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Senior Advisor to the President Lalith Weeratunga speaking to reporters yesterday
By Shailendree Wickrama Adittiya
Entering the global fray to procure vaccines Sri Lanka will order three million doses of the Oxford AstraZeneca jab from India’s Serum Institute by the end of the week as part of plans to immunise at least 50% of the population within this year, a top official said yesterday.
Rolling out its vaccine plans in earnest Sri Lanka will today receive the country’s first batch of COVID vaccines as part of a donation from India and will begin the vaccination process targeting 250 frontline workers tomorrow.
The batch will consist of 500,000 doses of the Oxford-AstraZeneca vaccine, which is also known as Covishield, and will arrive at 11 a.m. today via an Air India flight. The donation will be made under the #VaccineMaitri initiative and the vaccines will be handed over to President Gotabaya Rajapaksa at the Bandaranaike International Airport by High Commissioner of India to Sri Lanka Gopal Baglay.
Discussing the reception of the COVID vaccine as well as the vaccination process during a press briefing held yesterday, Senior Advisor to the President Lalith Weeratunga said: “This donation is extremely important to the country. Due to this, and to mark the long-term India-Sri Lanka relations, this batch of vaccines will be accepted by President Gotabaya Rajapaksa.”
Weeratunga added the Government has also entered the purchasing process. “The State Pharmaceutical Corporation (SPC) will place an order within the next two days with the Serum Institute for three million doses because there is a huge competition for the vaccine in the world,” he said.
“There is also no point in purchasing large quantities of the vaccine and storing it here because the vaccine has a lifespan of around six months. We must be prepared to provide the vaccine to the public as soon as it is brought down.”
The Oxford-AstraZeneca vaccine is approved by the World Health Organization (WHO) as well as the National Medicines Regulatory Authority (NMRA) of Sri Lanka. It must be stored in 2-8 degree Celsius freezers, which Sri Lanka has facilities for at district as well as MOH levels. The Health Ministry and the State Pharmaceutical Cooperation (SPC) also have the facilities for the proper storage and transportation of the vaccines.
Vaccination will begin tomorrow, and the vaccine will be provided to Sri Lankans free of charge. One hundred and fifty frontline health workers will be among the first to receive the vaccine.
“If we arm frontline health workers, like we would provide soldiers at the war front with bulletproof vests, they will find prevention easier to carry out and have more confidence in the measures,” Weerakody said, adding that 120,000 frontline workers attached to the defence units and police have also been identified as recipients of the first batch of the COVID vaccine.
The group will also include airport staff as well as those working at COVID-19 prevention centres.
The vaccine is administered in two doses, with a 28-day gap between the doses. After this group is vaccinated, persons aged 60 years and above will receive the vaccination. While persons with chronic and non-communicable illness among this group will be given priority, it is estimated that there are 3.5 million persons above the age of 60 in Sri Lanka.
The country will require seven million doses to vaccinate this group of the population. The rest of the population will receive the vaccination depending on the age group, with the 50 to 59 age group receiving the vaccine next, followed by the 40 to 49 age group and the 30 to 39 age group, and finally the 20 to 29 age group.
Data from the Election Commission of Sri Lanka will be used at a MOH and Grama Niladhari level to identify persons of the particular age group when administering the vaccine. Concerns have been raised by those who are not on the electoral list, to which Weeratunga said: “We are now contemplating this and planning to call for applications from persons whose names are not on electoral list.”
This will be done through various channels, including digital platforms and mainstream media.
Regarding residence visa holders, Weeratunga said: “Right now, to be very frank, we have not taken into consideration residence visa holders, but in the coming weeks we will look at those who are outside the electoral list.”
He went on to say that the first priority will be the citizens in the electoral register.
The vaccine is not recommended for persons below the age of 20 nor persons who are pregnant or breastfeeding. Such persons make up 35% of the population, according to WHO estimates, Deputy Director General of Health Services Dr. Susie Perera said.
She explained that of the remaining 65% of the population, 80% are recommended the vaccination and this would amount to 50% of the population. Of this group, 20% will receive vaccine under the COVAX facility.
However, Dr. Perera explained that the Health Ministry saw that considering all priority groups, more than 20% of the population will require the vaccine. “In addition to the 20% population covered by COVAX, we are going towards providing 50% of the population with the vaccine,” she added.
Dr. Perera went on to say that the vaccination plan took into consideration the combination of vaccines, where those that can be stored between 2 and 8 degrees, like Covishield, will be preferred. The country does also have facilities for vaccines that must be stored below -70 degrees, like the Pfizer vaccine. This was mentioned in the request made to COVAX, she added.
