Recalibrate the vaccination message

IF WE have been lucky, over the past few days large numbers of people were inoculated against COVID-19 with the AstraZeneca vaccine. And hopefully that momentum will continue into today, so that by midnight Jamaica would have used up all of the brand of the vaccine it had in hand.

It is not that this newspaper wishes for the drug to be in short supply. Rather, we want to prevent its waste – the possibility of which suggests the need for the Government to recalibrate its vaccination programme. It has to be far more aggressive. Targets must not only exist. They must be transparent outcomes regularly matched against performance.

In that regard, the recently launched, private sector-inspired and -dominated vaccination task force has to become more visible, and people must know its specific objectives, how it is going about achieving them, and the authority it has been given to deliver on its mandate. At the same time, there must be new, aggressive initiatives to make vaccines far more accessible. They have to be taken to where people are.

These matters were brought into sharp focus on Monday with the revelation by the health minister, Christopher Tufton, that 60,000 doses of the AstraZeneca vaccine, 20 per cent of 300,000 doses donated to Jamaica by the United Kingdom at the end of July, were in danger of being dumped by tonight because they have reached their expiry date.

But that is not the entirety of a worrisome vaccine story. Just over a month ago, Jamaica received a shipment of 115,000 doses of the single-dose Johnson & Johnson vaccine. These were bought on the open market. By this week a mere 25,000 doses, 21.7 per cent of the stock, had been administered to people. The Government has already paid nearly US$15 million for an additional 1.9 million doses to be delivered in the coming months.

POOR VACCINATION RATE

With statistics such as these, the reasonable presumption for the uninitiated is that Jamaica’s COVID-19 vaccination project is well advanced, with a substantial proportion of its citizens already fully vaccinated. That is not the case. Up to Tuesday, a mere 8.2 per cent of Jamaicans were. Another 18 per cent were partially vaccinated, having received the first dose of a two-dose vaccine. Among its partners in the Caribbean Community (CARICOM), only Haiti, the Western Hemisphere’s poorest country, which is wracked by political instability, ranks lower than Jamaica for fully vaccinated citizens.

Early on, Jamaica’s problem, the Government explains, was the difficulty sourcing vaccines. Rich nations had cornered the market, pushing the newly developed drug out of the reach of poor ones. This scarcity factor was also exacerbated by strong pockets of vaccine hesitancy and resistance.

That, however, is not the full explanation for the slow take-up of the AstraZeneca and Johnson & Johnson vaccines, and the possibility of large amounts becoming outdated. According to Health Minister Tufton, people are brand-shopping for vaccines, and the AstraZeneca and Johnson & Johnson ones are not at the top of their list. While the AstraZeneca vaccine was the first one in Jamaica and had early acceptance, it has apparently now been overshadowed by the Pfizer product. “... Our studies and polls suggest that’s largely because it is a strong brand,”

he said. “It has had the benefit of usage in the diaspora (United States).” Health officials, he said, initially felt that Jamaicans would gravitate to the Johnson & Johnson vaccine because it required only a single dose. This has not proved to be the case.

What Dr Tufton did not address in his analysis of the slow take-up rate, beyond the perceptions of the brands, is how this situation might have been affected by bureaucracy and inefficiency and a weak, uninspiring effort to mobilise Jamaicans around the idea of being vaccinated.

The point is, the vaccine roll-out has not been a national, and nationalist, movement. And neither has there been a transparent inspection of what was expected, with people being held to account when deliverables fall below projections. For example, several months ago, the Government established a vaccination plan, with various phases to the programme and specific demographic groups to be inoculated in each phase. Based on these matrices, 65 per cent of Jamaica’s population, the amount which the Government believes is sufficient to achieve herd immunity, should be fully vaccinated by the end of next March.

However, there has been no consistent reporting of outcomes; if, and why, there were shortfalls; and how the missed targets will be reached. This should now begin to happen. There must be objective reviews and analyses of performance against targets. Indeed, after six months, only eight per cent of Jamaica’s population is fully inoculated. At this pace, Jamaica would probably need four years to reach the Government’s vaccination target, which itself is lower than the upwards of 80 per cent of the population that should be the aim.

SHIFT TACK

That, though, need not be the case. We can radically shift tack. There are signs that that may be happening. There is the COVID-19 task force which is to spur things along. A few private firms and organisations have delivered vaccines to staff and members. This scheme was broadened this week through agreements with a handful of private medical facilities and doctors to deliver the jab. The next step must be to radically expand the project. Pharmacists, for instance, should be legally empowered and trained to give injections and allowed to administer vaccines.

The Government has also to accept the economic realities of large numbers of Jamaicans. There are people willing to take the AstraZeneca and Johnson & Johnson vaccines for whom the $130 taxi fare to travel to a clinic in a town centre may be prohibitive. It has to get vaccines into their communities. And the message about vaccination has to be about broad ownership of a crisis, whose solution is a national partnership. Prime Minister Andrew Holness has to find the right tone and appropriate words to sell this idea with sincerity.