Vaccinations are in full swing. Despite having second thoughts about taking the Covid-19 vaccine, Sri Lankans are now running after the vaccine, especially after seeing the horrifying situation in neighbouring India. Not only that; the daily toll of Covid-19 cases of Sri Lanka has escalated to several thousand, implying the importance of the vaccine.
Vaccination program
In contrast, this comes along with many unpleasant stories of trying out and popularising irrational methods to prevent the virus. Of course, in the absence of a scientifically developed remedy; the vaccine, it is quite natural that people tend to go after myths, while some opportunists get the maximum yield of the situation.
Sri Lanka rolled out its vaccination program in late January this year, with India gifting 500,000 Oxford-AstraZeneca (Covishield) jabs. Following the donation, the Government placed an order to purchase 10 million doses of AstraZeneca vaccine from the Serum Institute of India for US$ 52.5 million, according to ‘The Hindu’ newspaper. Thus, Sri Lanka received its second batch of vaccines in late February, (the first batch of purchased vaccines) from India. A few weeks after Sri Lanka received another 264,000 vaccines as a donation under the COVAX program in early march (COVAX has promised to provide 8.4 million vaccine doses to cover 20% of Sri Lanka’s population).
At the end of March, the island nation received 600,000 Sinopharm vaccines, the Chinese jab developed against the pandemic. At the initial stage, it was only given to the Chinese workers residing in Sri Lanka, as it had neither received WHO nor NMRA (The National Medicines Regulatory Authority) approval. However, following the domestic surge of the pandemic, NMRA gave a nod for the Chinese vaccine, followed by the WHO approval for emergency use.
The SPC had placed an order for 13 million doses of Sputnik V vaccine from Russia’s Gamaleya Institute. As a result, 15,000 jabs from Russia arrived on the island in early May. As Dr Prasanna Gunasena, the Chairman of State Pharmaceuticals Corporation told media, the SPC hopes to bring 600,000 jabs of Sputnik V in May, while another 800,000 consignments from Russia to be received later.
Throughout the vaccination program, special attention is given to those who are in the frontline of the battle against the virus. In the second round, the people who are above the age of 60 years (in some parts people between 30-60 years also received the jab) were given priority, especially in the Colombo metropolitan area. Currently, the focus is on the Western Province which has a high density of population and the greatest number of Covid cases. Once the vaccination program in the Western Province concludes the Ministry of Health plans to execute the program next in Kandy, Kurunegala and Ratnapura districts.
Top officials of the World Health Organization (WHO) and several local experts on the subject met last week to analyse and to ‘brainstorm’ about the island’s situation. Following the meeting, the WHO Sri Lanka office in a news release mentioned the following;
“Vaccines will be crucial to controlling the epidemic in the medium-term but will not address the immediate crisis we now face. Some vaccines are only effective after the second dose. Therefore, it will take a minimum of 6-8 weeks to see the effects of vaccination in the number of new cases”
Officer-In-Charge, WHO Sri Lanka, Dr Olivia Nieveras, Prof. Malik Peiris, Chair/Professor, School of Public Health, Faculty of Medicine,University of Hong Kong, Hong Kong, Professor and Head, Department of Immunology and Molecular Medicine, Sri Jayewardenepura University, Prof. Neelika Malavige, Past President of the College of Physicians, Dr. Ananda Wijewickrama and President, Sri Lanka Medical Association, Dr Padma Gunaratne were present.
The second dose dilemma
According to the statistics of the Epidemiology Unit of the Ministry of Health, 256,004 people have received both doses of Oxford-AstraZeneca vaccine as of last Saturday whereas, 669,238 are yet to receive the second dose. Meanwhile, 2,435 people have received both jabs of Sinopharm and 276,762 have gotten the first dose. 14,673 jabs of Sputnik – V have inoculated and the rollout of the second jab is yet to begin.
While the Government is also eyeing importing about 5 million doses of Pfizer vaccine as well, the public is more attentive towards the Government’s solution on how to give the second dose of AstraZeneca to those who took the first dose. The clock is ticking as it has now been 13 weeks since the jab was given to the general public.
Yet, the Indian media reported last week that the ‘Immunisation Panel of India’ has recommended increasing the interval of both doses of Serum Institute’s Oxford-AstraZeneca vaccine to 12-16 weeks. Earlier the interval was stated as 4-8 weeks.
Realising that Sri Lanka cannot rely on India’s Serum Institute to supply the much needed 600,000 consignments of AstraZeneca, following the emergency in India, the Government of Sri Lanka has now asked other nations and even pharmaceutical agents to secure the needed amount.
