Minimum 30 percent The Russian authorities have set a coronavirus vaccination target, but will they have enough doses?

Russia began a large-scale vaccination campaign on Monday, December 7. In Moscow and the Moscow region, the roll out happened two days earlier, on December 5. So far, the results look modest: Moscow Mayor Sergey Sobyanin reported that 6,000 people had been immunized in the capital as of December 10, whereas the regions are, at best, reporting that they have received doses of the “Sputnik V” vaccine. At the same time, the authorities are calling on the regions to vaccinate at least 30 percent of the population by the end of the first half of 2021, government sources tell Meduza. And it has been made clear that 60 percent vaccination would be “optimal.” That said, whether or not Russian manufacturers are up to the task of producing the millions of required doses of Sputnik V remains to be seen.

How many people are going to be vaccinated?

Six days after the vaccination campaign began in Moscow, only 6,000 people had been immunized against COVID-19, while an additional 20,000 had signed up for the shot via an online service, reported Moscow Mayor Sergey Sobyanin during a broadcast on the state television channel Rossiya 24. 

Immunizations began in Moscow on Saturday, December 5, whereas the Sputnik V vaccine only began arriving in the regions last week — some regions only got their doses closer to the weekend. For example, more than 2,000 doses were delivered to St. Petersburg over the course of last week and the city is set to receive several thousand more before the end of the year. Novosibirsk, Yekaterinburg, and Tatarstan received a thousand doses each. While Kaliningrad received around 900 doses, the first batch sent to Veliky Novgorod contained just 200, sources from the governments in these regions told Meduza. 

Going forward, the vaccine is set to be delivered once or twice a week in increasing volumes, one of Meduza’s sources explained. The company Immunotechnology — a subsidiary of Sberbank — is responsible for supplying the vaccines to Russia’s regions.

A source in a regional government told Meduza that the federal center is distributing the vaccine according to certain quotas. But how the exact number of doses sent to each region is determined remains unclear. “The principle of distribution isn’t clear — probably, it’s in proportion to the population, or perhaps based on the severity of the situation,” another Meduza source in one of the regional governments speculated. 

Meduza’s source from the federal headquarters for the fight against the coronavirus said that the calculations took into account the number of doctors and teachers in each region. At the same time, only people between the ages of 18 and 60 are being vaccinated across the country (research on the use of Sputnik V among the elderly is still ongoing).

In response to Meduza’s request for comment, the Health Ministry was unable to explain how exactly they are distributing doses of the vaccine. How many doses Moscow received in total also remains unknown — the capital’s health department didn’t respond to our request for comment either.

That said, it’s in the interests of the regions to use everything the federal center has allocated to them as quickly as possible — otherwise, they’ll receive fewer doses of the vaccine the next time, explained Meduza’s source from one of the regional governments.

What’s more, the federal center has already set targets for the regions: they are expected to vaccinate 30 percent of the population against COVID-19 by the end of the first half of 2021 — 60 percent would be optimal, two sources from the Kaliningrad and Novgorod regional governments told Meduza. 

“During the [video conference] there were two figures — 30 percent of the population should be vaccinated minimum, ideally it’s 60 percent. We’re also vaccinating 60 percent of the population against the flu yearly, so that there’s no flu in the region,” one of Meduza’s sources said. 

How quickly Russia’s regions could possibly hit this 30 percent goal is unclear, too. The regions are calmly handling getting 60 percent of their populations vaccinated against the flu within three months, but this involves a single injection, Meduza’s source explained. The coronavirus vaccine, on the other hand, involves two injections within a 21-day interval, as well as fairly long protocol procedures, meaning each doctor can vaccinate no more than two people per hour. “Currently, no one understands how quickly we can process this,” Meduza’s source concluded. 

Will everyone get the vaccine?

On the one hand, there are priorities for at-risk groups, on the other, there’s a task to carry out vaccination as quickly as possible, one of Meduza’s sources said. “As such, I understand why Moscows is doing that. If you need to vaccinate 30 percent, then setting up a strict line means slowing down the process.”

This regional official was referring to the fact that the Russian capital effectively abandoned its own rules during the first week of its vaccination campaign. Before it began, Mayor Sergey Sobyanin specifically underscored that in the first stage, immunization would be available to teachers, doctors, and municipal social services workers.

To get vaccinated, Muscovites belonging to risk groups were advised to bring their passport and proof of a compulsory medical insurance policy, as well as a document confirming their place of work.

