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Success of vaccination drive hinges on inoculation of the elderly

Vaccine and Infectious Diseases Forum of Sri Lanka
The Council of the Vaccine and Infectious Disease Forum of Sri Lanka has appreciated the decision made by the government to buy nine million doses of Covisheild vaccine from Serum Institute of India to be given to Sri Lankan citizens. We noted that 500,000 doses gifted to us by India have been given to healthcare workers and social workers involved in the care of the COVID patients and contacts. We also have observed that the remaining vaccines have been distributed to many MOH areas to be given to adults between 30 years to 59 years of age.
Our opinion and that of WHO are entirely different. According to the WHO protocol, the first priority is given to the healthcare workers and the next priority is given to people over 65 years and people with comorbid features.
Countries such as Israel has vaccinated elderly over 65 years and people with comorbid features first before giving the vaccine to healthcare workers. The reason was to bring down the mortality rate. In fact, Israel has seen the results within three weeks with a significant reduction of deaths. New Zealand has decided to follow Israel by giving the vaccine first to the elderly before giving it to healthcare workers.
In fact, the primary purpose of this vaccination is to prevent deaths.
The vaccine efficacy ranges from 70-84%, signifying a possibility of getting COVID 19 infection despite vaccination. But with AstraZeneca vaccine (Covishield), it is observed that the mortality reduction is almost 100%. That is the primary aim of this vaccine programme. However, the Ministry decision to give the remaining vaccines to the public between 30-59 years is meaningless. It does not avert deaths among the elderly. The basis of this decision by the Ministry of Health is not clear. The number of doses left would be only 2-3 hundred thousand. With such a limited number of vaccine doses, how could a population of Sri Lankans aged between 30 -59 years be protected. In fact, this limited number of doses, should have been given to people over 65 years of age. That would have helped prevent a significant number of deaths due to COVID-19.
There is suspicion among the members of the public, and it is unavoidable and excusable. The decision to give the vaccine to the persons of 30-59 years has created the wrong impression among the public that the vaccine should not be given to elderly over 60 years, as it is unsafe. We have heard that it is already happening and people may become reluctant to give the vaccine to the elderly.
When the new consignment of vaccines is available for elderly people, it may become difficult to convince the public that the vaccine is safe for the elderly. They might ask, “Then why didn’t you give the vaccine to elderly last time. We hope that the Ministry would come out with a convincing answer.
Saving lives is of paramount importance. Therefore, if the elderly are not vaccinated, the COVID vaccination programme will be in vain.
Dr. H.T. Wickramasinghe
Consultant Paediatrician
President, Vaccine and Infectious Diseases Forum of Sri Lanka
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