Over 600,00 teachers and health workers have not yet gotten their first dose of the COVID-19 vaccine.
Teachers and health workers were among the top prioritised groups that the first consignment of AstraZeneca COVID-19 vaccines was meant to protect. The health ministry targeted to vaccinate 550,000 teachers and 150,000 health workers. Other groups that were targeted were security officers, people with co-morbidities and persons aged 50 and above.
However, as at May 18, 2021, only 82,746 teachers and health workers had received one dose of the vaccine. According to the health ministry, 249,546 people in the priority groups have received one dose of the vaccine. The breakdown of the vaccinated groups shows that security personnel have the highest vaccination numbers at 115,800 followed by people aged 50 and above at over 51,000.
When asked why uptake of the vaccine has been low, the programme manager of the Uganda National Expanded Programme on Immunization, Dr Alfred Driwale attributed the figures to a number of challenges they have faced while implementing the vaccination campaign.
According to Driwale, given the country’s previous history of vaccinating as many as 18 million children in four days during the Measles and Rubella mass vaccination campaign in 2018, they expected to spend at most three weeks carrying out COVID-19 vaccination during the first phase.
However, he says mistrust of the vaccine, misinformation, and a poorly launched vaccination campaign have helped defeat the purpose of vaccination.
In addition to this, he says the novelty of the vaccines does not help the situation.
“Poor uptake is not surprising; these vaccines are new and little is known about them. They are not like measles or polio vaccines that have been used for years and are time tested,” he said.
Another challenge that Dr Driwale highlights is the poor training of health workers.
While all the above have played a hand in the low uptake of the vaccine, a source from the health ministry who preferred to remain anonymous says existing confusion in the rollout of the vaccination plan is to blame.
” Before we began vaccination, a number of meetings were held and a plan was developed,” the source said. “However that plan keeps on changing. The plan changing is not a bad thing if it is informed by what is on ground but in our case, at times it feels like some officials go home, dream about something and come back to change the plan, which does not help much in the end.”
Prior to the delivery of vaccines of the first donation of vaccines from the COVAX facility, according to the country’s vaccination plan, each consignment of vaccines that arrived into the country would be used to fully vaccinate certain groups.
For instance, the first 864,000 vaccines that were donated by the COVAX facility would vaccinate 432,000 people fully. The second donation from India of 100,000 vaccines would similarly vaccinate 50,000 people 4-8 weeks apart.
According to the rollout plan, five nurses were trained per district to carry out the vaccination. The nurses would be deployed at Health Center IIIs and IVs. People who belonged to the stated categories would go to the health centre, provide proof that they were Ugandans and get the jab. After getting the jab, the people would then get a vaccination card that would inform them when they should get their second dose.
However, the moment the vaccines arrived in the country, the plan began changing. Upon their arrival, the health ministry following a recommendation from the World Health Organisation, (WHO) decided to use the available vaccine stocks to vaccinate an equivalent number of people.
Each person was to get one dose of the vaccine and wait for the second COVAX consignment of over 2.3 million vaccines that was expected to arrive in between April and June. The government was also expecting to get some vaccine donations. According to Driwale, the donated vaccines were to be used to vaccinate as many people in the high-risk groups as the government procured more than 18 million vaccines from the COVAX facility and the Serum Institute of India.
Dr Driwale says the decision was made to protect as many people as possible.
“Instead of giving two vaccines and vaccinating a small number of people, we thought vaccinating a bigger number of people with one vaccine would be better since another consignment from COVAX was expected in May,” he said.
While the change meant many people would get the vaccine, it also meant that more vaccines would have to be transported to health centres than was previously planned for. As a result, due to logistical challenges, some district began vaccination a week later after it was launched.
In addition to this, supplies such as vaccination cards were not enough and people who got the jab had no proof of doing so. Elizabeth Mande, a 65-year-old resident of Kisasi is one of such vaccine recipients. Over a month since she was vaccinated, she has never got her ministry of health issued card.