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We are on track to hit Covid vaccination target - official
Dr Alfred Driwale, the head of immunisation programme at the Ministry of Health. Photo | Promise Twinamukye
What you need to know:
- . Dr Alfred Driwale, the ministry’s head of immunisation programme, spoke to Daily Monitor’s Tonny Abet about the key achievements, challenges and next plan as the country races to vaccinate at least 21.9m Ugandans to reverse the ravaging pandemic.
The Ministry of Health launched the national Covid-19 vaccination exercise on March 10 after receiving 964,000 doses of AstraZeneca vaccine from the global sharing initiative, Covax facility, and the Indian government. Dr Alfred Driwale, the ministry’s head of immunisation programme, spoke to Daily Monitor’s Tonny Abet about the key achievements, challenges and next plan as the country races to vaccinate at least 21.9m Ugandans to reverse the ravaging pandemic.
What were the targets for Covid-19 vaccination and how far have we gone towards achieving them?
The vaccination exercise so far is on course with our original plan. The plan was to spend the vaccine on healthcare workers, teachers, people who are 50 years and above, people with co-morbidities and essential workers who are at high risk of Covid-19 infection. The other groups we considered are lawyers, journalists and truck drivers and they are getting the jab.
We have used more than 70 per cent of the 964,000 doses of the AstraZeneca vaccine. In terms of absorption, we are on course and in terms of targeting, we are happy and more importantly, in terms of awareness and public response in the past few weeks, it is excellent.
If things are progressing well, why are you withdrawing vaccines from some districts?
We are taking this action to balance demand, which is low in some districts, with the risk of expiry. We are moving the stock towards Kampala because we are seeing large numbers of cases here.
We know there are old people and high-risk groups in those districts. But these vaccines have a lifespan, and so if people are not using them, we are going to take them to places where people want them. I am happy that as soon as we sent the message that we were going to withdraw vaccines, there are many districts that have now woken up and they are putting out very impressive performance [uptake of vaccine].
What caused the low uptake of vaccine in the districts and how did you help them to address?
The low uptake of vaccine was due to poor organisation. We have progressively been increasing the number of vaccination points to reach more people so that the service points are nearer to people and there is increased access.
Experts have been complaining that sensitisation for the vaccination drive was poor and that this could have caused the low uptake.
The only method we have been using was through radio, but not every district has a radio station. But for me, the most effective approach to mobilisation is meeting people [a task force] at village levels and you sensitise them and they go and sensitise other people in their community. This normally works very well like in the previous immunisation campaigns we had.
Have religious and political beliefs contributed to low uptake in some areas?
No, there seems to be no organised resistance against the vaccination campaign from religious or political sects. We have been vaccinating religious and cultural leaders in the country. Religious leaders and places of worship have greatly helped us to mobilise people. For the political sphere, we vaccinated the entire Parliament [all Members of Parliament], including the new ones. We have vaccinated the Kabaka of Buganda and the Queen in public. This was also done in the Tooro Kingdom. We are meeting cultural leaders to boost the mobilisation of people for the vaccination.
How did social media misinformation affect the vaccination exercise?
What I have seen in the country is that individuals are being tormented by social media because “infordemics” is one of the features of this pandemic. There is social media terrorism to a point where people greatly fear taking a vaccine. But I have seen mainstream media having very exceptional support for the vaccination exercise. This kind of support was not there in the previous immunisation campaigns.
What’s your position on the move by employers to force workers to take the jab?
Making Covid-19 vaccination voluntary is different from making it optional. Making the vaccination voluntary means we want you to have informed consent. If your employer insists that you get vaccinated, then that is the right employer. Because in your workplace, there are many people and he is mandated to protect the workers. Crowding increases risks of Covid-19 infection and the alternative would be to close the workplace if people refuse to take the vaccine.
Schools are closing because young learners, who have not been considered as a priority group in the first vaccination drive, are getting infected. What’s the plan for vaccinating young people?
