Editorial Comment: Need for more incentives to vaccinate

Source: Editorial Comment: Need for more incentives to vaccinate | Herald (Opinion)

Zimbabwe’s preliminary Covid-19 vaccination target is 10 million people, using 20 million doses, to meet the lowest estimate for herd immunity, although that target might well have to be increased significantly considering the likelihood of new variants and the need to vaccinate teenagers.

It was hoped that this total could be reached by the year end, with the supply chains that were secured by July and the growing ability of vaccination teams from that time to cope with ever more people coming forward each day. 

Unfortunately ever more people are not coming forward and last week only 75 000 turned up for their first dose, and so entering the programme, with the number of newcomers falling continually and steadily since the third week of August when 265 333 joined the queues for their first shot. 

Eventually those who queue up for their first shot come back, even if some are a week or two late, for their second shot to become fully vaccinated so our weekly dosage rate has not slumped so badly, although it still fell to 190 328 last week. 

Right now with just over 3,1 million Zimbabweans having had their first shot and just over 5,4 million of the more than 12 million doses delivered actually given out we are falling behind our targets quite dramatically. 

By this stage we should be giving at least three times as many jabs each week and if the demand was there we should be managing four times. 

The problem centres on a reluctance of people to come to come forward. We have the vaccine doses in stock, with just last week our first shipment, well over 900 000 doses, coming in from the Covax facility set up to help developing countries ensure supplies, although Zimbabwe as one of the few African countries ready and able to buy its own was already assured of supplies.

The Ministry of Health and Child Care assigned a lot of extra staff to the vaccination programme and opened it up to approved private practitioners and pharmacies, who unlike the public system are allowed to charge a small dispensing fee for the free vaccine of around $400. 

Most offering that service are charging between US$3 and US$5 converted at the prevailing rate.

While all vaccines are free, and while the bulk are dispensed for free through the public hospitals, clinics and vaccination points, those who really do not want to queue can pay a trivial sum to get their vaccination on demand. So there is really no reason why someone should wait.

With the Government now taking over the urban clinic staff from the municipalities one bottleneck will be eliminated. Some council nurses have been keeping the number they are prepared to inject each day very low, partly because of gross under-staffing admittedly. 

But with vacancies being filled at urban clinics and staff paid on time, we assume far more people can get their shots each day.

Everybody reads the anti-vaccination social media messages, and one steady strand of fake data is the death rate from vaccines. The actual figures in Zimbabwe show these up as a lie. There have been 96 adverse reactions from the 5,4 million doses that needed medical attention, that is 0,0018 percent. 

More importantly a maximum of two people may have died from the vaccine. Four people did die soon after being vaccinated, and obviously the medical authorities were very particular about investigating these. 

The first two have been found to be coincidental, that is the vaccination had nothing to do with the death. In other words, they would have died anyway. They were people with an untreated chronic complaint.

The other two are still being investigated. This is not an instant process since it requires looking at the person’s medical history and the precise symptoms exhibited, and then at the results of the post-mortem. 

It may be that they too died coincidentally. But even if the side effect of the vaccination was a factor, two out of more than 5 million is a tiny, very tiny, percentage. They had more chance of being killed if they had been in a kombi rather than standing in the queue.

Besides the 96 there were others who felt discomfort for a few hours or a day, nothing dramatic or needing medical attention, although sensibly most of them made the phone call for reassurance. 

But again almost everyone who has been vaccinated did not even have this discomfort. 

One reason for the very low percentage of side effects is the types of vaccine selected. Zimbabwe opted, for several reasons, for the inert vaccines. 

These were available, since the Chinese suppliers were prepared to sell them to us and the Chinese Government, unlike some countries, which include the US, were prepared to allow exports.

But the inert vaccines are also inherently safer than the live vaccines so common in Europe and the Americas. The live vaccines are a genetically engineered version of a harmless virus, one actually being a chimpanzee virus, the genetic engineering being the splicing in of a portion of the Covid-19 virus into the vaccine virus. 

The vaccinated person is then infected with this modified virus to generate the anti-bodies. The inert vaccines use the protein coat of the real virus, without any virus at all, to get the body to generate anti-bodies.

The only reason why some companies went for a live vaccine was because they are usually more effective, although studies show that with Covid-19 this advantage is very small. 

A final reason for using the inert vaccines is that they can be stored and carried in the sort of fridges and bags we already have everywhere for that collection of vaccines we give all children. We did not have to buy the ultra-cold freezers needed for most live vaccines.

Some private health experts want the Government to do more to encourage people to stand in line. It is difficult to see what more can be done. 

Free vaccines freely administered with all Government leaders, from President Mnangagwa down standing in line near the beginning to show how easy and safe it was surely a good start. 

The Government then ruled that all civil servants must be vaccinated by the end of next week, or in effect face suspension without pay and possible disciplinary action. 

The fact that there was no sudden surge in vaccination suggests that most were already fully vaccinated or just waiting for a second shot. Many companies are also encouraging staff to be vaccinated, but again most have been done.

It appears that the reluctance is in the informal sectors, although special efforts to get the vendors at major markets vaccinated were successful. 

But perhaps we need something like allowing vendors a bit more legal freedom to operate so long as they can produce their certificate, and coming down hard on the unvaccinated, might make our streets safer. 

Victoria Falls did that when pushing herd immunity. 

The present rates are not that bad, but they could be so much better and until the reluctant have lined up the vaccinated are not as safe as they could be. So the pressure must continue.