By Kemo Cham
After interruption to its Covid-19 vaccination programme due to jab shortages, the National Covid-19 Emergency Response Center (NaCOVERC) on Monday, 23 August resumed the exercise.
But this leg has been different in that the process was designed to see an increase in both coverage and speed of the vaccination process nationwide. Officials said the goal was to reach as many eligible persons as possible. Due to the short shelf life of the available jabs, the authorities were racing against time to beat the expiry of the vaccines in stock.
Some 600 teams of vaccinators were deployed across the country in the 10-day period that ends on September 1, according to NaCOVERC which says that this marks the first phase of the exercise dubbed ‘Covid-19 Vaccine Surge One.’
Sierra Leone started its vaccination programme in March this year, with vaccines donated by the Chinese government (Sinopharm) and AstraZeneca, through the COVAX facility. It was halted when the jabs were either exhausted or expired in June.
As at August 25th, an estimated 165,000 people had received at least one dose of a vaccine, according to data from WHO. This represents only about 4 percent of the country’s vaccine eligible population of 4.2 million. And only about 35,000 of those had received their second doses, the WHO data shows.
At the commencement of this phase of the vaccination exercise, last week, NaCOVERC said it had 436, 000 doses of Sinopharm and AstraZeneca vaccines in stock, which were recently shipped into the country.
According to Harold Thomas, Risk Communication Lead at NaCOVERC, more doses of three other kinds of vaccines - Johnson and Johnson, Pfizer and Moderna - were expected in the coming weeks. Thomas said the rush has nothing to do with the integrity of vaccines, which he assured were ok, adding that it had nothing to do with the cold chain system either. He stressed that it had to do with the shelf life of the vaccines. But he hoped that all the jabs in stock will be utilized before they expired.
To ensure this, the NaCOVERC says unlike the previous phase, this time round teams of vaccinators will be deployed in far flung areas of the country, with mobile teams moving from place to place.
During the first phase, vaccination sites had been largely limited to the urban communities, including the district headquarter towns, making it difficult for many to access them.
With Sierra Leone’s revised COVID-19 response plan, the aim, according the NaCOVERC, is to reach 20% of the total eligible population by the end of the year.
The 600 vaccination teams represent an increase from 72 teams. The age limited of the beneficiary targets have also been reduced to 18 years.
Dr Tom Sesay, head of the vaccination programme at NaCOVERC, said efforts to expand vaccination is at the heart of the country’s goal of reopening its economy.
“We are at a stage wherein everyone has come to terms with the fact that vaccination is the only lasting solution to Covid-19. We have seen a lot of countries opened-up their economies because they have been able to vaccinate their people. We also want to join that approach, to ensure that we vaccinate as many Sierra Leoneans as possible,” he said in a video message issued by the NaCOVERC prior to commencement of the vaccination exercise.
Dr Sesay in the video also stressed the importance of speed.
“We have a lot of vaccines…but because these vaccines will expire within one month, it is very important for us to use them very fast and ensure that people get vaccinated,” he said.
Vaccine expiration poses a growing challenge for countries around the world, particularly in Africa, where authorities rely on goodwill and have to wait for long for donated consignments to arrive. Many African countries were forced to discard expired vaccines during the first phase of the vaccination process. One estimate puts it at 450, 000 doses, as of July.
The challenge has been that while the vaccines have short shelf life, their shipment takes long to be effected. And by the time they arrive, the largely unprepared countries are unable to fully deploy them.
The AstraZeneca vaccine, which is in use in Sierra Leone. for instance, can be stored safely in refrigerated conditions for up to six months. Some other vaccines are said to have a shelf life of up to 36 months.
And according to experts, the challenge with all these vaccines is that they have been in use for less than a year and there is no substantive data on their effectiveness after long periods.
The World Health Organization (WHO) had initially warned against destruction of the expired vaccines, arguing that more data was needed to determine whether they could be used even after their expiry date. But the global health body later backtracked.
"While discarding vaccines is deeply regrettable in the context of any immunisation programme, WHO recommends that these expired doses should be removed from the distribution chain and safely disposed of," it said in a statement on May 17.
This leg of Sierra Leone’s vaccination campaign comes in the face of rising antivaccination sentiments. According to the NaCOVERC, its data shows that more men (66.67%) were taking the vaccines than women, a situation that has been attributed to growing fears that the vaccines cause sterility.
But Col. Dr. Stephen Sevalie, Case Management Lead at NACOVERC, says there is no data backing up that view.
The resumption of the exercise also comes as the government announced that it had put under control the third wave of the pandemic which saw cases and deaths rose exponentially between mid-June and the third week of August.
The government reimposed restrictive measures in July as a result.
As of August 23, Sierra Leone had cumulative total confirmed positive cases of 6, 355 and 121 deaths.
"Taking the COIVD-19 vaccination closer to the people in the communities at this critical moment is very impressive. The exercise is an opportunity to expand access for so many people to receive these lifesaving commodities, thus improving equity in the vaccination process", said Dr Steven V. Shongwe, the WHO Country Representative in Sierra Leone.
"In addition to these vaccines. it is still highly recommended that the other public health measures - correct use of facemask, frequent hand washing and avoiding crowded areas or maintaining physical distance - are adhered to at all time even after receiving the shots," he added in a statement.
WHO has been supporting the government to respond to the pandemic by mobilizing partners and resources, and by providing strategic technical expertise. It has further helped strengthen key components of the response including laboratory, surveillance, data and information, training, logistics and supplies as well as demand creation through the financial support of its donors.
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