One of my points in the vaccination exercise was that young people are being infected by Covid-19 than old people [because of our population structure which is dominated by young people]. But old people are being targeted for vaccination because they are at the highest risk of severe Covid-19 and death. But also, we appreciate that most of the infections among young people end up as asymptomatic disease but these people continue driving the spread of infections. So, [in the first and second wave of the pandemic], younger people had most of the Covid-19. When we see young people admitted to Covid-19 wards with Covid-19, that should be put to a scientific test [to determine the significance in relation to how many of them have the disease]. I don’t want to talk much about that yet.
… but now as the vaccine proves safe for adults, studies are now being done to determine whether the Covid-19 vaccines are safe and can work for children and this is expected to be out soon.
The vaccine doses are getting exhausted. What is the next plan?
The vaccines must get finished. Now we are working on a scheme of giving people the second doses and we are expecting those vaccines to arrive in the country in June [this month] but we are yet to confirm the date and the quantity. We are in touch with manufacturers of the Johnson & Jonson vaccine and there is good progress because we already expressed interest. But I cannot share more details as of now. All this takes processes and we can’t promise today and deliver the vaccines tomorrow.
The vaccines are also expected through the Covax facility, the African Union and other methods that exist to acquire vaccines. There is a global shortage of Covid-19 vaccines and Uganda is not the only country which is affected.
When are you receiving 300,000 doses of vaccine from China?
China had promised to give us Sinovac, which had not been approved. So when we asked them to give us Sinopharm, which had already been approved by WHO, they said the demand for it had gone so high and that we needed to wait for Sinovac. [WHO reported in the evening after the interview that they have approved the Sinovac]. When WHO approves, then National Drug Authority will need to review the data and also approve the vaccine for use in the country and we shall accept the donation.
Those who already received the first dose of AstraZeneca are concerned about mixing different types of vaccines especially as government plans to bring Johnson and Johnson. What is your take on this?
We need to balance the reality of international demands, which has caused a shortage of the vaccine type we wanted with the internal processes. Internally, we need to build consensus that these are the vaccines we will use in Uganda.
AstraZeneca vaccine is not there to meet the global demand. So, we can’t tell when Uganda will be able to get more doses of the AstraZeneca vaccine.
So about mixing the Astrazeneca vaccine with Johnson and Jonson in a person, there are people who are doing research on it. And when the research is over, World Health Organisation will review and give a recommendation.
What’s the rationale of vaccination, if some people still get infected and recipients are told to continue observing SOPs?
But the vaccine works from between 12 and 21 days after vaccination. So you can get infected within the few days when you have just got the vaccine because your body is still building the immune response as triggered by the vaccine. The body requires time to do this. If you get infected, don’t say vaccines don’t work. You need to protect yourself more jealously within that time when the body is mounting immune response. The vaccine efficacy is not 100 per cent in stopping Covid-19. This is because not everyone’s body will build immunity. For this matter, whether you are vaccinated or not, you have to continue wearing masks, sanitising and social distancing.
There was a suspected case of death after the Covid-19 vaccination in the country. What did your investigations find?
It is normal for people to die, during or after vaccination because this had always been happening before vaccines came. There are people who died after vaccination and found that they died due to other diseases. After vaccination, if you have abnormalities, you have to come to us and we have a team who will handle you.
We have investigated more than 100 such complaints. Some people say they were vaccinated but their toe is now rotting, but when they are examined, you discover that the person had diabetes and he didn’t know. The rotting is called a diabetic foot and has nothing to do with the vaccine.
Tell us about the challenges in vaccine storage and how the absence of ministers in office could be affecting the drive.
We have one of the best vaccine supply chains on the continent. We have not had any problem with the storage of the vaccine in districts. Our outgoing [health] ministers are scientists, so they are always in meetings with us. But the permanent secretary is feeling the gap well.
