By Edward Ihejirika
AS a public health physician, development and health policy management consultant I like to state unequivocally that vaccines save lives and clearly people need to take vaccines this time to stay alive; but what is more important are the protocols advised for prevention. This alone can cut down the spread of COVID-19 in great proportions.
In the year 2010, then as Programme Coordinator in a US Department of HHS funded programme in the Upper Valley Region comprising the States of New Hampshire and Vermont, we supervised the administration of ‘seasonal’ flu shots and people would turn up and take them. Even then, there was mild suspicion about vaccines and low turn out on some days but overall more people got immunised.
Although not everyone got vaccinated, these flu viruses eventually would not do much harm and medically the teaching has been that the concept of developing ‘herd immunity’ is responsible for conferring immunity on the rest of the population against viruses.
What is worthy of note here is that in two seasons in which I participated, I found that some of the same people responded and brought their kids and got vaccinated each time on each of those calls.
So I got thinking: why would the same kids always get vaccinated every flu season? This clearly is due to the willingness of the receiver, knowledge base of the receiver especially, that viruses mutate and this can happen very fast or slow depending, etc., thereby providing the incentive to get the shots.
This job coincidentally led us at the MVHI to participate in the planning and design process of a board game at the Tiltfactor Laboratory in Dartmouth University known as “POX: save the people”. POX was developed to help teach the 1-4 players on board to stop the spread of disease, herd immunity and the need to vaccinate. Ultimately, that prevention is key and vaccines work!
For this we received a State Award in 2011, “Excellence in Immunisation Partnerships’. Maybe today we deserve the ‘Nobel Prize’. While settling down in 2013 as the Commissioner for Health in Imo State and taking charge at the Ministry, the Ebola virus in early 2014 was before us and eventually it arrived Nigeria.
We applied the same practices of public health hygiene (sanitisers, hand washing, no hand shaking, use of PPEs by health workers, etc), health promotion and we demonstrated these prevention techniques at several fora (from screening for temperature at airport to conferences we hosted in Imo) all in a bid to prevent entry and stop the spread of the Ebola.
We never got to the point of vaccine but Ebola was contained; and if it mutated, it is a story for another day. Perhaps for this in 2015, I was appointed to represent South East in the technical working group, TWG, for the implementation and operationalisation of the National Health Act.
First in 2019/2020 and now a second wave in 2021, we are dealing with COVID-19. There are high numbers and numbers could even be higher if more people are tested. What are we faced with? There are behavioural issues, uncertainty, fears, economic considerations, work life imbalance. Poor healthcare infrastructure, funding, world events, etc.
The more people are in denial about this COVID-19 the more the risk of spreading especially with and by the asymptomatic carriers and hence all hands must be on deck to continue the promotion of social distancing, use of hand sanitisers and other protocols in place. How do we tackle the fears of vaccination in the face of several conspiracy theories flying around; theories of birth control, demographic control, 5G to mention a few?
Education, education and more education using available tools, engagement of all stakeholders at the grassroots level to bring the information home and better prepare them for uptake or acceptance of the vaccine when it is available.
All who have received can serve as sources of feedback to several people who look up to them; agencies of government like the National Orientation Agency can also move with their equipment to sensitise fully the people on what is to come; incentives have been known to work where less understanding, culture or cooperation are issues.
In this period of economic uncertainty the people are unlikely to observe fully these prevention protocols due to the fact that majority of the population run on daily take home pay and income. This has certainly created a lot of work-life imbalance since from the first wave and any further disruptions can be met with negativity; therefore, targeted incentives, or palliatives as it were, again come to mind.
There is no gain saying the fact that our healthcare infrastructure is poor. When analysed in terms of our GDP and population served, it is clear we need to do more in this sector. What is of most significance is that we lack the robust infrastructure to adequately deal with vaccine distribution effectively and of note is this COVID vaccine which requires very cold temperatures for some of them. The multi-departmental approach of government agencies are trying to address this.
I have been privileged to attend the first ever “National stakeholder engagement with medical and Health Associations on COVID-19 Vaccine Introduction” recently hosted by the NPHCDA. These efforts by government to introduce the vaccines certainly will require huge funding not only for purchase of the vaccines but also for the logistical infrastructure that comes with its distribution.
At this point in time, if you evaluate what is on ground, while the state capitals may be ready with their cold stores in the 774 LGAs up to the PHCs, it is doubtful that we can cope without some stroke of ingenuity at this time.
Although the world is now plagued with this COVID pandemic, for some reason Africa has again shown some difference in its response to the virus, perhaps due to the strain (not clear) but in the face of all the attendant uncertainties it continues to record lower mortalities; and if the world is going to support us as has been proposed, it will look at some of the ways in which we have helped ourselves through governance structures in place, prevention protocols, governments priority to health budgets and healthcare spending.
That said, it is still going to cost a lot to get vaccines to arrive here and based on ‘purchase orders’, time is of significance and procrastination is unhelpful since the manufacturers must satisfy quotas or prioritise orders while initiating delivery of our requests.
Is this a call to action for our scientist to go into the labs and see why and how and perhaps come up with vaccines perculiar to Africa? Very expensive venture we all know and unprepared for.
Perhaps someday the private sector may play here. What happens in the event that there is a shortfall in vaccine supply and cases or even mortality rises? I dont want to imagine the scramble that ensues due to panic and a fight for survival.
What should our deliverables be? Resource mobilisation from the private sector players to compliment or enrich a national vaccine development, storage, distribution and administration and reporting plan. Furthermore, we should obey the authorities and laws of the land by avoiding unnecessary crowd, do social distancing, wear you face masks, wash hands often, use hand sanitizers, cough or sneezing hygiene, travel only if absolutely necessary, sensitization towards vaccination.
Should vaccination be voluntary especially where still in doubt? I think it depends on social responsibility, knowledge and exposure to know that what affects one can affect all and therefore the common good of all starts with the interest of one. A good number of people still think Covid is a medical or political stunt and have adopted practices like steam inhaling and so on, the goal being to stay protected and it maybe working for them.
In conclusion, either way we see it for or against Vaccines lets stay with the science, stop the spread! For now we must do with the prevention protocols and hope that the vaccine will reach everyone willing when it arrives or better still, may God let the virus mutate into a less harmful strain and finally nail this Covid to the dustbin of history.
In retrospect, Chance favors the prepared mind.
Dr. Ihejirika, a Senior Legislative Aide to the Deputy Speaker of the House of Representatives, and the Founder of IMOFUTA- Imo Futures Assembly, DEAN- Devt exchange advocacy network, wrote from Abuja.