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Covid vaccines: SL vs. rest of the world

02 Mar 2021

Following the outbreak of the Covid-19 pandemic last year, in less than 12 months, researchers from around the world developed several vaccines to protect people from the virus that has already caused over 2.5 million deaths. It is observed that the entire world has now reached a juncture where collective Covid-19 management efforts are of utmost importance. The focus of all such vaccines is to enhance people’s immune systems, thereby making sure people do not get severe complications even if they happen to contract the virus. A large number of countries have commenced Covid-19 vaccination programmes, and to continue it as a collective endeavour, countries and global health organisations have come forward to support countries in need of support. Similar to Sri Lanka’s Covid-19 vaccination drive, many countries have prioritised those who were identified as groups at high risk of contracting the virus, due to the aggressiveness of the virus as well as factors such as the availability of adequate doses and affordability.   Global Covid-19 vaccination drive According to statistics, currently the global seven-day moving average of administered doses of vaccination is about 4.8 million per day. CNN reported that among the top 10 countries/territories that had administered the most number of doses of Covid-19 vaccines per 100 persons are Gibraltar, Israel, Seychelles, the United Arab Emirates (UAE), the Falkland Islands, the Cayman Islands, the UK, Guernsey, Jersey, and Bermuda. Meanwhile, Great powers such as the US, Mainland China, India, Germany, Russia, and Canada had administered a relatively lesser number of doses. However, over a period of 73 days, the US had administered a total of 72,806,180 doses, while China had administered 40,520,000 doses within 72 days. Statistics showed that Sri Lanka has administered two doses per 100 persons and 441,976 doses over a period of 27 days. Looking at the situation in the South Asian region, India has recorded the highest number of Covid-19 cases after the US. According to Al Jazeera, India has vaccinated more than 12 million frontline healthcare workers under the initial stage of their vaccination drive, and has now started vaccinating the country’s elderly population as well as those with health conditions. India has identified people over the ages of 60 and 45 with medical conditions as eligible to be vaccinated. Foreign media also reported that the vaccine is given for free at government hospitals and is also sold at over 10,000 private hospitals at a fixed rate of Indian Rs. 250. The Indian Government has announced that it would allow people to choose their vaccination centres. Nepal also commenced its vaccination drive on 27 January and, like Sri Lanka, gave priority to frontline healthcare workers initially. Reuters reported that Nepal was planning to cover 72% of its 30 million population. Last month, Nepal approved the emergency use of a Covid-19 vaccine developed by an affiliate of China’s Sinopharm. The country received one million doses of the Covid-19 vaccine from India in January and is also expected to receive vaccines from China. XinhuaNet, quoting the President of the Maldives, reported that the Maldives was planning to vaccinate its citizens within six months. The Maldives started its vaccination programme on 1 February, giving priority to frontline healthcare workers and vulnerable groups. The country received 100,000 doses of the Oxford-AstraZeneca vaccine manufactured by India’s Serum Institute. Meanwhile, Bhutan received 150,000 doses of the Covid-19 vaccine from India in January. However, as of last week, Bhutan had not administered the vaccine, as the country has adopted a wait-and-watch policy, The Straits Times reported. Foreign media also reported that Bhutanese authorities were waiting until the country receives Covid-19 vaccines for all citizens eligible to be vaccinated, and were also planning to look into the potential side effects of the Covid-19 vaccine after evaluating the situation in the country. The Guardian reported that Pakistan has decided to allow private companies to import Covid-19 vaccines and has exempted the vaccines from price caps in a divisive move that health experts fear will create vast inequalities in access. As of mid-last month, Pakistan had only been able to secure the vaccine manufactured by China’s Sinopharm. Foreign media also reported that Pakistan was expecting 17 million vaccines from the World Health Organisation (WHO)-supported Covax initiative and that the country had only vaccinated over 30,000 healthcare workers as of last month. Moreover, the people of Pakistan had on some occasions refused to be vaccinated out of fear of negative health impacts of the Chinese vaccine, it was further reported. Bangladesh began its Covid-19 vaccination programme early last month, with the aim of vaccinating 3.5 million people in the first month, Reuters said, adding that the country was planning to inoculate 80% of its population of around 170 million.   SL’s Covid-19 vaccine drive The first stage of the much-anticipated Covid-19 vaccination drive in Sri Lanka commenced on 29 January, a day after Sri Lanka received a stock of half a million doses of the Oxford-AstraZeneca (also known as “Covishield”) vaccine from India. The first stage of the drive gave priority to frontline healthcare workers as well as selected members of the defence and police forces who work closely with Covid-19 management efforts. The second stage of the drive commenced on 15 February and is currently in progress, giving priority to the public, especially those who deal with a larger number of persons and are at high risk of contracting Covid-19, such as the elderly population. Under the Government’s plans to continue and expand the vaccination drive, the Government last week announced that the Ministry of Health is planning to vaccinate 14 million people out of the total population and that the Cabinet of Ministers had granted approval to purchase a total of 13.5 million doses of the Oxford-AstraZeneca vaccine from India and the UK. As per this decision, the Government is to purchase 10 million doses at a cost of $ 52.5 million from India’s Serum Institute as a direct procurement, and 3.5 doses million from the AstraZeneca institute in Britain after the State Pharmaceuticals Corporation (SPC) entered into an agreement with the said institute. In addition, the Cabinet had decided to sign the standardised indemnification agreement submitted by the Covax mechanism in order to expedite the vaccination under the Covax Facility.   