Challenges in Deployment of Corona Vaccine
In April 2019 a scaremongering video of children becoming unconscious after
being administered polio vaccine in Badaber, Peshawer, appeared on social media
nearly bringing the entire national immunization program to a grinding halt.
Even more unnerving is to note that the perpetrator was a local school teacher.
The video is a clear manifestation of the prevailing mindset of masses that
greatly swaddles the success of such campaigns in our country.
The last mile for the vaccine i.e. from centralized distribution centres to sub
district-level clinics, and finally to the patients, will certainly be strewn
with myriad of challenges. Before the vaccine fights the deadly virus in
Pakistan, it will have to face the people first.
Conspiracy theories against the existence of the coronavirus are still morbidly
rampant in the country including the educated class. One doesn’t have to look
far to hear notions like it being a manmade virus, designed to keep a check on
global population –the government is killing its own people in the name of
coronavirus as it brings foreign aid, they are denying the very existence of the
virus altogether, etc. – the list goes on. Our public is by and large equally
skeptic about the vaccine.
The likely impediments to the deployment are going to be, as is in the case of
polio vaccine, firstly the general distrust against the vaccine. Many a time
such programs have been labeled as being un-Islamic (haram) and designed to make
the population sterile. Secondly, since the deployment of vaccine will
inevitably require government partnering up with World Health Organization (WHO)
and other such agencies, it is quite likely to be viewed as a foreign program,
which implies an unsettling undercurrent of mistrust.
Thirdly, the inter-district or inter-city movement of people, for various
reasons, might leave a certain number of people remaining unimmunized, willfully
or otherwise. Additionally, the marginalized population in the country like the
transgender and slum dwellers are likely to evade the authorities’ radar thus
continuing the overhang of virus’ spread. Fourthly, the risk of substandard or
altogether fake vaccine appearing in the market, a phenomenon not so novel in
our part of the world, could potentially jeopardize the whole program.
Circulation of any such vaccine could further fuel the underlying distrust and
ultimately cost lives. The requisite technical wherewithal for deployment to the
far-flung areas of the country like cold chain storages, etc., will prove to be
a significant challenge in itself.
Equitable distribution of vaccine between provinces by federal authorities, or
lack thereof, has a potential to give the situation a political angle.
Furthermore, managerial and coordination issues at the level of city or district
governments like shortage of staff, lack of inter-departmental liaison, etc.,
could also pose a serious impediment to the coronavirus vaccine deployment.
Lastly, post-immunization program, if not managed properly, could lead to a host
of problems. Unsafe disposal of used syringes may lead to spread of other
degenerative diseases like HIV, Hepatitis, etc. Environmental pollution may rise
as a result of used pharmaceutical waste; an area in which our country is
lagging behind at global level.
Therefore, sensitization of public will be a keystone of the entire immunization
program; without public getting onboard, the policy is not likely to yield great
dividends. Rigorous campaigning for education of masses at grass root level, in
both print and electronic media, will be required in this regard. Awareness on
programs like Covax and initiatives on similar lines as ‘Team Halo’ could prove
to be highly beneficial.
Additionally, local clergy and tribal chieftains hold the power of swaying
public opinion particularly in the rural areas. Making them an instrument of
government’s policy, expounding the benefits of vaccination will play a key
role. Equitable distribution of drugs between provinces based on headcount and
priority of immunization will preclude any chances of political turmoil.
It will also be incredibly important to conduct the immunization program across
the length and breadth of the country simultaneously. A robust week-long
project, on the lines of general elections, will have to be conducted. A
government directive, ensuring that both public and private sectors make their
employs available for the vaccination must be issued. The government ought to
update its database on the transgender and other marginalized members of the
society lest they slip through the cracks.
Also, mass transit between districts and provinces will have to be halted for
this period, in order to ensure that the entire population undergoes the
program. The Drug Regulatory Authority of Pakistan (DRAP) will have to
proactively work in order to keep a check on counterfeit vaccine. A helpline for
easy reporting of such infractions should be established by DRAP. In order to
avoid friction between managerial echelons, district level teams comprising
representatives of public health experts, district health organizations,
district management group, partnering agencies like WHO, etc., working under the
auspices of Army will have to be formulated for a wholesome response. The
inclusion of Army will not only help to overcome the shortfall in manpower faced
by the district administration but will also lend credence to the efficacy of
the vaccine itself.
Facilities for safe disposal of a monumentally large number of used syringes and
associated paraphernalia will also have to be looked into. All in all, the light
at the end of the tunnel has started to become visible. With so much already
invested in procurement of the vaccine, both the society and government will
have to play their part of role to make the campaign a success. The government
would be well counseled to anticipate the challenges likely to be encountered
beforehand, and start the remedial measures now.
(The writer is a freelance columnist)