Vaccine distribution

Each day hope grows that Sri Lankans are getting closer to public vaccinations. However, despite numerous political statements of vaccines being available as soon as next month, the process for getting the vaccines remain opaque. So far the Government has said efforts will be made to immunise people over 30 and 60 at the same time but much of the logistics remain unclear. 

Will Sri Lanka follow electoral lists or will people have to register on the latest Government website? How will older and vulnerable communities be ensured access? Many segments including exporters and journalists have been assured priority status but how would that be practically implemented? Policy makers may only have a few weeks to get these systems organised and conveyed clearly to the public to ensure that vaccines are administered in as fair and transparent a way as possible.   

WHO in December issued a handbook that calls on policymakers to take steps to address reservations harboured by populations. These include factors such as the convenience of location and time, associated costs, and the quality of the experience of being vaccinated.

Making vaccines easily accessible in safe, familiar and convenient locations, such as “drop-in” clinics that are near where people often go, can also encourage uptake, the report said. It added that governments should have targeted, credible and clear communication from trusted sources demonstrating that getting vaccinated is important, beneficial, easy, quick and affordable.

Health systems must also be prepared to reduce barriers to supply, service delivery and quality of services, in addition to ensuring that health care and community workers are well trained and well supported.

The State Pharmaceutical Corporation (SPC) has already placed a bulk order with India and China has indicated it is ready to provide an initial supply. This means that vaccine access will have to evolve in parallel to other regulatory requirements such as potential approval for the Chinese and Russian vaccines and attention to impacts of new variants. With news of the UK virus variant being found in Sri Lanka, stronger attention will also have to be paid to efficacy rates, even though initial global studies have indicated that Oxford AstraZeneca is responsive to it. 

This pandemic has been accompanied by an overabundance of information and misinformation, an ‘infodemic’ on a global scale. People are inevitably exposed to misinformation, rumours and false conspiracy theories, which may erode their confidence in vaccination. Vaccine acceptance and uptake may also be undermined by COVID-19 vaccines being not fully effective, meaning that people will have to continue to engage in preventive behaviour (e.g. mask wearing and physical distancing) even if and after they have been vaccinated.

It will be important to manage expectations and ensure that those who have been vaccinated do not stop adhering to protective behaviours and expose themselves and others to risk. It is important to build trust in COVID-19 vaccines before people form an opinion against them.

This should involve using trusted messengers to help navigate the COVID-19 information landscape and building confidence in the vaccine development process through transparency and managing expectations.

Communicating consistently, transparently, empathetically and proactively about uncertainty, risks and vaccine availability will contribute to building trust and this should also get the attention of policymakers. A clear path to getting in line is a good place to start.