When contacted, the Army Commander and Head of the National Operation Centre for Prevention of Coid-19 Outbreak (NOCPCO) Gen. Shavendra Silva said that the Ministry of Health and SPC is in touch with all medical suppliers to procure all vaccines, not just AstraZeneca covishield.
 Getting ready to give the jab |
“About the AstraZeneca second dose, we have informed our requirement to the Serum Institute of India and also various other countries. Because other countries are manufacturing the same vaccine. And not only countries but there are even agents for AstraZeneca. We have contacted them all. However, the Ministry of Health and SPC who are authorised to bring vaccines to the country, are in touch with these groups,” the Commander said.
The Government is now awaiting another consignment of 185,000 Sputnik V jabs from Russia., whereas another 400,000 vaccines within 10-14 days and another 800,000 vaccines in July to be received, he said.
By last Saturday, about 300,000 people had taken the Sinopharm vaccine. However, the Government is yet to sign an agreement with China to import more vaccines. “We are in touch with the authorities in China and there are some agreements to sign yet. We are hopeful, but we have not yet been given an exact date of the next shipment of Sinopharm” he said.
The Covax program which was launched to establish a systematic delivery of vaccines is also facing major issues due to the low supply and high demand for the Oxford-AstraZeneca vaccine.
“We cannot tell the exact date until we receive it. Because there is a huge demand for the vaccine” the State Minister of Primary Health Services, Pandemics and COVID Prevention, Dr Sudarshani Fernandopulle told the Sunday Observer on Saturday.
“We have funds and we are trying our best to get it. One or two-week delay would not cause a problem because once you get the booster the immune system will respond,” she said.
Keeping it or not?
Sri Lanka has received several grants to strengthen the vaccination program and pandemic response. The Government and the World Bank signed an $80.5 million supplementary financing to help Sri Lanka access and distribute COVID-19 vaccines. Also, Japan’s JICA signed a bilateral agreement with the Ministry of Health to provide some crucial medical equipment.
As of now, Sri Lanka has received 1.2 million doses of Oxford-AstraZeneca in total, which is sufficient for about 600,000 people to get fully vaccinated. However, trusting the assurance given by the Serum Institute of India‒ the vaccine manufacturer‒ Sri Lanka continued the vaccination program exceeding the 600,000 limit. As a result, 925,242 people have received the first dose, when the Serum Institute stated that they have to temporarily hold the exports, following the pandemic outbreak in India. The Government is still finding a way to procure over 600,000 AstraZeneca vaccines to give the second dose to the rest of the people.
After the Indian vaccine, the largest vaccine batch (600,000) Sri Lanka received was from China, whereas it had been given close to 300,000 people as of Saturday morning. When asked about the readiness of the government to limit the first dose to only 300,000 people, by which the second dose can also be given to the same people without a delay, the Sunday Observer learnt that Dr Fernandopulle also believes so.
“Until we have vaccines in hands, we have to keep vaccines for the second dose. That is what I told the Epidemiology Unit about the Sinopharm vaccine. Basically, we have to keep vaccines for the second dose until we get the next batch,” she said.
However, she was not aware of the methodology followed by the epidemiology unit with regard to the vaccination. Also, she was not aware whether another batch of Sinopharm is also on the way or not.
“But I told them to have the vaccines in hand. Because we have to give the second dose of Sinopharm in four weeks,” she said.
Responding to the same query, the Head of NOCPCO General Shavendra Silva said that SPC has got the assurance of receiving another batch of Sinopharm vaccine. Accordingly, the Government has decided to continue the vaccination program exceeding the 300,000 mark.
“This issue was discussed at the last briefing we had with all stakeholders which was presided by the President. There itself, SPC Chairman got the assurance from authorities that we are almost getting it (the second batch of Sinopharm). With that confirmation the President instructed to go ahead without keeping vaccines stored” he said.
The acceleration
In the wake of the horrendous third wave of the pandemic, the demand for the Covid-19 vaccine has turned out to be the only solution, other than the general Covid prevention guidelines such as Social Distancing, Wearing Masks and Sanitising Hands. Due to this high demand of the vaccine, President Gotabaya Rajapaksa has personally instructed the Head of NOCPCO, General Shavendra Silva to deploy the tri-forces to advance the vaccination program.
“President Gotabaya Rajapaksa is a leader, one out of a very few who said that vaccination is the key thing regarding Covid-19. Therefore, he is keen that we have an accelerated program for vaccination. Initially, the Ministry of Health was vaccinating 2,500 to 3,000 maximum people per day. President personally spoke to me and said that it’s not going to work, if we continue at this speed”, General Silva said.
“The tri-forces have helped in vaccinating about 65,000-70,000 people per day. The Army and Army Seva Vanitha unit sponsored the putting up tents and other logistic facilities. MoHs have been very appreciative of our support,” he said.