Covid jab travails in Colombo

The vaccination of residents in Colombo and suburbs with Oxford-AstraZeneca vaccine has now been continuing for almost eight weeks. The programme started with great hype but soon had many hiccups. First, the vaccine was given to all healthcare and non-healthcare staff involved in the campaign. This went on without any issues, although there were rumblings from some health staffers who were left out.

The vaccine was to be given to those over 18 in the beginning. Then it was decided to give to only those over 30, perhaps because the country could not muster enough doses of the vaccine. I thought the priority would be given to those over 60 years of age as in other countries, but soon this was changed. Many who were over 60 that went for the vaccine were turned away unnecessarily. In one case, the widow of a former parliamentarian and a diplomat, who had to climb several floors despite having a severe physical disability, was turned away despite my attempts to convince the doctors at the clinic there. The argument was that the ‘Computer’ rejects the details when they enter the NIC number! Although saner counsel prevailed, and after 15 minutes, I was called to inform that a VVIP had ordered that those over 60 could be given the vaccine: The lady was not fit enough to climb the stairs again.

Then of course, although the clinics were organized by the nurses, midwives, and doctors satisfactorily, the other elements of the campaign were much to be desired. There was no proper communication to the people, who should have been told very clearly when and where to go, and to whom the vaccine is given. Meanwhile there were allegations and counter-allegations of malpractices but I would not dwell on these issues. It is up to the authorities to verify what happened. What was clear was that due to the poor planning and communication, the people had to stand in the sun for hours to get the vaccine or to be turned away at the last moment, stating that they do not belong to that area.

In view of the above, we had a meeting at CMC on how to improve on what was already being done. My suggestion, using my experience in controlling epidemics, was that we give priority to those over 60 years of age, and have the programmes in the areas where the disease was spreading at that time, and then move into other known focal areas. However, the counter suggestion was that we go into “Virgin” areas, where the disease had not touched the people by that time. I was left aghast at that suggestion, as it was against basic principles of epidemic control. However, by midnight saner counsel prevailed, and we were told that the Head of the Epidemiology Unit had ordered that the vaccination programmes should be held in areas where the disease was present and in known Covid-19 infected areas.

At present the vaccine is given only to those over 60 years of age. The queues have lessened and anyone over 60 years of age can just walk in to one of the six centres in Colombo city and get the vaccine. The programme is organized much better now due to small numbers, and online bookings can be made. I would have preferred if the vaccination services were taken to the people and not get old people to come to the centres and climb stairs. We were very successful in getting rid of polio 20 years ago, in 2001, because we delivered the service to the door-step and vaccinated all the children in the city in one day. We are now in a much more complex situation, but the staff should go from one area to another in a planned manner according to the needs and guidelines. I was at a centre last week when only 10% of the expected number came for the vaccine.

Proper planning and communication are a must for this type of exercise, and when the second round of vaccinations start in April, the authorities should get the help of volunteers, local politicians and NGOs, in organizing the people to come in an orderly manner to get the vaccinations.

Dr. PRADEEP KARIYAWASAM