Vaccine Rollout in Bangladesh: No antibody tests, even no dry run

The government plans to roll out Covid-19 vaccines next month without any dry run and antibody test, which, experts say, are two critical aspects of a vaccination programme.

A dry run or a practice run of a vaccine is a testing process where the effects of a possible failure are intentionally mitigated. It is the complete testing of the system involving all components of the process but is undertaken before delivery to the actual end-users.

Experts said the dry run reveals all possible issues and offers a chance to address them. The testing process reduces chances of wasting the vaccine doses, they said.

Dry run is also needed to find out whether the vaccine makes any adverse impact, they added.

On the other hand, the antibody test would reveal who has developed antibodies against Covid-19, thus allowing the authorities to pick who should receive the jabs first, said the experts.

Officials involved in the national vaccination taskforce said they would go for a pilot testing at some centres before rolling out the vaccines.

The first batch of 50 lakh doses of Oxford-AstraZeneca coronavirus vaccine, branded as Covishield, is expected to arrive in the country later this month and the vaccination is scheduled to start early next month. The government placed an order of 3 crore Covishield shots from Serum institute of India. Besides, it has also confirmed another 6.8 crore vaccine doses from COVEX, a global vaccine alliance.

Bangladesh has so far recorded more than 5.26 lakh Covid-19 cases since March 8 last year when the virus was first reported in the country.

As many as 7,862, people lost their lives to the disease till yesterday. The death rate currently stands at 1.49 percent.

Contacted, Dr Shamsul Haque, member secretary of the Covid-19 Vaccine Management Taskforce, said, "It would have been good if we could do the dry run. But we will do piloting. Nurses and volunteers would be administered the vaccine before the mass vaccination programme begins. So, it will give us some insight."

Asked how many people would take part in the pilot test, he said the number was yet to be fixed, adding that the process would involve people who wish to volunteer.

He declined to give the number of vaccination centres where the test would take place.

An official from the Directorate General of Health Services (DGHS) said the test might take place at three centres.

According to media reports, India has done a dry run in around 1,900 centres before mass vaccination that kicks off today. It aims to inoculate more than 20 percent of the country's 1.3 billion people against Covid-19 in the first phase.

Other countries that have already started the vaccination programme, have also conducted dry runs before rolling out mass vaccination, said experts.

Prof Md Sayedur Rahman, chairman at the BSMMU's pharmacology department, said dry runs were very important. "Through this exercise, problems are identified and their solutions are found."

Sayedur said the government must hold a dry run at least in 200 centres in upazila, district and city levels.

"Otherwise, the mass vaccination programme may face different obstacles during the campaign," he cautioned.

Prof Be-Nazir, a former director of disease control at the Ministry of Health and Family Welfare, said dry run helps assess people's response to the inoculation campaign.

DGHS officials said they would not do any antibody test as the World Health Organization has not made it mandatory.

"We will not do the antibody test. It would have been better if we did it. But it has not been made mandatory by the WHO," Meerjady Sabrina Flora, additional director general of DGHS, told The Daily Star.

A recent study published in a journal found a rising trend of asymptomatic cases in the country.

Another study by the Institute of Epidemiology, Disease Control and Research (IEDCR) and the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) published in August last year, found that nine percent of the Dhaka city dwellers had already been infected with coronavirus and 78 percent of them had no symptoms.

Prof Dr Nazrul Islam, former Vice-Chancellor of Bangabandhu Sheikh Mujib Medical University (BSMMU), said there were many asymptomatic cases in the country and the antibody test would detect the people with the antibodies.

"Those who developed antibodies do not need vaccines now. We suggested the antibody test but there is a crisis of proper testing kits," he added.

Echoing Prof Nazrul's view, Prof Be-Nazir Ahmed said if antibody testing could have been done, many people who have developed enough antibody would have required a single shot of vaccine, instead of the usual two.

"Antibody tests would indicate whether the person needs a vaccine. Through the test, we can see how much antibody was formed in the body. Whether the person needs two doses or one will be okay," he added.

He also said even after the vaccination, an antibody test is required to see how long the antibody would last.