Vaccine realities

On Wednesday Sri Lanka is to receive 600,000 doses of the Sinopharm vaccine, which has sparked much controversy and confusion. Few would argue that scaling up vaccinations is Sri Lanka’s best and fastest route to beating COVID-19 and returning to normalcy. But it is also important to do it in a credible and transparent manner so that public trust remains with the immunisation process and people remain engaged with this essential task.

The crux of the controversy has been reported multiple times. The waiver granted by the National Medicines Regulatory Authority (NMRA) to allow the import of the Sinopharm vaccine from China on 19 March drew much fire, with the Vaccine and Infectious Diseases Forum of Sri Lanka urging the Health Ministry to ‘strictly’ follow the unanimous decision of the NMRA’s independent Panel of Experts.

The eight-member Panel of Experts on candidate vaccines in its report submitted on 17 March states categorically that it recommends not to use the Sinopharm vaccine until more information is made available and evaluated.

Matters have not been helped by the unceremonious removal of four board members by a State Minister and arguments over who has the authority to give permission for the vaccines. Opposition members have also joined the fray and echoed concerns made by the Panel of Experts that insufficient data exists to prove the efficacy of the vaccine.

Given the global fight to procure vaccines it is laudable that every effort is being taken to push Sri Lanka ahead of the queue but it is equally important to connect this effort with credible mechanisms at home.

So far public access to COVID-19 vaccines has been uneven at best. There are still critical public sector essential workers and other vulnerable groups such as private sector healthcare professionals that have not had access to the vaccine. Given this situation it is imperative that better systems are used to roll out the new vaccine stocks.

The Government has also exacerbated the issue by rolling back PCR testing in areas where vaccines are being distributed even though there is no data on coverage and the Western Province remains the region with the highest spread footprint. Scaling down PCR testing before scaling up vaccinations could create an asymmetrical situation where infection numbers will appear artificially reduced but the virus is prevalent in the community.

Public health officials have defended this decision by insisting that infection clusters are being closely controlled and monitored but given the refusal of authorities to admit to community spread despite much evidence to the contrary, the scaling down of PCR testing is worrying. PCR testing must be increased systematically even as vaccine coverage increases, because infections and new variants remain an ever-persistent threat.

With more and more vaccines coming online, it is also important for policies to evolve and clear information to be communicated to the public. Different vaccines have different efficacy rates, which means that decisions need to be made on whether consumers will get a chance to pick the vaccine they prefer. Chances are this will be unlikely, but in that case, how will the Government deal with brand preference and still scale up vaccines? How will potential overlaps be managed? Who will be prioritised for Sinopharm? These are just a few among the many questions the Government will have to engage on with the public from this week.