The Punjab government recently announced a door-to-door vaccination drive in Lahore, to contain the spread of the highly contagious Delta variant of Covid-19 that has already crippled the neighbouring India. Experts cast doubt at the initiative’s effectiveness
The Covid-19 pandemic has caused a global health crisis of unprecedented nature. Millions of lives have been lost in the battle against the deadly virus, which began spreading in late 2019. Healthcare systems worldwide are in tatters, and the only way to prevent further loss of life is to achieve herd immunity through vaccination.
However, many people are still struggling with misinformation and false theories making rounds on social media regarding the different vaccines’ efficacy and potential side effects.
In Pakistan, vaccination started in March this year. And so far, roughly four percent of the population has been fully vaccinated, while most are still waiting to get their first jab. To help speed up the process, the Punjab government recently announced a door-to-door vaccination drive in high-risk districts to curtail the spread of the highly contagious Delta variant of the coronavirus that has already crippled the neighbouring India.
Pakistan isn’t the first country to propose a door-to-door drive; however, the move’s effectiveness remains a significant concern, because vaccination campaigns haven’t had it easy in the country. Think poliovirus. We are one of the only two countries in the world where it remains endemic, primarily because of the failure of the door-to-door vaccination campaigns.
One could argue that comparing polio vaccination drives of the past with the Covid-19 one is unfair. Actually, a door-to-door campaign has a greater potential to fail in the latter case. It is virtually impossible to vaccinate millions of adults by sending the already overworked and underpaid health workers to every single doorstep with injectable vaccine vials.
“A door-to-door vaccination drive is a false hope,” says a health official speaking on condition of anonymity. “Yes, the concept was under consideration for some time now. However, to say that the drive is in full gear is a gross overstatement.”
The official says that special centres are being set up in Shah Jamal, Askari IX and X. “People can get the vaccine shots in these areas, but hoping for a health worker to pay you a visit, similar to how they administer the polio vaccine, is ridiculous — the two drives are incomparable.”
Talking about the kinds of vaccines, he says, “Injectables are different from oral ones. It is relatively easy to maintain the cold chain in the case of polio vaccines. Besides, prior experience has prepared the health workers to work out contingencies.”
Over the years, Pakistan has faced several setbacks in its polio vaccination drives. A door-to-door campaign to vaccinate the populace is definitely a quick way to reach herd immunity, but not entirely feasible in all cases.
According to Sahwaiz Faiz, a pharmacist working at the vaccination centre of a renowned private hospital in Lahore, “Immunisation is simple to achieve, but the vaccines can cause reactions that need to be monitored. These [reactions] may be rare but they can’t be ruled out, especially in people with certain underlying health conditions.”
Faiz believes that a door-to-door drive will not allow for proper monitoring of individuals’ post-vaccination reaction, if any. Hence, it’s “not feasible.”
Interestingly, a fresh polio immunisation drive is all set to start in Lahore from August 1. To quote a Lahore-based health expert, “[This means that] most health workers shall be occupied, and therefore the claims that a Covid-19 vaccination campaign is in full gear don’t hold true.”
Administration protocol varies depending on the vaccine. For instance, it is recommended that children get two doses of the MMR vaccine, which protects against three viral diseases, i.e., measles, mumps and rubella. The first dose should be given through 12 to 15 months and the second at 4 to 6 years of age. The MMR vaccine falls in the category of injectables. It is administered under supervision at health centres.
In contrast, the polio vaccine is given orally and poses negligible threat of acute reactions, making its door-to-door administration fairly simple.
In the case of Covid-19 vaccines, “You’ve to consider the medical history and vitals of individuals with underlying health conditions,” says Esther Tanvir, a nurse who is employed at the prevention centre of a local public hospital. “Pre-registration is also part of the [Covid-19 vaccine] protocol. Doctors and paramedic staff are available at hospitals’ vaccination centres, which is why people feel safer getting the shots there.”
Tanvir adds that in her career so far, she hasn’t encountered a single patient of polio at the centre.
Vaccine reluctance amongst Pakistanis is not entirely similar to what it is like elsewhere in the world. In the West, the anti-vaxxers often quote infringement of basic human rights and the ineffectiveness of vaccines as their reasons for refusing to be vaccinated. In Pakistan, religion is often used as an excuse for anti-vaccine behaviour.
Muhammad Jamal, 33, a factory worker, believes that not getting one’s children vaccinated against preventable diseases is a grave folly. “Both my children have received their shots,” he says, adding that he and his wife are also vaccinated against Covid-19.
“In order to continue working through the pandemic, which has no end in sight, vaccination is absolutely necessary.”
Over the years, Pakistan has faced several setbacks in its polio vaccine drives. Militant attacks on health workers in the north caused much fear and derailed efforts to protect the future of Pakistani children from disability. A door-to-door campaign to vaccinate the populace is definitely a quick way to reach herd immunity, but not entirely feasible in all cases.
In the words of the health expert quoted earlier, “If the polio vaccination drive is difficult to manage, that of Covid-19 is next to impossible.”
The writer is a staff member