However, Meduza uncovered that in Moscow and the Moscow region healthcare workers are often vaccinating whoever comes along. For example, a clinic in Khimki told Meduza’s correspondent that anyone can register for Sputnik V. 

There’s also another incentive for distributing the drug — it comes in bundles of five doses, which can be stored for no more than two hours after opening. Therefore, healthcare workers are inclined to vaccinate five people at the same time — whoever they may be — rather than throw doses away. 

And that’s not to mention the fact that Moscow is also focused on vaccinating as many people as possible against COVID-19. As Sobyanin said himself, the Russian capital needs to immunize six to seven million people to achieve herd immunity. Meduza’s source close to the headquarters for the fight against the coronavirus explained that since doctors and teachers in the capital are reluctant to get the vaccine, city hall is set to expand the list of people eligible for immunization. Sobyanin has already said that as of December 14, vaccination appointments will be made available for employees of municipal services centers, as well as “cultural workers” and people working in the commercial and services sectors.

Are there enough doses of Sputnik V?

According to Meduza’s estimates, vaccinating 30 percent of the country (excluding everyone under the age of 18 and over the age of 60) will require more than 20 million doses of the coronavirus vaccine. The number of doses already produced is dozens of times fewer than that, and whether it will be possible for Russia to manufacture these 20 million doses is not yet clear.

As Meduza reported previously, two Russian companies are currently manufacturing Sputnik V on an industrial scale — Pharmstandard’s “Generium” and AFK Sistema’s “Binnopharm.” They will soon be joined by the St. Petersburg-based company “Biocad,” which recently announced that it will release around one million doses of Sputnik V in December.

That said, the Sputnik V vaccine is made up of two injections, which need to be administered several weeks apart. The manufacturers have already worked out the kinks when it comes to producing the first dose, but difficulties have arisen with the booster shot — since it turned out to be “more finicky,” fewer of the second-stage dose were produced than the first one, explained a Meduza source from the leadership of one of the manufacturers.

In early November, The Bell reported that none of the Russian manufacturers had been able to consistently mass produce up-to-quality doses of both components of the vaccine. On December 10, Meduza’s source close to one of the Russian manufacturers said that this problem still hadn’t been resolved.

As Meduza reported, as of December 4, the Russian Health Ministry had approved 200,000 doses of Sputnik V for mass release (doses available for use outside of clinical trials). According to the federal healthcare watchdog, Roszdravnadzor, four more batches of the Sputnik V vaccine produced by Generium have been tested in the past week. An informed source told Meduza that there’s currently a total of 300,000 doses of this vaccine (including both components) in civilian circulation.

Prime Minister Mikhail Mishustin promised to send the regions an additional half a million doses of the vaccine in December. According to Meduza’s estimates, this is the total number of vaccines currently being held in warehouses — around 500,000 doses (including both components). At the same time, these doses have yet to be quality tested. 

In turn, Deputy Prime Minister Tatyana Golikova promised to put almost seven million more doses of Sputnik V into circulation before the end of February 2021. How this will be achieved remains unclear. Generium — the leading manufacturer — said that it will produce two million doses by the end of December, and only after that begin producing “several million doses of the vaccine” per month.

However, on December 11, Sergey Sobyanin announced the launch of the “R-Farm” plant in Moscow, which is set to produce 10 million doses of the vaccine monthly. A Meduza source close to Moscow’s coronavirus headquarters said that in actual fact, the plant will produce several times fewer doses.

In the event of such a shortage, people will need to be vaccinated very selectively, said an epidemiologist, who wished to remain anonymous (since October, the Russian Health Ministry has forbidden doctors from medical institutions under its jurisdiction from making comments to the press about the coronavirus without approval). First and foremost, Russia will need to vaccinate people who come in contact with many others — potential super-spreaders, who pass the virus along at an accelerated rate. Elderly people, for whom the coronavirus is especially dangerous, will also need to be vaccinated (as previously mentioned, Sputnik V’s clinical trials for the over 60 age group have yet to be completed). Other countries are taking this approach to vaccination.

At the same time, on Friday December 11, Rospotrebnadzor head Anna Popova announced that the first batches of Russia’s second coronavirus vaccine had entered into civilian circulation — the “EpiVacCorona” vaccine, developed by Russia’s Vector Research Center. Fifty thousand doses of EpiVacCorona are set to be released by the end of the year and mass production of the vaccine is scheduled for early 2021.