By Chioma Obinna
Despite the euphoria generated by last Tuesday’s arrival of COVID-19 vaccine in Nigeria, some challenges may affect the successful vaccination of Nigerians, findings by Sunday Vanguard revealed.
After several postponements of arrival dates, the country received
3.94 million doses of Oxford/AstraZeneca vaccine on March 2, 2021.
The country intends to vaccinate 70 percent of its 200 million people to effectively get the required immunity against COVID-19 infection.
According to the Director of National Primary Health Care Development Agency, NPHCDA, Dr. Faisal Shuaib, doses of vaccines would be arriving in batches due to limited supply. Richer countries have gone far with vaccinations, leaving poorer countries behind.
The first batch of the 3.94 million doses of Oxgord/AstraZeneca vaccines facilitated by the COVAX facility has not only raised hopes of curbing the pandemic, which has wrecked economies and lives worldwide but also raised pertinent questions on the vaccination.
Since the agency, NPHCDA, in charge of vaccination in Nigeria came up with a self e-registration portal there have been a series of concerns on equitable distribution to avoid leaving out groups or persons in the country.
According to the World Health Organization, WHO, the coronavirus crisis cannot end unless every country inoculates its populations.
WHO’s disposition is one reason it is not yet Uhuru for Nigeria or any country in the fight against the virus.
Vaccines, according to WHO, save millions of lives each year and they work by training and preparing the body’s natural defences to recognise and fight viruses and bacteria.
WHO noted that after vaccination, if the body is later exposed to those disease-causing germs, the body is immediately ready to destroy them, preventing illness.
Nigeria officially rolled out COVID-19 vaccination with four frontline health workers receiving jabs of the AstraZeneca-Oxford vaccine at the National Hospital, Abuja, last Friday.
The vaccines were administered after undergoing a final assessment by the National Agency for Food and Drug Administration and Control, NAFDAC, with positive results.
The first set of health care workers to receive the vaccine in Nigeria includes Dr. Ngong Cyprian, Faith E. Eragbai, Dr. Nuru Joseph and Dr. Thairu Yunusa.
Sunday Vanguard identified some hurdles the Federal Government and partners must surmount to ensure a hitch-free vaccination exercise.
Chiefly among them is growing apathy among the populace, who for different reasons, said they would not be taking the vaccines.
Across Nigeria’s 36 states many told our correspondents they wouldn’t make themselves available should they have the opportunity of being vaccinated.
Out of every 10 people, seven ended up saying they wouldn’t accept the vaccines. Ironically, even those who believe and others, who don’t agree that COVID-19 exists, share this apathy.
The country may face immense security and logistics challenges especially, transportation of vaccines by road to states where there are no airports.
Besides, some medical health experts who spoke to Sunday Vanguard further identified certification of vaccines for safety, good storage system, public enlightenment, availability, and accessibility, as well as equity in the distribution as hurdles the country must cross.
According to the President of Nigeria Medical Association, NMA, Prof Innocent Ujah, the vaccines must not be diverted for group or personal usage.
”We are happy that vaccines have eventually come and Nigerians are going to have access to them but they should not be diverted,” he cautioned.
A renowned Medical Laboratory Scientist/Public Health analyst, Dr. Casmir Ifeanyi, warned that the country could experience vaccine apathy if handlers of the exercise failed to build enough confidence in people.
Ifeanyi, who urged the federal government to be prudent in the disbursement of the vaccine, said Nigerians should be wary of political challenges that may come with the distribution.
Acknowledging the efforts of COVID-19 management team in Nigeria for facilitating the arrival, he urged more commitment to cover 70 percent of the population to build enough immunity against the virus.
“I also envisage that we are going to have a political challenge in which some states that are not participating in active surveillance, sampling, and testing will allege they are being sidelined, marginalized and shortchanged,” he added.
Consequently, Ifeanyi recommended that the vaccine distribution be done according to the reported disease burden across the states.
He said a scientific approach should be employed in the process. “Let the vaccine go to where we have a disease burden,’’ he maintained.
Calling on NAFDAC to activate its pharmacovigilance unit, he said it would help generate post-vaccination reactions.
