Inoculation Gathers Pace In Nepal

Nepal has entered into the second phase of Covid 19 vaccination from March 7. Prime Minister KP Sharma Oli along with the first lady Radhika Shakya were inoculated with the covid vaccine at the beginning of the campaign. The vaccination campaign for 65+ years population is gathering pace notably after Prime Minister Oli set an example, being someone who has been through two kidney transplants. According to the Ministry of Health and Population (MoHP), around 700,000 people were inoculated till March 10. “It is because people are confident about the vaccines as inoculated people have not reported any side effects and also because of the increased number of vaccines centres,” states Jageshwor Gautam, Spokesperson of the MoHP. Currently, the vaccination drive is being conducted through 3,000 vaccine centres across the country with at least one vaccine centre ensured at each local level. However, only 184,857 took the jab in the first phase while the government has expected 430,000 to be immunised in the period between January 27 to February 6. According to the MoHP, 24,224 people took the jab in province 1, 25,636 in province 2; 63,308 in Bagmati Province; 18,372 in Gandaki; 28,941 in Lumbini; 9,420 in Karnali and 14,855 in Far West province in the first phase. There were only 222 vaccine centres in the first phase and 3.9% of the population are immunised, according to MoHP. Though the country has launched the immunisation campaign exactly a year after the first case of Covid 19 infection was reported in the country, the vaccine program did not gain the traction as anticipated even from frontline health workers who expressed reluctance to get vaccinated. The government then decided to inoculate journalists, staff of diplomatic missions and financial institutions, officials at local and provincial governments and elected representatives of provincial and local governments in the first phase that was conducted from January 27 to February 6. Nepal has received one million shots of the vaccine from India in donation and the country has already purchased another one million shots with plans to purchase an additional million doses from India in the immediate future. Northern neighbour China has promised 800,000 doses of vaccines. The government of Nepal has already granted emergency-use approval of a vaccine developed by an affiliate of China’s Sinopharm last month. In a recent meeting with the Finance Minister Bishnu Prasad Paudel, Ambassador of PRC to Nepal, Hou Yanqi has signaled that the government of China might grant additional shots of vaccines once the promised 800,000 doses of vaccine are consumed by Nepal. Nepal ranked among the top 10 countries for vaccination in relevance to population size. Seychelles, a country in East Africa is at the top of the inoculation campaign with 59% of its population vaccinated. Israel has immunised 56.2% of its population. The UK has provided vaccines to 33.7%, the United States to 18.1% and India to 1.4% of its population so far. The vaccine that Nepal has been using is developed by Oxford-Astra Zeneca and is produced by Serum Institute of India. It is a herculean task for countries to inoculate all their citizens in terms of carrying out the vaccine outreach program when production is limited and the demand is enormous. Currently there are six types of vaccines available globally: Russian sputnik-v, Moderna Covid 19 Vaccine (mRNA-1273) of the USA, Pfizer-BioNTech Covid 19 Vaccine (developed by the US and German companies), BIBP-CorV and Ad5-nCoV of China developed by Sinopharm and CanSinoBio, respectively. The Ministry of Finance has ensured Rs 40 billion for the purchase, supply and inoculation of vaccines to the MoHP. The mid-term review of the fiscal budget 2020-21 has realigned the priorities of the budget for inoculation of all citizens (pregnant women and children are excluded from vaccination considering the clinical trials have not included such samples) free of charge. The Minister for Health and Population Hridayesh Tripathi has said that if the vaccines are easily available for purchase, the country might complete vaccination for all of its citizens within three months. Nepal has purchased vaccines with Serum Institute of India at $4 per dose. Talking to Business 360, Minister Tripathi said that the vaccination drive will not be obstructed without accomplishing the objective of vaccinating all citizens. Nepal, while beginning its second phase vaccination drive on March 7, has received its first consignment of Covid 19 vaccine doses shipped through the COVAX facility, a partnership between CEPI, Gavi, UNICEF and WHO, made possible through generous donor support from governments, international organisations, foundations and the private sector. The