Caracas Chronicles

Every day, doctor and public policy expert Marino González goes on Oxford University’s Our World in Data website. Like many other specialists looking for local statistics, this member of the Venezuelan Academy of Medicine is used to resorting to international organizations to find data for his research, information government officials almost never share with the public. It’s been 57 days since the country kicked off its national vaccination program, the same plan Maduro promised on national TV in late March would be “massive”.

But nothing seems more delusional and farther from the truth now that Venezuela has been swallowed by the second COVID-19 wave, with deaths spiking and thousands of medical requests saturating social media and crowdfunding platforms. 

González looks at his computer to confirm the latest report available on the Venezuelan vaccination deployment. “Until Monday (April, 12th), 250,000 people have been vaccinated,” he says after looking at the Oxford site, which specifies that the number refers to the population who’s received at least one dose. The source, he points out, is an article published by an international news agency quoting the government. 

Since the program started, Alvarado said Venezuela has registered a daily vaccination rate of 0.05%. The country has administered at least one shot to only 0.88% of the population, data available on the site reveals. 

The erratic vaccination plan, which authorities haven’t fully disclosed after eight weeks, is a continuation of what experts have consistently reported to the media as a secrecy policy surrounding data of all sorts, including the country’s sanitary statistics. 

The Health Minister’s Enigmas

On Thursday, Venezuela received a new shipment from Russia carrying 50,000 doses of the Sputnik V vaccine. The regime’s Health minister Carlos Alvarado said the batch will cover the second dose of some health workers and added that part of the batch will be used to vaccinate the elderly and essential workers.

“We have already administered more than 200,000 doses of this vaccine,” Alvarado said in a confusing statement without explaining how many Venezuelas have received the two required doses since the vaccination campaign began. “This has come to complete the immunization of healthcare workers and to continue vaccinating older adults, who are the most vulnerable and most prone to complications.”

To date, Venezuela has officially received enough doses to fully vaccinate 400,000 people—300,000 doses come from a paid agreement with Russia to import the Sputnik V, while 500,000 doses of Sinopharm are, according to Delcy Rodríguez, part of a donation from China. Both rely on applying two doses.

Publicly, Venezuelan officials have recognized receiving 800,000 doses, including the cargo from Thursday. 

The government announced it would start vaccinating the elderly, but authorities considerably restricted access to the vaccine by only summoning adults over 60 through the Patria system.

But where have these vaccines gone? Earlier this week, the regime’s Health minister gave a vague update about the national vaccination plan in a barely publicized interview. 

According to Alvarado, 230,000 healthcare workers have received at least one of the two doses so far, but 120,000 are still waiting to get their first shot. He added that “a group of educators” out of a total of 1.2 million also received one dose. 

The minister also said that officials intend to vaccinate the elderly with chronic conditions next, estimated at around 4 million people, followed by elders in home cares, which are about 10,000. The next group to receive it is composed of essential workers, including firefighters, rescue groups and carriers.

However, Alvarado didn’t mention that members of the government party were in the prioritized group. Just days after the scheme kicked off, members of the chavista National Assembly, the Army, Nicolás Maduro, and his close circle received the first dose of Sputnik V.

“I’m vaccinated, I don’t feel any kind of ‘chillsky’ or ‘feversky’,” Maduro joked on national TV in early March. “They say that one ends up speaking Russian.” 

During that presidential address, Alvarado said that 100,000 teachers and an additional 50,000 people on a house-to-house scheme would receive the Chinese vaccine, but didn’t specify the criteria for prioritizing these groups.  

Last week, the government announced it would start vaccinating the elderly, but authorities considerably restricted access to the vaccine by only summoning adults over 60 through the Patria system. 

Some hospitals in Miranda began administering the vaccine to people that got an appointment via the platform but only in limited quantities. Authorities from the Dr. Eugenio P. D’Bellard Hospital in Guatire, Miranda, reported receiving only 760 doses, which would be administered to 80 people per day.

When the next batch of vaccines will arrive in the country is still uncertain. The vaccine procurement hasn’t been more transparent than the deployment of the national immunization scheme. 

A Sudden Shift

A month after the deadline to access COVAX’s supply forecast—led by the World Health Organization (WHO) involving the Global Vaccine Alliance (Gavi) and the Coalition for Epidemic Preparedness Innovations (Cepi)—Maduro announced an agreement with Russia to receive 10 million doses of Sputnik V after making a 200 million dollar payment. 

So far, Venezuela has only received 3% of the agreed amount, and 9.7 million doses, although secured, are still pending. Authorities have not yet explained the reasons for the delays.

How’s it possible to argue that the country cannot access vaccines due to the blockade? They owed 18 million dollars to the WHO and didn’t have money back then to make the payment but now they suddenly do.