”If our pharmacovigilance is not optimal, we will not be able to track all manner of reactions that may come. The vaccination will also be an opportunity to generate indigenous literature about how Nigerians would react to this particular vaccine because of our genetic diversity. Expectedly, it is important we keep a good record,” Ifeanyi suggested.
On apathy, he said, NAFDAC and NPHCDA should commence public education and enlightenment to facilitate maximum use of the vaccines.
He, however, said the COVID-19 registration portal created by NPHCDA is capable of destroying the vaccination process, describing it as an indication of failure from the beginning.
Also, the President, National Association of Resident Doctors, NARD, Dr. Okhuaihesuyi Uyilawa, warned against politicisation of distribution. Uyilawa, however, urged government to prioritise the vaccination of health workers on the front-line.
He said other Nigerians whose vaccination should be prioritised are those in contact with people that can be infected.
According to him, “we should also prioritise administering the vaccine on low-income Nigerians and not the high and mighty.
“I believe by now they should have a good study or data of the areas that are more affected so that the vaccines would be channeled to such places, rather than trying to use the population of a place to determine the number of vaccines the place gets.
”We cannot be giving Kano State more vaccines than Lagos when we know that Lagos has more numbers which have skyrocketed given the current progression of a new infection outbreak.”
He further applauded the NPHDA for opening a portal that requested persons interested in getting the vaccination shots to register.
“It is a way to get information about those interested in taking the vaccination. It is also a way to get the number of those that will take the vaccine.
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“If you don’t keep accurate statistics you end up using vaccines for those that don’t need it. It is good to always have statistics,” he explained.
On his part, National President of Nigerian Union of Allied Health Professionals, Dr. Godwin Ogbonna, said the first hurdle facing Nigeria is to authenticate the vaccine to ascertain if it is relevant to the strain of the virus in the country as the virus keeps mutating.
He said: “Government needs to convince the average Nigerian that the vaccine is safe and would not have immediate or future side effects on the recipients because there are so many conspiracy theories about its assumed adverse effect on our genetic make-up.”
Ogbonna also identified the challenge of having reliable cold chain systems at the various local governments and health facilities to preserve the vaccines.
“Do we have an advanced freezer that can maintain as low as -200 p c in our localities? There may be distribution challenges to the various states with a total population of over 200 million. How would it be distributed randomly to the nooks and crannies?”
He further pointed out thus: “When people have been vaccinated, will they not fail in non-pharmaceutical precautionary measures and get infected and in the process infect others? As proclaimed, that you are vaccinated does not necessarily mean you are immune. These are just a few among other worries.”
Also speaking to Sunday Vanguard, NMA President, Prof Innocent Ujah, stressed the need for government to follow the plans already mapped out by the NPHCDA to ensure a hitch-free vaccination.
“The problem we envisage will be the inability to vaccinate all the front health workers and of course to abide by their plan to vaccinate all the people who are aged 60 years and above and all others who have diseases like diabetes and hypertension. If they do this, the impact on the vaccination would be very smooth. We expect them to follow the plan,” Ujah noted.
He also pointed out the need for NAFDAC to monitor the adverse effects of the vaccines once the vaccination starts to ensure the country quickly responds to the side effects, know how to tackle them and document them.
On apathy, he appealed to Nigerians to begin to believe in the system and register for vaccination.
On his part, the Chairman of Medical Guild, Dr. Oluwajimi Sodipo, said government should be ready to face scepticism about the safety and efficacy of the vaccines.
Sodipo said a proper enlightenment campaign has to be carried out, with consistent messaging about possible side effects, contraindications.
Similarly, he said a robust data gathering system should be put in place to monitor the efficacy and adverse effects.
“This enlightenment should also extend to religious leaders, many of whom fuel scepticism about the safety of the vaccines. Also, Public officials should take the vaccines to boost the confidence of others.
“The second hurdle is logistics, including storage, deployment, and administration. This involves a coordinated effort between the federal, state, and local governments. The necessary materials such as syringes and cool boxes among others must be made available.”
He added that coordination of registration for the vaccine must be strengthened.