What is the Covax Facility? As the global Covid-19 pandemic worsened, a pressing need to effectively and efficiently carry out Covid-19 management efforts arose. As part of these efforts, a global public-private-philanthropic collaboration, named Access to Covid-19 Tools (ACT), was created in order to accelerate the development, manufacture, and fair distribution of Covid-19 tests, treatments, and vaccines. Covax is the vaccine pillar of the ACT initiative. Currently, 190 countries have joined the Covax Facility. According to the WHO, all South Asian countries including Sri Lanka have partnered with this initiative. According to the Covax interim distribution forecast as of 3 February, Sri Lanka has been allocated an indicative distribution of more than 1.6 million doses of the Oxford-AstraZeneca vaccine from the Serum Institute in India. The indicative distribution doses specify the contracted number of doses for Q1 and Q2 supply, with 35-40% available in Q1 and 60-65% available in Q2.   Vaccination: A collective effort Even though the first stage of the vaccination drive was carried out flawlessly, the second stage, which intended to vaccinate the public, came under fire due to several reasons. First of all, the website introduced by the State Ministry of Primary Healthcare, Epidemics, and Covid Disease Control for the public to register to receive the Covid-19 vaccine has not been functioning for several weeks. Those who access the website can see a message about the website’s purpose, saying “this website is currently being updated and will be available shortly”, which is unacceptable at a time when the second stage of the vaccination drive has already begun. Secondly and most importantly, the health authorities’ “priority list” – which the health authorities said was for the purpose of prioritising those who need to be vaccinated before others – also came under fire due to multiple allegations that certain parties outside the priority list had attempted to get vaccinated. The Morning earlier reported an incident where certain parties had allegedly tried to influence healthcare workers to get the Covid-19 vaccination, claiming to be in the list of a prominent Colombo-based politician, despite not being in the priority list in the first place. Health authorities had also confirmed that there were reports of certain parties attempting to influence healthcare workers. To look into the status quo of the second stage of the vaccination drive, The Morning spoke to the Public Health Inspectors’ Union of Sri Lanka (PHIU), who are directly involved in the vaccination drive along with other healthcare workers. The PHIU said that even though there were a few hiccups in the administration of the Covid-19 vaccination due to unclear guidelines, with the Minister of Health issuing specific guidelines in writing, the vaccination drive is now in step with the standard guidelines. PHIU Secretary Mahesh Balasuriya, speaking of the much-talked-about priority list, said that the vaccination drive is not based on anyone’s ethnicity or profession, and that those registered as voters in a grama niladhari division and are over the age of 30 are eligible under the second stage. “There were issues in the past few days when administering the Covid-19 vaccine in several areas, including the Western Province, due to the instructions regarding the vaccination drive being unclear and certain people such as politicians and public officials trying to exert undue influence to get their family members or acquaintances outside the priority list vaccinated. There were also incidents where PHIs were pressurised and threatened by certain parties, and the public was also inconvenienced. “Also, having different instructions for various groups of healthcare workers administering the vaccination drive caused issues. While some had been instructed to vaccinate people above the age of 60, some had been instructed to vaccinate people between the ages of 30 and 60. Due to these issues, on 26 February, those administering the vaccination in the Gampaha District withdrew from duties and informed health authorities in the Western Province as well as the Director General of Health Services. As a result, the Health Minister issued specific guidelines in writing with regard to the priority list.” He added that issuing different instructions for different groups of healthcare workers is likely to cause issues as there is no uniformity in the vaccination drive. “The Covid-19 vaccination is a new vaccine which is still in its clinical test stage. Therefore, some people may have complications. In the event certain people experience complications due to the vaccine, it would be difficult to gather data and information from around the country, if the vaccine has been administered on groups of different ages. This would have created a hugely problematic situation. However, with the Minister of Health issuing proper guidelines, for the time being, we do not expect any more issues. However, if certain parties try to change this process again in order to fulfill their needs, issues may arise.” Balasuriya emphasised that when vaccinating the public, the latter group too has a huge responsibility to assist healthcare workers, adding that those who were vaccinated due to their eligibility requesting the vaccine for their relatives or family members who are ineligible sets a bad precedent. He also stressed that all citizens have the same rights as per the Constitution and that the public should understand that depending on the eligibility criteria, which is applicable to all citizens, some of their family members may get vaccinated while some may, for the time being, not. He noted that when carrying out a vaccination drive according to a certain set of guidelines, all parties should express their support. Balasuriya further noted that due to the complicated situation regarding the above-mentioned issues, some also level allegations against PHIs and some have even told the media that PHIs oppressed them. He stressed that there is no oppression and that PHIs are required to act in accordance with the guidelines they have received. He further emphasised that health workers working at the grassroots level are the ones who are subjected to undue influence more than others, noting that due to minor issues, all the good work done by PHIs have been devalued. The Covid-19 vaccination drive is expected to bring about a huge change to Sri Lankans' lives; however, that change would not be possible through vaccination alone, as the vaccination in itself cannot guarantee that we would be safe from Covid-19. It is of utmost importance that everyone, vaccinated or not, keep in mind that the vaccine can make us immune to Covid-19 only to a certain extent. Adhering to Covid-19 health regulations is still necessary. At the same time, adapting to a new lifestyle, particularly through healthier eating habits and physical activity that help strengthen the immune system, is also important.   PHOTO PRADEEP DAMBARAGE


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