Hurdles Past: Now target double-dose vaccine for all by June

Amid the Covid-19 pandemic raging throughout the best part of 2021, Bangladesh had to tackle myriad challenges to ensure vaccines for its citizens.

So far, over half the population received the first dose, and the government aims to administer a double dose for all eligible persons by June and a booster dose by the end of this year.

Government officials say they have now overcome the initial challenges, including smooth vaccine supply.

The government is also working to set up a vaccine plant to cut dependency on other countries, although progress has been slow.

"We are hopeful about setting up a vaccine plant next year for our own vaccine production," Health Minister Zahid Maleque told The Daily Star recently.

He said initially there were challenges but health workers did a fantastic job inoculating around eight crore people with the first dose.

Alongside jabbing the adults, the government is now vaccinating children aged 12 and above, and has launched a booster dose campaign on a limited scale.

The booster dose coverage will soon be widened -- targeting  vulnerable groups like the elderly and frontline workers, including medical professionals.

Currently, around 13 lakh doses are being administered every day, thanks to the  supply from China's Sinopharm and other sources.

But it was not as smooth when the mass inoculation was launched on February 7 last year mainly due to "vaccine nationalism", misinformation and skepticism.

The government began the campaign with contract for three crore doses of AstraZeneca vaccines procured from Serum Institute of India, and commitments of 6.8 crore doses from Covax, a global initiative, by 2021.

But the campaign had to be postponed for around a month due to a sudden suspension of vaccine supply from Serum.

Serum stopped supply of the purchased vaccine after sending only 70 lakh doses in two consignments following the Indian government's embargo on export in April 2021.

Covax's pledge to supply vaccines to low-income countries also suffered a blow due to vaccine nationalism, a popular phrase used during the pandemic as a reference to wealthy governments signing agreements with manufacturers to secure supply for their own populations.

The Serum suspension forced the government to explore other sources. The campaign resumed after 1.5 crore doses of Sinopharm vaccine were purchased from China in June. The government procured another six crore doses of Sinopharm in August.

Besides, the country got around one crore doses of different brands from Covax in phases.

Apart from this, the government started administering Pfizer vaccines, received as donation under Covax arrangements, mostly among students and Middle East-bound migrant workers.

As the supply became smooth, the campaign got some momentum -- the government reduced the age bar from 55 years to 40 and ensured better management. Soon the age bar was lowered from 40 to 18 years in efforts to boost the vaccination rate and open the long-closed education institutions.

To ramp up vaccination, the government also launched several special drives to bring more people under the coverage, especially for people living in rural areas with limited access to online registration. The registration through Surokkha app started on January 26.

There were some complaints of irregularities and sufferings in special drives. But apart from that, regular vaccination campaigns through over 1,000 centres across the country were generally trouble-free.

Experts said tireless efforts from health professionals and a strong setup of Expanded Programme on Immunisation (EPI) helped a better vaccine management despite the ill-equipped public health facilities overburdened with influx of Covid-19 patients.

Bangladesh, however, failed to make any considerable progress in vaccine production.

The government struck a trilateral agreement for bottling, labelling and dispensing China's Sinopharm vaccine in August. Under the deal, Bangladesh's Incepta Vaccines Ltd is expected to supply five million doses of Covid vaccines a month from its plant in Savar, but the production is yet to start. 

For the last few months, the country has seen a gradual decline in Covid deaths and infections after the Delta variant, detected in May, ravaged the country in June and July.

But the detection of the Omicron variant in late November raised alarm bells. The World Health Organisation has labelled Omicron as a variant of concern.

Experts say vaccination, which curbs hospitalisation and deaths, is key to tackle coronavirus, along with maintaining health guidelines.

Prof Be-Nazir Ahmed, a public health expert and former director of DGHS, said Bangladesh started well in vaccination but slipped due to dependency on a single source of vaccine.

"But Bangladesh recovered from that slip very well in managing vaccines and in inoculation. But still the vaccination coverage is not at the expected level, especially when we are a champion in vaccinating people."

Dr Shah Ali Akbar Ashrafi, chief of health Information Unit of DGHS, said it was not easy to work with a completely digital vaccine management system as adult education was a challenging process.

"We needed to teach statisticians from 492 upazila health complexes and 64 district offices quickly. We needed to hire data assistants right away. We used the online platform Zoom to train many healthcare workers in Surokkha.

"Management Information System had to go through a critical period at the start. All of the officers, data assistants, and support staff were working round the clock to resolve the issues."