delivery of COVAX-procured vaccines to Nepal is part of a historic step towards ensuring equitable distribution of Covid 19 vaccines globally, in what will be the largest vaccine procurement and supply operation in history. The goal of the COVAX facility is to supply Nepal with enough doses to vaccinate 20% of the population depending on funding availability. Under the first COVAX allocation, the COVAX Facility will deliver 1.92 million vaccine doses to Nepal by the end of May 2021 in support of the Government of Nepal’s nation-wide vaccination campaign. The first COVAX shipment of 348,000 doses of AstraZeneca ‘Covishield’ vaccines manufactured by the Serum Institute of India (SII), together with 350,000 syringes and 3500 vaccine safety boxes arrived in Kathmandu on March 7 before being distributed to provinces and municipalities across the country. COVAX-supported vaccines provide a critical contribution to the Government of Nepal’s National Deployment and Vaccination Plan (NDVP) target to vaccinate roughly 22 million people, among them refugees, migrant returnees and other migrant populations. The COVAX facility is funded by partner governments including the governments of Australia, Finland, France, Germany, Japan, Korea, Norway, Qatar, Saudi Arabia, Switzerland, the United Kingdom, the United States and the European Union as well as foundations and corporations. The arrival of the COVAX supplied vaccines helped in boosting Nepal’s vaccination efforts as it coincides with the launch of the second phase of the vaccination campaign which targets those who are most vulnerable to developing severe illness from Covid 19 including the elderly and people with comorbidities. The second phase has also targeted teachers, as part of the expanded group of frontline workers. Jageshwor Gautam, Spokesperson of the MoHP has said that a single vial is sufficient to vaccinate 10 people, this is why it requires at least 10 people at once to vaccinate in each vaccine centre to properly utilise the scarce vaccine. “If the vial is opened for emergency use then we’ve asked the health workers to inoculate people of eligible age rather than dumping that vaccine in the absence of 65+ years people at that time,” said Gautam. The country has set the priority to vaccinate people in different phases. Front line health workers, female health care volunteers, garbage collectors, drivers of the ambulances, security forces involved in management of deceased (due to covid-19 infection) bodies, staff of the international airport, private sector, diplomatic missions, non-governmental organisations and frontline public utility service providers are given top priority. Likewise, journalists and staff of banking and financial institutions were given top priority. Second phase of the priority 1 has included elderly people (65+ years), prisoners and security personnel of the prison as well as people living in old age homes and their caregivers. Priority 2 (second priority) includes people in age group of 55 to 64 years, and those suffering from the chronic diseases irrespective of their age (defined chronic diseases are chronic obstructive pulmonary diseases, severe asthma organ transplantation, cancer, chronic kidney diseases, serious heart condition, diabetes mellitus, sickle cell anemia). Likewise, people returned from the foreign countries including migrant workers and refugees.  The country will make inoculation easily accessible to the age bracket of 40 to 54 years after launching a vaccination drive for the third priority category and then everyone above 15 years. In mid February, Isarel became the first nation to implement a domestic vaccine certification system which allowed the vaccinated persons to access gym, restaurants and public events. The format may be replicated worldwide for international air travel. China recently introduced ‘vaccine passports’ to boost domestic and international travel. The EU and United States are contemplating their own certification platforms. Flyers on Singapore Airlines will be able to use a mobile app to verify their Covid 19 test results and vaccination status as the national carrier becomes the first airline to test the International Air Transport Association’s Travel Pass. The trial will begin from Singapore to London between March 15 and March 28. Digital certificates or health /vaccine passports will be the new norm for international air travel. There is no common format as yet and definite lack of uniformity across jurisdictions in requirement and issuance of proofs of vaccination which makes it a complicated solution. There are also concerns about data protection and individual privacy. We cannot also forget that the vaccination is not compulsory, so discriminating people on this basis will have ramifications.