Demand Finally Outstrips Supply in Russia’s Vaccination Race

Karaoke club manager Tatiana Amaliya has been scrambling to find a clinic with jabs to spare since a June 24 announcement of mandatory Covid-19 vaccinations for hospitality workers.

She needs to vaccinate her staff within the next three weeks or her venue in the plush Krasnaya Polyana ski resort — the setting for Russia’s 2014 Winter Olympics — will face fines or a forced shutdown.

“I tried the two clinics closest to us today. They both said they had no vaccines and told me to call the other one. Neither knew when they’d be back in stock and just told me to keep calling,” she told The Moscow Times.

While shortages have been commonplace across most of the developed world, Russia has for months faced the reverse problem: a supply glut as Russians proved reluctant to get vaccinated. Just 23 million people — or 16% of the population — had received a first dose by Monday, the Health Ministry said.

Now amid a devastating third wave of the coronavirus which has set new records for Covid-19 fatalities, regions across the country are rolling out mandatory vaccination programs to kick-start the flagging campaign.

The sudden spike in demand has left vaccination centers outside the main cities of Moscow and St. Petersburg understocked. Alongside Sochi and the surrounding Krasnodar region, local media have reported shortages in Yekaterinburg, Novosibirsk, Khabarovsk, Bashkiria and Udmurtia, among others.

“We were receiving an average of 3,000 doses per week. But we have the capacity to deliver 7,000 vaccinations per day — so we could use up a week’s supply in half a day,” Tomsk Governor Sergey Zhvachkin said of Russians' newfound desire to get vaccinated — often under threat of losing a job.

For the first time since the start of Russia’s vaccination campaign, launched last December, more than 500,000 doses a day were administered over the weekend, according to the independent Gogov website, which tracks and collates regional vaccination statistics in the absence of complete national information.

Inflexible logistics

Officials and experts have put this down to logistical challenges.

Vitaly Shakhnazarov, quality director at COREX, a pharmaceutical logistics firm working in Russia and Eastern Europe, told The Moscow Times the localized shortages were the result of an “inflexible” delivery network.

“Since it’s hard to predict demand for vaccinations among the population, it’s necessary to create reserve supplies at regional distribution centers that would allow prompt deliveries to the vaccination centers at short notice.” 

He said Russia’s current vaccine distribution plan is being set in advance with any excess stored centrally, making rapid distribution to the far-away regions in times of rising demand difficult.

Trade Minister Denis Manturov told a government meeting Tuesday 36.7 million vaccine doses had been produced for use inside the country — with each dose comprising two components.

Until recently, production had been enough to satisfy tepid demand at home and provide some batches for export. But the new dynamics have raised questions over whether Russia will be able to step up its production to meet the higher levels of demand, as well as deliver on its dozens of commitments to supply countries around the world.

Manturov said another 30 million doses would be produced in July. Previous claims that Russia was on the verge of an exponential increase in domestic vaccine production have fallen short of expectations, and there are signs Russia’s domestic producers of the flagship Sputnik V vaccine are struggling to fulfil existing pledges.

Pharmaceutical company R-Pharm — touted as a possible game-changer for the mass production of Sputnik V — started growing cells to produce the vaccine last November, and billionaire owner Aleksei Repik previously told The Moscow Times it would aim to produce 10 million doses a month.

But the company has yet to release a single batch of the vaccine into circulation, data from a Health Ministry database which logs individual medicine series approved for distribution shows. 

Generium — another of the seven companies approved to produce the jab domestically, and which said it could produce 5-8 million doses a month at full capacity — has not released a batch of vaccines since mid-March.

R-Pharm, Generium and the other approved producers did not respond to requests for comment. Nor did the The Russian Direct Investment Fund (RDIF) which is marketing and financing Sputnik V.

Tricky production

Part of the possible production hold-up is the complicated make-up of Sputnik V, industry experts say. Unlike other two-dose coronavirus vaccines, Sputnik V’s first and second doses are different formulations. Developers say this “vaccine cocktail” provides a stronger level of protection — but it is significantly more difficult to manufacture.

“The issue with that is you have to have two different factories or at least two separate sections to manufacture the two doses,” Vikram Punia, founder of Pharmasyntez, told The Moscow Times.

“So there’s a very big problem of cross-contamination — and if you get cross-contamination you’ll have really big issues. This is a big problem in the case of Sputnik V.”

Pharmasyntez initially announced it would produce the full Sputnik V vaccine, but Punia said he ultimately “rejected the idea of producing Sputnik V because we really don’t have that kind of capacity.” Instead the firm will manufacture the one-dose Sputnik Light, mainly for export, as part of Russia’s global push to sell the jab across the developing world.

Another factor potentially disrupting production is the long time between a manufacturer completing a test batch of the vaccine and then receiving government approval for mass manufacture, Punia said, citing that Russia’s Health Ministry has lengthened the time it wants to keep test samples under observation before granting approval. 

He expects Pharmasyntez’s first jabs — just submitted for analysis — to be under inspection for a minimum of four months before the firm gets authorization, pushing back his launch date from summer to at least fall.

Delayed delivery

Despite demand for jabs being finally on the rise, surveys continue to show a significant portion of Russians opposed to inoculation, and the Kremlin on Tuesday abandoned its target to have 60% of the population vaccinated by Sept. 1. 

Shortages are also being complicated by Russians’ views of the four coronavirus jabs approved for use in the country. Only the flagship Sputnik V has published late-stage Phase 3 clinical trial results and has been the most heavily promoted both at home and abroad.

“There is more information about Sputnik V and therefore more trust,” said Sochi resident Polina Petrenko, who has tried three times to get inoculated at the drop-in vaccination center in Sochi’s main mall in recent days.

“Yesterday they offered me CoviVac” — another Russian vaccine — “but I don’t trust it. When I was in the queue, lots of people were calling around to different clinics in Sochi — there aren’t Sputnik V vaccines anywhere,” she said.

President Vladimir Putin has refused to say which of Russia’s vaccines he was vaccinated with.

Sochi Mayor Alexey Kopaygorodsky said the supply shortages are temporary and that extra jabs are being delivered from Moscow. 

But residents told The Moscow Times clinics are unable to guarantee vaccines even for those who have booked appointments.

“The vaccination center was still out of supplies on Tuesday and said new ones hadn’t arrived,” said Polina.

“The mayor is again saying that vaccines are ‘on the way.’ From Mars probably — I don’t understand how it can be so difficult to supply a city with vaccines.”

Pjotr Sauer contributed reporting.