2020, while still president, Igor Dodon was echoing Vladimir Putin’s triumphant claim that Russia had registered the world’s first Covid-19 vaccine. The pro-Russian Socialist leader also promised that Sputnik V would be available in Moldova already in the fall of 2020.
That didn’t happen of course. As sic! noted back then, despite the fanfaronade, Sputnik V had just cleared the second phase of its clinical trial. The third and final phase started already after Putin and Dodon claimed the vaccine was ready for use.
Later, as he lost re-election, Igor Dodon advised Moldovans against getting anything else but the Russian jab. Never mind it’s not even available in Moldova. The ex-president warned that the vaccines from the likes of Pfizer, Moderna or AstraZeneca were mere “Western analogues, developed in a hurry,” with the implication that they were not to be trusted.
Sputnik V is one of the first Covid vaccines out there, but certainly not the first. Moderna, for instance, was among the first to start testing its preparation on human volunteers. Pfizer/BioNTech kicked off their 2/3 phase trial on as many as 30,000 people when the Sputnik V human trials were just in the hundreds. AstraZeneca/Oxford were the first to publish the results of their phase 3 trial. All in all, Sputnik V has proved to be an effective and safe vaccine, but not the first by far.
The “Sputnik moment” proclaimed by Vladimir Putin in the vaccine race was clearly a publicity stunt which Igor Dodon readily embraced. Too bad this has to happen at the expense of trust in other vaccines. The lie promoted by Igor Dodon, a politician who earned 42% of the popular vote in the November election, could cost lives.
The vaccine technology
Meanwhile, the pro-Russian media in Moldova, too, is pushing the Russian vaccine to the detriment of its Western counterparts. The Moldovan edition of Komsomolskaya Pravda, for example, published a short interview with an infectious disease specialist who claimed “the new vaccines developed in America – Pfizer and Moderna – are based on a novel method that uses nanotechnology. Many fear these jabs that are introduced into the human body could upset the immune system. Such concerns do exist. The Russian doctors, on the other hand, say their vaccine has been developed using older, time-honored technologies.” 
The KP article goes further and implies that it’s the Western jabs which are to blame for the high levels of vaccine skepticism among Moldovans. There’s nothing in the existing opinion polls to suggest this is the case. But for KP, one opinion is enough, enough to run a headline that says: “This vaccine will kill me. Moldovans are reluctant to get vaccinated as they fear this will give them Covid”.
Now as Moldova starts slowly rolling out an inoculation effort with AstraZeneca jabs, the only kind available so far, KP strikes again with a headline that reads: *“I understand that the long-term side effects from this vaccine are currently unknown. This is what Moldovans will have to consent to before getting the AstraZeneca injection”. The consent form, of course, doesn’t mention any brands or developers. In all likelihood, those opting for Sputnik V will be given the same thing to sign when and if it becomes available in Moldova. But KP chooses to stoke fear with a manipulative title that creates an association between AstraZeneca and the risk of unknown side effects. 
President Maia Sandu criticized the retired Chicu Cabinet for failing to budget money for vaccine procurement. Viorica Dumbrăveanu, the former health minister, retorted that there was actually a total of 15 million lei (some $0.8M) in the rainy day fund put aside for Covid vaccines. Which is true – technically speaking, Maia Sandu is wrong when she says the former government didn’t allocate any money for the immunization campaign.
Trouble is, the amount is terribly inadequate given the situation; it’s even smaller than the budget for annual flu vaccination. The digital outlet Newsmaker calculated the amount to suffice for immunizing 61,000 people with a two-shot vaccine at an estimated price of $7 a dose. In the more optimistic scenario where an AstraZeneca dose reportedly costs $3-3.5, the allocated amount would be enough for vaccinating 122,000 Moldovans.
Covax, the global platform, is expected to provide only 20% of the population with free – yet very slow to arrive – vaccines. Which leaves the rest uncovered. It seems the Chicu Government’s principal strategy was to rely on donations, but bearing in mind the numerous conflicts of the former prime minister with our neighbor Romania, it’s fair to assume his bet was rather on Russia.
To conclude, Viorica Dumbrăveanu and her team left behind a ridiculously small budget for Covid vaccines, but it’s also not true the former government didn’t allocate any money at all, as president Sandu claimed.
What vaccines can Moldova receive?
Moldovan politicians have also quarrelled over the type of shots that can be stored and distributed through our health care system. Viorica Dumbrăveanu insisted that Pfizer “is an impossible dream” and that Moldova doesn’t have the conditions and infrastructure needed for it. While still minister, Viorica Dumbrăveanu confirmed this in a letter to Covax, where she pointed out that Moldova had zero space and equipment to be able to store a preparation at -70 degrees. 
The Ministry of Health reiterated this in a press release issued on 31 December 2020: “Vector-based, protein-based or inactivated vaccines are more suitable for our country as compared to mRNA ones, which require specific resources for ensuring the cold chain.” 
Dr. Ala Nemerenco, herself a former health minister and currently presidential adviser, criticized then minister Dumbrăveanu for not doing anything to prepare Moldova for importing Pfizer vaccines, the first to be authorized in Europe.
On January 11, however, the government suddenly discovered that “all the medical institutions have conditions to store vaccines at temperatures of +2...+8°C; Public Health Centers have refrigerators capable of maintaining a temperature of -20°C; and the National Public Health Agency is equipped with a refrigerator capable of storing up to 100,000 doses of vaccine at a temperature of -70°C.”* The Ministry also announced on that occasion that it asked the Global Fund COVID-19 Response Mechanism if it could provide additional medical-grade freezers.
A week later, surprise – the Ministry tells of capacities to keep 140,000 doses at -70°C, with a possibility to extend the total number to 540,000 doses starting in 2021.
Confidence in vaccines doesn’t depend only on how they work, but also on the capacity of the government to receive, store and administer them. For a month or so, politicians have fought over whether Moldova has or has not the required storage capacities, and the Ministry of Health has had a different position every week. Meanwhile, the issue is no longer relevant as it turns out the Pfizer vaccine doesn’t require ultra cold temperatures after all.
Vaccine availability is very limited in Moldova and it’s to be expected that politicians will claim every dose that reaches us as a great victory. Maia Sandu is more likely to praise the donations made by Romania, while Igor Dodon will tend to showcase the Russian donations – when and if they arrive in Moldova. But when people are already reluctant to get the jabs, before vaccines are even available, such partisan and geopolitical labels slapped on every dose achieve nothing but further erode the confidence of Moldovans in Covid vaccines.
Politicians can’t even agree on whether there are funds or conditions for the vaccination campaign – every aspect, down to the manufacturing technology, is subjected to fierce debate with political overtones. The affiliated media, especially the one lenient to Russia, works actively to undermine trust in rival vaccines.
At the same time, the situation is rather absurd: with a laughable budget for vaccine procurement, Moldova is practically at the mercy of its neighbors and international organizations – we are not in a position to be choosy. And yet our politicians are adamant to make an electoral weapon out of vaccines, even at the risk of prolonging the pandemic and losing lives.
We can only hope that Maia Sandu and Igor Dodon will leverage their external contacts for a good cause and give Moldovans plenty of vaccines to choose from, even if the choice has to be political for some people.
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Guvernul lui Dodon nu s-ar fi preocupat intenționat de pregătirea R. Moldova de vaccinarea anti-COVID: „Sistemul dispune de un singur frigider - 80*C, cu capacitate de stocare pentru 14 000 de doze de vaccin”, ziarulnational.md ↩︎