(Bloomberg) -- Indonesia is set to start its coronavirus vaccination program on Jan. 13, with President Joko Widodo taking the first jab as the race to immunize people against Covid-19 gains pace in Southeast Asia.

Strategies are evolving across the region even as countries sign more vaccine procurement deals. Indonesia, which is battling the worst outbreak in Southeast Asia, ended 2020 by switching up who’s on its priority list for shots -- focusing on the elderly instead of the young as previously announced.

Meanwhile, wealthier but smaller Singapore has pulled ahead of its neighbors to become the first in Southeast Asia to start an official Covid-19 vaccination program. The city state began inoculating healthcare workers on Dec. 30, when it gave Pfizer-BioNTech SE shots to 40 staff from its national infectious diseases center. Its prime minister got his first dose on Jan. 8 as more jabs were administered.

Indonesia, which was the earliest in the region to receive a vaccine shipment, still needs to approve China’s Sinovac Biotech Ltd. shots for use in its first inoculations. Southeast Asia’s biggest and most populous economy has announced multiple agreements to receive potential vaccines.

Both countries are also involved in vaccine development and manufacturing, a testament to the variety of strategies employed by Southeast Asian nations. Here’s how the region of more than 650 million people is dealing with differing fiscal, demographic and distribution challenges in their vaccine strategies.

INDONESIA

STRATEGY:

Indonesia seeks to vaccinate 181.5 million people -- about two-thirds of the population -- by March 2022 and President Widodo has called on the cabinet to shorten that timeline further.

The nation expects its vaccination program to cost more than 73 trillion rupiah ($5.2 billion). It plans to be able to vaccinate 16 million people a month; the initial phase of inoculations will target 1.3 million health workers and 17.4 million public workers nationwide during the first quarter of 2021.

The country will offer free vaccines to people. With about 13,000 community health centers and 9,000 hospitals across the country, the government says it will be able complete its targeted vaccination to achieve mass immunity.

  • The world’s fourth most populous nation is banking on both Western and Chinese vaccines, ordering 125.5 million doses from Sinovac, 50 million from AstraZeneca Plc and another 50 million from Novavax Inc., while developing 57.6 million of its own Merah Putih
  • It is now requesting 108 million free doses from the GAVI alliance, after previously saying it was seeking 54 million from the global vaccine facility
  • Talks are also on with Pfizer Inc. for 50 million doses and loaned cold storage facilities for the vaccine

TIMELINE:

January, 2021: Sinovac

  • President Widodo is set to get vaccinated against the coronavirus on Jan. 13 along with public and army representatives, which would kick off Indonesia’s inoculation program. The event will be televised for the people to witness as a show of confidence in the vaccine
  • China’s Sinovac Biotech shipped 3 million doses of vaccines to the country in December. The government is waiting on the local food and drug regulator to issue emergency use authorization
  • Even before the regulator’s approval, the government has started distributing the vaccines to its 34 provinces spread across the world’s largest archipelago
  • Sinovac will also ship raw material for 45 million doses to be manufactured by Indonesia’s PT Bio Farma by January. The state firm aims to produce 24 million doses a month
  • PT Bio Farma plans to also produce shots for other countries through the Coalition for Epidemic Preparedness Innovations as early as the fourth quarter, according to Indonesia’s state-owned enterprises ministry. Bio Farma will produce 100 million doses a year for CEPI.

2Q 2021: AstraZeneca

  • Indonesia will get the AstraZeneca vaccines delivered in stages starting from as early as April through the first quarter of 2022
  • The deal also includes the option for the country to purchase an additional 50 million doses.

MALAYSIA

STRATEGY:

Malaysia is spending $504 million to buy enough shots to cover 26.5 million people, or about 80% of its population. It will start vaccinations from February, according to Prime Minister Muhyiddin Yassin.

The country will have a “slight extra” stockpile of vaccines as only those 18 years old and above will be inoculated. The excess vaccines will be administered to migrant workers, expatriates, and non-Malaysian residents, the cost of which must be borne by their employers.

Pfizer vaccines will probably be administered to those in urban areas due to the need for ultra-cold storage, while AstraZeneca vaccines will be deployed to rural areas.