However, that means Venezuela has managed to secure enough vaccines to fully protect 5,250,000 people through its long-standing allies. That number was still far away from the 22 million goal (around 70% of the country’s population) experts have insisted is necessary to achieve herd immunity.

Still a long way to go, and having blamed the sanctions once again for their inability to pay a debt to the WHO, the government finally turned to COVAX to secure enough doses for 20% of the population amid the increasing pressure from civil society. 

In mid-March, Maduro assured that the Anglo-Swedish vaccine AstraZeneca, which comprised most of COVAX’s available stock, wouldn’t enter Venezuela after “technical reports” showed that the immunization had minor secondary effects.

Less than a month later, Delcy Rodríguez celebrated an advanced payment to COVAX of 59.2 million Swiss francs (about 64.2 million dollars) to acquire 11.3 million doses.

“Pressure from the civil society had a lot to do with this decision,” says former Health minister José Félix Oletta. 

During the announcement, Rodríguez lashed out against Juan Guaidó, who controls Venezuelan funds abroad that have been blocked by international sanctions. Rodríguez didn’t mention Guaidó’s efforts to use 30 million dollars so Venezuela could enter the WHO mechanism. Instead, she accused him of “kidnapping” the money.

“When the time comes, it’ll be known where we got the money from,” Maduro said, adding even more opacity to the vaccine procurement process.

“How’s it possible to argue that the country cannot access vaccines due to the blockade? They owed 18 million dollars to the WHO and didn’t have money back then to make the payment but now they suddenly do,” Oletta inquired. 

Building Expectations

But the late incorporation to the WHO mechanism doesn’t mean the vaccine procurement is done—even with the supply from the government’s allies and COVAX, Venezuela is still far from improving its daily vaccination rate and preventing its death toll from rising. 

Venezuela’s current vaccine availability only reaches 38% of the total needed.

“Venezuela’s current vaccine availability only reaches 38% of the total needed,” says public policy specialist Marino González, based on his estimations. “18% of that demand has been covered by the agreements with Russia’s Gamaleya Institute and another 20% via COVAX. That means that the government still has to find a way to cover the supply for the remaining 62% needed.” 

The lack of transparency in the process builds up as the government keeps from specifying which mechanisms it’ll use to find the remaining supply, especially as countries have already established deals in 2020 to guarantee enough provisions for their populations. 

When Venezuela will receive the first shipments from the COVAX agreement is still uncertain, too. The coordination platform has agreements with Oxford-AstraZeneca for 340 million doses and Pfizer-BioNTech for about 1.2 million doses of the vaccine.

COVAX has reached an agreement to roll out the single-dose Janssen vaccine, but its delivery is scheduled for July of this year. 

“The government already discredited the AstraZeneca vaccine we could’ve received and if they plan to wait for the Janssen immunization, the vaccination process will remain paralyzed for four months,” Oletta adds. 

Without a clear short-term solution, the government has brought Cuban vaccines to the table, to the point of even promising to produce millions of doses locally. 

Contrary to its Russian and Chinese counterparts, the Cuban product has a long way to go before approval. While Sputnik V has proven to be a solid vaccine with 92% efficacy in trials, Chinese officials have openly recognized that their vaccine isn’t “effective enough” and said they need to improve its 79% efficacy rate. But the Cuban alternatives, Soberana 02 and Abdala, promoted by the island’s Instituto Finlay, are on phase III and I/II, according to the WHO’s database of vaccines in clinical trials.

“They haven’t procured any vaccines, and now they’re trying to fill the gap by offering the Cuban alternative as immunization when it’s still a candidate to vaccine,” Oletta warns about Maduro’s announcement. “This seeks to create a false expectation, just like all the other miraculous products they have promoted. It breaks all of the sanitary justice values.”

Even the Health Ministry’s recent interview contradicts Maduro’s announcement about producing 2 million Abdala vaccines per month by August, a solution still months away for a pressing emergency. 

“Right now, we’re in the process of inspecting our vaccine plant with Cuban experts to see if we can start producing the Cuban vaccine in Venezuela. If implemented, it will ease the process to access the vaccines,” Alvarado said about a possibility that seems to still be under assessment. The minister’s interview was published one day after Maduro talked about manufacturing Abdala in Venezuela.

Producing a vaccine that doesn’t have enough studies on its effectiveness would delay even more the much-needed access of millions of Venezuelans to urgent immunization. 

“To date, there are 14 vaccines that have been approved to be used worldwide. Why not use one of these instead of engaging in a complex process with a candidate we know nothing about?” González asks. “The time we waste has a clear effect: many more people will die.”