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COVID-19 VACCINE ROLLOUT DILEMMA

08/02/2021 09:24:00 BY NTOMBI MHLONGO

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MBABANE – Where will the ordinary man on the street get their first dose of the COVID-19 vaccine?

For now, the answer to the above question remains a dilemma.

As the nation awaits with bated breath for the arrival of the COVID-19 vaccine, more questions on the country’s readiness for the rollout exercise remain unanswered.

This is because, despite the Ministry of Health having presented the country’s phased approach for the vaccination exercise, there has been less information on the readiness of the selected centres or sites to be used for the process.

In actual fact, government has not come out to state whether it will use the available hospitals and clinics as vaccine centres or will create special sites for the vaccination exercise.

During the presentation of the rollout strategy, Minister of Health Lizzie Nkosi reiterated that the Kingdom of Eswatini was a participant of the COVAX Facility through which it was expecting to receive 20 per cent of the population’s vaccine doses. The minister stated that about 108 000 indicative doses of the AstraZeneca vaccine were expected in the kingdom by mid or late February, subject to finalisation of logistics on the ground from various stakeholders involved in the distribution of this vaccine.

If the words of the minister are anything to go by, by the end of the month, which is in less than three weeks time, the vaccine would have been delivered.

Worth noting is that phase two of the rollout process, according to the minister, is expected to accommodate the elderly population of 60 years and above, and people living with comorbidities which make them more vulnerable to fatalities.

Most of the elderly live in the rural areas and in communities where healthcare centres are kilometres away.

This, therefore, begs the question whether government will consider bringing the vaccination sites or centres closer to them, a strategy that has already been adopted by other countries.

In neghbouring South Africa, the Eastern Cape provincial government announced last week that it was considering using schools when the coronavirus vaccine is being rolled out.

According to the TimesLive publication, it was stated that analysis done on more than 5 000 communities in the Eastern Cape test positive for the coronavirus, a predicament which is also faced by a fair share of local citizens.

Guidelines

Meanwhile, other countries have not only set up COVID-19 vaccine centres, but even prepared guidelines and procedures to be followed when setting up such structures.

For example, according to an operation framework prepared by the NHS in the United Kingdom titled ‘COVID-19 Vaccination Centres: Operating Framework’, a vaccination centre must appoint a clinical lead and operational lead responsible for the delivery of all aspects of vaccination centre services.

The framework outlines that once a site is approved to become a vaccination centre by the regional and national teams, the vaccine centre management will need to set up an account on the national reporting tool

“Sites will need to complete a site security risk assessment as part of their preparation for readiness. Providers should ensure that their vaccination centres are accessible to all members of their community and take reasonable steps to improve access and reduce potential inequalities for people eligible to receive vaccinations. This includes having access to translation and interpretation services as required to support consent, mental capacity and clinical assessments,” reads part of the framework.

Providers should be prepared to respond to three possible medical emergencies associated with vaccination: Fainting, Hyperventilation, and Anaphylaxis.

In an interview with Swaziland Democratic Nurses Union (SWADNU) President Bheki Mamba, he said they believed that to ensure the exercise covered all citizens of the country; it would make sense to use the same format that has always been used for other vaccination exercises.

“We will follow the old format, it won’t be different. This means that for healthcare workers, the hospitals will be used. Then during the second and other phases where the public will be vaccinated, centres will be stationed in all parts of the country. We will use what we refer to as outreach centres,” he said.

Mamba said the outreach sites will be a must since there are areas where clinics are far from the people, especially the elderly, who would have challenges in reaching them.

“So obviously we will need to make use of imiphakatsi and even schools because the aim is to ensure that all citizens are vaccinated. Even gogo centres, we expect that they will be used as has been the case when vaccinating children,” he said.

Mamba said they expected government to have a proper strategy in place for the exercise as there will be a need for the provision of transport.

He said it will not be ideal to use hospitals and clinics alone for the vaccination exercise as they would be flooded and end up becoming breeding grounds for the spread of COVID-19. “We have to avoid a situation where people cram hospitals because some of them are sick and this will spread the virus. You can’t then say the elderly should go to hospitals to get the vaccine. Rather try and reach them where they are. We know that there is no other way that can be used.

“If you want to reach the people, use all available spaces. We hope by the time the vaccine arrives, our government will have prepared well by providing fuel, cooler boxes for the doses and other resources so that the process can be effective,” he said.

Conspiracy

On another note, Mamba warned the public against believing conspiracy theories around the vaccine and said they should just accept it in order to save their lives. He said the COVID-19 vaccine was no different from others that have always been used.

Mamba said when travelling to countries such as Uganda and Zambia, travellers were expected to vaccinate against yellow fever and said it would be the case with the COVID-19 vaccine.

He said there would come a time where people will have a problem crossing from one country to another if they have not vaccinated against COVID-19.

Meanwhile, Director of Health Services Dr Vusi Magagula said government will inform the public in due course on where people would be vaccinated.

He said government wished to have the vaccine at all the country’s tinkhundla centres, but that such would be costly.

“We will explain to the people. That is coming. The reason we have to think hard about using the outreach centres is that there are usually logistical problems like shortage of cars and fuel. We will be updating the public now and again, but for now we are waiting for the vaccine to arrive,” Dr Magagula explained.