  • Malaysia is set to secure 6.4 million doses of the AstraZeneca vaccine through the Covax facility, and another 6.4 million directly, enough to inoculate 20% of the country’s population, according to Science and Technology Minister Khairy Jamaluddin. The first batch is expected in the second quarter of 2021
  • The government is also in final negotiations with China’s Sinovac for 14 million doses, CanSino Biologics Inc. for 3.5 million doses, and for 6.4 million shots of Russia’s Sputnik V vaccine, Khairy said. The deals will involve local companies that can provide fill-finish manufacturing capacity for the vaccines, he said
  • The nation is in talks with Moderna Inc. and Johnson & Johnson, Khairy said
  • Malaysia was due to conduct its first Covid-19 vaccine trial in December as part of a government-to-government agreement with China. It would be a phase-III trial on a vaccine candidate developed by the Institute of Medical Biology Chinese Academy of Medical Sciences
  • Malaysia signed an agreement with China in October to be given priority access to Covid-19 vaccines that China develops.

TIMELINE:

1Q 2021: Pfizer

  • The government has already secured 12.8 million doses from Pfizer-BioNTech SE in a deal signed in late 2020
  • Pfizer will deliver to Malaysia one million doses in the first quarter of 2021, 1.7 million in the second, 5.8 million in the third and 4.3 million in the final three months of the year
  • The agreement with Pfizer covers 6.4 million people and is contingent on the vaccine being approved by the U.S. FDA and Malaysia’s regulator
  • Malaysia has negotiated with Pfizer an option to boost its purchases to cover another 20% of its population

MYANMAR

STRATEGY:

Myanmar said at the start of 2021 it has established a $251 million fund for the purchase of Covid-19 vaccines.

It plans to purchase vaccines for 15 million people from neighboring India, and aims to begin inoculations in February, de facto leader Aung San Suu Kyi has said.

It may take several months to vaccinate the entire population, she said. Frontline health workers will be prioritized, and others will depend on the nation’s needs.

The government has also been cooperating with GAVI, the vaccine alliance, to get shots for 20% of its 54 million population through the Covax facility.

PHILIPPINES

STRATEGY:

The Philippines plans to buy 148 million vaccine doses to inoculate more than half of the population this year. Up to 70 million Filipinos are expected to be vaccinated this year.

The nation is eyeing 73.2 billion pesos ($1.5 billion) in vaccine purchases that it plans to fund with financing from multilateral agencies, state-owned banks and companies and bilateral sources, Finance Secretary Carlos Dominguez said.

A number of mayors in Metropolitan Manila have separately drafted plans to provide shots to their constituents while waiting for guidelines on how local government units can purchase the vaccines, according to Paranaque City Mayor Edwin Olivarez, who also heads the Metro Manila Council of mayors.

Priority for vaccinations will be given to medical frontliners and workers in industries deemed critical, including low-income groups and those identified as at risk.

  • The government is seeking to close deals in January with AstraZeneca, Novavax, Pfizer, Johnson & Johnson, Sinovac Biotech and Russia’s Gamaleya research institute, according to vaccine czar Carlito Galvez
  • The nation is working on a pact with Moderna for an initial 20 million doses, it said late last year. It was aiming to secure at least 80 million vaccines from pharmaceuticals companies including AstraZeneca, Novavax and Johnson & Johnson
  • Russia’s Gamaleya National Center of Epidemiology and Microbiology had offered another 25 million doses, according to Galvez
  • The country has informed Sinovac it needs 25 million doses for 2021
  • Pfizer and AstraZeneca have applied for emergency use authorization with the local FDA, with Gamaleya also expected to submit its application soon.

TIMELINE:

1Q 2021: Sinovac, Sputnik V

  • Vaccinations could start as early as the first quarter of 2021 using Sinovac and Russia’s Sputnik V shots, according to Galvez
  • Sinovac, Sputnik V are yet to receive the local FDA approval.

May, 2021: AstraZeneca

  • The country will receive as early as May 2.6 million doses of AstraZeneca vaccines purchased by local companies which pooled about 800 million pesos to buy 3 million shots.

SINGAPORE

STRATEGY:

The city-state has set aside roughly S$1 billion ($755 million) for vaccines, tapping the likes of Arcturus Therapeutics Holdings Inc., Moderna Inc., Pfizer and Sinovac for supplies. It estimates it should have enough for its around 5.5 million-strong population by the third quarter of 2021.

The city-state plans to start vaccinating the elderly and those at greater risk of severe disease from Covid-19 infection from February 2021, beginning with seniors aged 70 and above. Priority will also be given to those in jobs or settings where risk of a super-spreading event is high, such as the construction, marine and process sector, including migrant workers.