“There is another benefit to the COVAX program. We do not have to bear the cost of the vaccines for 20% of the population but there is a cost for everything else, like freezing and safety procedures. We requested from the COVAX facility that we needed to give 50% of the population or 11.5 million people this vaccine. Through the COVAX facility we can go to a cost sharing method.”
Combination of vaccines
COVAX is yet to provide a timeframe or type of COVID vaccine that will be allocated to the country. However, Sri Lanka has also been assured 300,000 doses of the Sinopharm COVID vaccine from the Government of China. Discussions are to take place, but the donation comes in response to a request made by President Rajapaksa.
“Even the vaccine we are receiving is based on a request made to Indian Prime Minister Narendra Modi during the first week of January,” Weeratunga said, adding that President Rajapaksa has also made a request to the president of Russia regarding the Sputnik V vaccine.
However, both Sinopharm and Sputnik V are yet to receive WHO and NMRA approval. Once NMRA approval is received, the procurement process can begin. However, Weeratunga said that it is still too early to make any predictions and more information regarding this can be provided in the coming two weeks.
Weeratunga also stressed that the NMRA worked independently, adding: “We did not at any point of time exert any influence on the NMRA. The NMRA was completely left to do a job on their own, a job of expertise.”
Vaccine development process
Speaking at the press briefing, Epidemiologist Dr. Samitha Ginige addressed concerns the public may have about the vaccine, especially considering it was developed within a short period of time.
He explained that the vaccine development process typically involved various phases, with the second phase beginning once the first has been completed. With COVID vaccines, however, the different trial or testing phases were carried out simultaneously but all procedures were followed.
While the Serum Institute has been tasked with manufacturing the vaccine, they will do so as per the quality standards of the vaccine developers. Dr. Ginige explained that COVAX has come into agreement with the Serum Institute for a large portion of the vaccine production in 2020 to be purchased by COVAX and distributed to countries around the globe.
“It has not even been a month since powerful nations in the world have been able to administer the COVID vaccine. Given this, for a country that does not have the capacity to manufacture the vaccine, it is an important milestone that at least some portion of the population can receive the vaccine,” Dr. Ginige added.
In response to a question on testing carried out in the country, Dr. Ginige explained that very few countries have the facilities to carry out vaccine testing and that even vaccines administered on children are not tested in our own labs. The main criteria are WHO approval and NMRA registration.
Administration
The Epidemiologist went on to outline the country’s preparedness to carry out vaccinations, explaining that through the National Immunization Programme, Sri Lanka has the infrastructure, human resources, training, and facilities to carry out immunisation programs.
In response to a question on who will bear responsibility for any complications that arise as a side-effect of the vaccine, the President’s Senior Advisor said the Government is required to sign an indemnity agreement before it can receive the vaccine.
“This process applies to all vaccines, but especially for this vaccine that is received in an emergency and all documentation has been sent. The manufacturer does not take responsibility if anything happens. The Government and the Health Ministry will accept responsibility,” Weeratunga added.
He went on to say that there may be small risks involved with vaccination but added that the benefits are far greater considering the impact the pandemic has had on the economy and Government spending on PCR tests, which amounts to Rs. 80 million daily.
“Any long journey starts with a single step. I strongly believe in taking the right step forward. If we had not even received this 250,000 now as a donation from the Government of India on the goodwill between the two countries, we would have gone nowhere.”
While the first step has been taken in terms of immunisation against COVID-19, a timeframe could not be given for when the process will be completed. However, Weeratunga did say the country was looking at a combination of vaccines, which would have to be received and administered in a timely manner.
“I have had various discussions and very tentatively I can say at least 50% to 60% of the target group that we are looking at can be vaccinated during the course of the year.”
However, this could take less time depending on production capacities and faster turnout.
Voluntary vaccination and awareness
The discussion also focused on the voluntary basis on which the vaccine will be administered and persons who are opposed to getting vaccinated. Weeratunga explained that the COVID vaccination cannot be made compulsory due to it being an emergency vaccine, but that all persons will be invited to get vaccinated, depending on the age group.
A question was raised on frontline workers who may have concerns about getting vaccinated, to which Weeratunga said refusal to get vaccinated will be done at their own risk. “They are frontline people who are meeting possible or potential COVID-19 patients face to face. If they think they can look after themselves, then why not? There is no way we want to compel, but on the other hand, there is a huge demand from the frontline health workers.”
Deputy Director General of Health Services Dr. Perera commented that awareness programs will be carried out to explain to the public the importance of immunisation against COVID-19 and how the vaccination process will be carried out.
She went on to add that all persons above the age of 60, and even those in the 50 to 59 age group, are encouraged to get vaccinated even if they are not aware of any chronic or non-communicable conditions as a majority of the population is unaware of their health conditions.
