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Covid-19: Sierra Leone changes approach to vaccination

  • People queuing for COVID-19 Vaccination during outreach by a team from FOCUS 1000

By Kemo Cham

As the race to contain the Covid-19 pandemic heats up, countries like Sierra Leone are lagging far behind in terms of vaccination.

Seven months since it commenced its vaccination programme, only about 3 percent of Sierra Leone’s population has been fully vaccinated, according to official data.

Besides hesitancy, which has been due to misconceptions fueled by fake news, occasional shortages of the jabs has also contributed to the low uptake. But authorities say not only is there enough jabs now, hesitancy has also reduced.

The National Covid-19 Emergency Response Center (NaCOVERC) says it has revised its approach to focus on providing access by reaching out to the people, rather than expecting them to turn up at designated centers.

With this new approach, the Center is targeting special interest groups like transport unions, the teachers union and religious establishments. A pilot phase of this approach has already seen long queues at mobile vaccination centers in parts of the country.

Harold Thomas, Risk Communication Lead at NaCOVERC, says they also found out that people are more inclined to take the vaccine when their leaders take it.

“We were dealing with some mosques in the Lumpa area around Waterloo. And when the Chief Imam for a cluster of mosques took the vaccine, every Friday since then, the least we have is 500. And more and more mosques are requesting for the service. So this means that the problem now is not hesitancy, but it’s access. If we provide access a good number of them will take it on their own freewill,” says Thomas.

Data from NaCOVERC indicates that only about 500, 000 people have received at least one does of a Covid-19 vaccine. Of this, only about 140, 000 have had the full dose.

NaCOVERC officials says this gap in the number of people who have taken the first and second doses emphasizes the urgent need for the access approach.

In the early days of Sierra Leone’s vaccination programme, a lot of people rushed to take their first dose when a policy requiring proof of vaccination to access government buildings was imposed. Thomas admits that they focused too much on the first doses.

Stockout of vaccines, particularly AstraZeneca, also contributed to the situation.

The NaCOVERC says it is expecting more vaccines and that it intends to expand the programme when they are available.

When Sierra Leone started its vaccination campaign back in March, it had only two types of vaccines – AstraZeneca and Sinopharm. There are now two more types – Johnson and Johnson and Pfizer.

Unlike the others, the Johnson and Johnson vaccine requires just one dose for full immunity. And officials hope that this will help in increasing the number of fully vaccinated people in the country.

In May, the World Health Assembly set up a goal to vaccinate 10 percent of every country’s population by September 30. Only 15 African countries met that target. Sierra Leone is one of the 37 countries that failed to meet it.

Some 4.8 million people [18 years and above] of Sierra Leone’s approximately 8 million population are eligible for the vaccines. The country’s revised Covid-19 vaccination goal is to vaccinate 20% of this by the end of 2021.

Some countries have done so well with their population above 18 years that they are reducing the age limit to 12.

But NaCOVERC says its focus remains on the 18-years-and-above bracket.

Healthcare workers have performed the best in Sierra Leone, with 65 percent having received at least one dose, according NaCOVERC data.

Sierra Leone is doing poorest with the age group 60 years and above. This prompted a recent public appeal by NaCOVERC urging people who have family members within that age bracket to bring them forward for vaccination. It even made available its emergency toll- free line - 117 - for families to request for home service.

A policy requiring people to provide proof of vaccination to access entertainment centers hosting large groups of people at a time is also in force.

Even though NaCOVERC officials say hesitancy is no longer a serious barrier, it obviously remains an issue, despite massive public education over the months. And the concerns include the effect of the vaccine on fertility, pregnancy and people with co-morbidities.

These are all common concerns across the world, even in the developed world.

Seventeen-year-old Blessing T. Massaquoi, a student in the southern Pujehun District, feared the prospect of getting sick from taking the vaccine. She said her fears were due to news she got on social media.

She only recently summoned enough courage to take the jab after an educative encounter with social mobilizers from the Kombra Network.

“People, including myself, were afraid because we heard that you could get sick by taking it. But since I took it now, I have not felt anything bad. So I want to encourage my fellow women to take the vaccine,” she said, waving her vaccination certificate.

The United States Centers for Diseases Control and Prevention (CDC) recommends for vaccination of pregnant women. In its advisory, updated in August, it says:

“COVID-19 vaccination is recommended for all people 12 years and older, including people who are pregnant, breastfeeding, trying to get pregnant now or might become pregnant in the future. Evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy has been growing. These data suggest that the benefits of receiving a COVID-19 vaccination outweigh any known or potential risks of vaccination during pregnancy.

“There is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems in women or men. Pregnant and recently people are more likely to get severely ill with COVID-19 compared with non-pregnant people.”

While WHO doesn’t call on member countries to vaccinate pregnant women, it doesn’t rule it out either.

The policy of NaCOVERC appears to align with that of the global health agency. But as Dr Sesay explains, it has nothing to do with safety issues.

“The Covid vaccines are all safe for everyone, including pregnant women and lactating mothers. But the current position of the technical working group is to leave pregnant women out for the time being, for the simple reason that pregnancy is a very delicate process. There are a lot of instances of miscarriages, and we do not want a situation wherein someone gets a miscarriage and attributes it to the vaccine,” he says.

Rumours of expired vaccines and reports of episodes of side effects from the vaccines have also fuelled these fears. The public concerns reached a crescendo in July when a woman died shortly after taking a Covid-19 vaccine.

But Dr Sesay says all reported reactions to the vaccines have either been the usual episodes of fever and headache, or coincidental health issues resulting from infections from other diseases like malaria.

“Vaccination doesn’t necessarily mean an end to other sicknesses. You may be sick with typhoid, for instance, malaria, diabetes, hypertension and all of that. So when in this situation people take the vaccine and coincidentally they feel sick, they easily attribute it to the vaccine, which is usually not the case,” he says.

He stressed: “Over 550, 000 doses of the vaccines have been administered in Sierra Leone, to Sierra Leoneans. That is more than 10 percent of the people of this country. I think that in itself is a level of assurance of the safety of the vaccines.

“If you are taking a two-dose vaccine, go back after the time given to you and get the second dose, because it is the only way you can get the full immunity against Covid infection.”

The author is the National Coordinator of the Kombra Media Network, a member of the Kombra Network.

Copyright © Politico Online 25/10/21

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