History’s largest vaccine rollout and Punjab preparations — I

The COVID-19 Pandemic remains invariably the largest global event of my generation. It will be remembered as a disaster that shut down the entire planet, brought world economy to its knees and killed millions of people. As the first health catastrophe of the digital era, it will also be remembered as an event that triggered a transition towards a tech-based health intelligence system.

The climax of the pandemic is presumably over. Hail our virologists and microbiologists who unfolded and decoded the complex genetic structures of SARS-COV2 and enabled mankind to develop vaccines. I often wonder that the development of vaccines itself is one of humanity’s greatest scientific achievements. With plans afoot to inoculate the entire planet, the year 2021 is going to be documented as the year of history’s largest public health initiative. Inarguably, this is the biggest vaccine rollout program I have seen in my lifetime. Nothing on this scale has been ever carried out before. Within just 15 months of virus discovery, vaccines have been developed, tested and approved which is an epoch-making achievement of mankind. Whereas virus may live with us for years to come, we have discovered ways to thwart it through collaborative international efforts. Globalized world is both fragile and robust in its own ways. The pandemic brought to the fore realization of an ironic yet ingenuous bond of shared destiny and shared vulnerability.

Pakistan had a nervous beginning and less tumultuous climax than foreseen. Notwithstanding a very strong third wave, we had encountered first two waves with a fair degree of success wherein new infections and mortality rate had remained much less than most parts of the world. Besides timely decisions, fast-track arrangements and effective implementations, the age distribution of our population worked to our advantage. Around 60 per cent of our population is less than 30 years of age. Nearly 50% of Punjab’s population is below 25 and 42.5% people are less than 15 years of age. We have only 4 % population in the 65 plus age group category, the most vulnerable age group. Over the course of the pandemic, our incidence has varied between 30 % to 34% in the 31-45 years age group, between 21 % to 24 % in 45-60 years age group and stayed around 10% in 61-75 years age group. Similarly, incidence remained around 30% in 16-30 years age group. This data indicates that around 70% infections were in below-45 age group where severity of symptoms is less likely in any case. However, age group alone does not determine the course if not capitalized smartly. In neighbouring India, the population age distribution is not much different to that of Pakistan, yet incidence, severity, case fatality and transmission rate are not same as ours. State interventions have to be carefully planned to make the most of favorable variables.

Most leading vaccines — Moderna, BioNTech, AstraZeneca, Sinopharm, Sputnik V, Novavax, Covax and few more names have shown remarkable results. Due to immense global demand, supplies are not as smooth especially for under developed countries yet we are making effort to get our people vaccinated and achieve the herd immunity within this year. From among the available supplies, we have prioritized frontline workers followed by healthcare workers in the first two rounds of vaccination. As I write on these pages, the vaccination campaign for people of over 60 years of age is already into the fourth week. Phase-wise, the vaccination will be scaled up for general public. We must remember that no one is safe until everyone is safe.

We plan to vaccinate most of the population around third quarter. For prioritized population, a system of online registration and SMS pin code has been developed in which people are informed of their date, time and venue for their own convenience. Walk-in service for over 65 years on CNIC is available.

I have strong reasons to believe that Pakistan is better prepared to carry out a strong Corona vaccination program than many other countries of the world owing to our long experience of managing large scale campaigns. Our teams are adept at managing vaccine supply chains, cold chains, storage, trainings, AEFI systems, communication programs and resource mobilization. For Service Delivery (supply side) and for Demand Generation (demand side) we already have developed integrated plans of Operations and Communication.

Given the diversity in age groups and demographic settings, our teams are especially working on addressing reluctance, refusals and public concerns. A recent survey on Vaccine Hesitancy by renowned research body IPSOS reported that nearly 40 % Pakistanis disagreed to get themselves vaccinated immediately which shows how big a challenge health communication is going to be.

Therefore we anticipate big challenge in demand generation and our technical teams have put together complete plans so that we are able to see the back of the pandemic by the year end. —To be continued

(The writer retired as Professor of Obstetrics and Gynecology at King Edward Medical University Lahore and currently serves as Health Minister of Punjab)