The allocation of vaccines will largely be based on medical indications, suitability and availability, the health minister said in January

Singapore aims to vaccinate the entire adult population, though this will be voluntary. Vaccines will be free for all Singaporeans and long-term residents.

  • In addition to those listed below, Moderna has concluded an agreement with the Ministry of Health to supply the country with its mRNA-1273 vaccine

TIMELINE:

4Q 2020: Pfizer

  • Singapore started vaccinations on Dec. 30, 2020
  • Prime Minister Lee Hsien Loong got a first dose of the vaccine on Jan. 8, making him the first member of cabinet to get the coronavirus vaccine shot. He got the jab on the same day that about 90 Singapore General Hospital staffers are expected to be vaccinated as part of the official roll-out for healthcare workers, Channel News Asia reported
  • The city-state received its first shipment of the Pfizer-BioNTech vaccine on Dec. 21. The shots have been approved by the Health Sciences Authority.

Early 2021: Arcturus

  • Arcturus and Singapore’s Economic Development Board have entered into a supply agreement for the right to buy the ARCT-021 vaccine
  • Arcturus may ship the first batch of the Covid-19 vaccine it’s developing with local scientists early 2021
  • Results so far show that the vaccine could be effective as a single dose, the Straits Times reported, citing a professor who co-developed the vaccine with Arcturus.

THAILAND

STRATEGY:

Thailand wants to inoculate about 50% of its population by the end of this year.

It will allow private companies and hospitals to import and sell Covid-19 vaccinations as long as those shots have been approved by the nation’s Food and Drug Administration.

Thailand’s health regulator may endorse AstraZeneca Plc’s vaccine later this month, while Sinovac Biotech Ltd. is still in the process of registering its shots, the government said Jan. 7.

The Southeast Asian nation plans to distribute shots free of cost, while the imports by private firms would allow those who can afford to pay for inoculations along with non-Thais an alternative pathway to get shots.

  • The government expects to receive the first batch of the Sinovac vaccine in February, and it expects to roll out AstraZeneca shots in May
  • It has so far secured 2 million doses from Sinovac and 26 million doses from AstraZeneca, and it plans to get 35 million more doses from AstraZeneca, according to Prime Minister Prayuth Chan-Ocha
  • Not wanting to rely solely on inoculations from abroad, Thailand is also developing its own anti-coronavirus shot
  • An mRNA vaccine research project is set to start the first phase of clinical trials in April and the second phase in June. The vaccines may be available by end-2021 after receiving emergency-use authorization
  • A DNA vaccine effort by Thailand-based BioNet-Asia is expected to start its first phase of human trials in Australia early 2021.

TIMELINE:

February, 2021: Sinovac

  • The country has said it plans to roll out 200,000 doses of Sinovac vaccines in February, 800,000 in March, and 1 million in April

May, 2021: AstraZeneca

  • Thailand has an advance agreement with AstraZeneca to secure Covid-19 vaccines, which are expected to be distributed by mid-2021, the prime minister has said
  • The country said early January it plans to roll out AstraZeneca vaccines in May
  • Under agreement with AstraZeneca, Siam Bioscience will produce vaccines at its facilities, and Thailand will receive technology transfer
  • Thailand will supply coronavirus vaccines at “reasonable prices” to Myanmar, Laos, Cambodia and Vietnam when it begins production, Prayuth said.

VIETNAM

STRATEGY:

Vietnam is working on developing vaccines and will work with suppliers when vaccines are available, according to a spokeswoman at the foreign affairs ministry.

  • It signed a deal with AstraZeneca to acquire about 30 million doses of the Covid-19 vaccine, Deputy Health Minister Truong Quoc Cuong said during a government briefing in January
  • It has also been negotiating to buy vaccines from Pfizer and companies from Russia and China, Cuong said
  • Vietnam has four companies and institutes working on developing vaccines. Nanogen Pharmaceutical Biotechnology began its human vaccine trials Dec. 17. The Institute of Vaccines and Medical Biologicals plans human trials starting Jan. 21, according to the health ministry.

TIMELINE:

1Q 2021: AstraZeneca

  • Under the deal with AstraZeneca for about 30 million doses, Vietnam expects to receive vaccines each quarter this year, the deputy health minister said Jan. 4.

©2021 Bloomberg L.P.



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