Sri Lanka: Vaccinating Against Covid-19

By Dr. K E Karunakaran –

Covid 19 pandemic is now reaching one year. Also known as the coronavirus pandemic, the virus infection was first identified in December 2019 in Wuhan, China. The World Health Organization declared the outbreak a Public Health Emergency of International Concern in January 2020 and a pandemic in March 2020. As of 30th December 2020, more than 82 million cases have been confirmed, with more than 1.79 million deaths attributed to COVID-19[source: Wikipedia]. The virus has caught over 41,600 Sri Lankans and death toll will soon reach 200.

The current wave of the viral infection has produced clusters and sub-clusters in most parts of the country. The unusual yet highly vulnerable location; the Prisons not only reported an escalation of infected persons but also a significant blood shed the country witnessed this month. The education sector is continuing to be the worst affected, still struggling to get to near-normal state. Tourism likewise received a very high blow. The ever vibrant BIA turned into a pathetically deserted place. The sector of passenger transport appearing a recovery in operation nevertheless continue to have impacts due to restrictions. Although the industry sector is still suffering due to the detection of infection in an apparel factory and other reasons, the agriculture sector continue to function reasonably resulting in the interest of home garden production as well. These are some of the negative and positive factors which brought impacts on Sri Lankan society. Many countries experience the situations worse than ours, suffering the worse including famine. United Nations forecast a ‘Hunger Pandemic’. The most recent experience is the mutant virus reported in Britain with more virulence.

Therefore, the entire world has the most fervent wish: the ‘covid pandemic should be brought to a halt’; easier said but very difficult to realize. Many factors play in this regard. Important are; health, socio-political and economic factors. An infection can be effectively be handled only by preventing people getting infected. Thus at present strict adherence to the hygienic measures are very much advocated, even with legislation. Lockdowns and travel embargo still very much in place. The other form is development of immunity in people. This would be achieved through vaccination. 

Vaccination is not new to Sri Lankan people. The older generation are aware that the illness ‘small pox’ had been completely eradicated via the vaccination and the present generation do not know of such vaccine. Another good example of success is ‘polio’ which is also on the verge of eradication except in two countries in the world. The ‘Expanded Program of Immunization’ is being implemented with full coverage. This is possible due to the Primary health care system network effectively functioning throughout the country. Thereby the disease, disability and death are prevented and health of our people is ensured. Thus, infrastructure for vaccination against covid virus will be implemented when it is available.

In a general circumstance vaccine for use in mass scale among the population takes an average of fifteen years. This period is necessary for initial production, phases of clinical trials which are performed among groups of people, identifying effective dosage and frequency of vaccination, studying on immune protection and side effects. Once safety is ensured for use in the population, after ensuring its safety and efficacy and also licensing by regulatory authorities, then production of vaccine in mass scale takes place. All these processes require a length of time. 

With regard to covid vaccine, within one year of the emergence of the disease, the world is talking about the vaccination extensively. This is because currently there are 60 vaccines on trial in 41 countries and 15 are on phase 3 clinical trials. So far three vaccines have been approved.

News came as early as mid-November 2020 of the preliminary results upon the efficacy of vaccines under trials. The Pfizer/BioNTech vaccine was 90% effective. The Sputnik V COVID-19 vaccine showed 92% efficiency. Moderna reported about 95% efficiency of their test vaccine and the Chinese CoronaVac also reported showing good efficiency from the early trials. The Oxford/AstraZeneca vaccine is also shown to be 70% effective. These are some of the vaccine trials which made the preliminary reports. Trials are ongoing. There will be more vaccine trials reporting expected in the dawn of the new-year 2021.

On the 2^nd of this month U K announced of giving the vaccine to its citizens the Pfizer/BioNTech vaccine for emergency use. The vaccine producer Pfizer and BioNTech are hoping to supply 1.3 billion doses of vaccine by the end of 2021. Russia also announced mass scale vaccination program initially to Doctors and teachers. Subsequently the USA regulatory authority FDA (Food and Drug Authority) approves the emergency use of Pfizer/BioNTech vaccine. There was also a news flash of allergic reaction to two health workers in the UK who received the Pfizer/BioNtech vaccine. Both of them recovered.

Therefore, sooner than later vaccine against the Covid 19 infection will be available for the world population. Although vaccine will be available, whether people will prefer to get it! This will become a major issue. There is a high possibility that Health care workers and those working in the frontline of control of covid 19 spread are the first lot of people who will receive the vaccine. This lot constitute a small percentage of a given population. There is also a high possibility that people will wait till the ‘definite evidence’ upon the safety be established with regard to the vaccine. Thus public confidence needs to be developed. It was reported that ‘In an attempt to increase public confidence, three former presidents — George W. Bush, Bill Clinton, and Barack Obama — have all stated that they would be prepared to take the COVID-19 vaccine publicly once it receives approval’ [source Medical News Today]. Nevertheless there are other concerns – the cost of the vaccine, storage, transport, maintaining appropriate cold temperature and the related expenses are to name some.

Thus the year 2021 is going to be the vaccination year against covid 19. The challenges are also ahead of us.

The data used in this article has been obtained from ‘COVID-19 vaccine trials: Live updates’ published in ‘Medical News Today’ and also in Wikipedia

*Dr. K E Karunakaran – Senior Lecturer, Faculty of Health-Care Sciences, Eastern University, Sri Lanka