Next up for vaccines: elderly Nepalis

health workers receive covid vaccine
The first frontline health workers being inoculated with Covishield last week in Kathmandu from the 1 million doses of the AstraZeneca vaccine donated by India. Photo: MONIKA DEUPALA

The Ministry of Health has assured the public that there will be enough free Covid-19 vaccines for everyone above 18, after the first phase of inoculating frontline workers is complete.

Nearly 150,000 of the 430,000 health workers and other high-risk groups in the first phase have already been vaccinated with the Astra Zeneca Covishield made by the Serum Institute of India.  However, that is only half of the people on the government’s priority list.

The ministry is now waiting for more than 2.25 million more Covishield vaccines to arrive under the World Health Organization (WHO) and the Global Vaccine Alliance (GAVI) COVAX initiative.

The first lot of 1 million vaccines was gifted by the Indian government on 21 January, but the rest of the doses will be needed for the booster shots in two weeks. That is expected to coincide with the new Covishield consignment under COVAZ that will arrive by the end of the month.

The Chinese government has also promised to gift 300,000 doses of its own Sinopharm vaccine, but the timetable for that is also unknown. Nepal has not ordered vaccines from any other private company or country.

“We will administer the vaccines that are already here, and give the jabs as new COVAX vaccines arrive,” Health Ministry spokesperson Jageshwar Gautam said, “but they will not be coming all at once, we have to depend on the international supply chain, and have to adhere to our guidelines on which vaccines are affordable and available.”

Gautam confirmed that the COVAX doses should arrive later this month, and immediately dispatched for inoculation of remaining frontline workers after which it will be the turn of citizens above 60.

British Ambassador to Nepal Nicola Pollitt expressed happiness via a Twitter post in Nepali on Thursday that COVAX doses would be arriving soon: ‘The UK government assisted COVAX with 550 million pounds, and I am very glad that more than 2 million doses of this vaccine will be arriving next month. We will be cooperating with the Ministry of Health, WHO and UNICEF to make the vaccines available.’

Frontline health workers, ambulance drivers, female community health volunteers, those working in senior citizens’ homes, security officials and prisoners were the first priority, but they make up only 3% of the population that need to be vaccinated.

Covishield is being administered from 143 centres in all 77 districts, and there will not be enough for everyone in the first phase since there are 911,000 people on the Ministry of Health’s priority list of those eligible.

The ministry is readying to vaccinate 5.154 million people in the second phase, which is 17% of the target population. The priority will be those above 55 years of age, and those in the 40-54 age group with chronic diseases.

In the third phase it will be the rest of those aged 40-54 who total 2.9 million, which is 9.55% of the population. Then it will be the turn of all 12.78 million in the 18-39 age group who will get their jabs next, and they form 42% of the population. Those under 18 will not get the vaccine until safety issues are cleared up.

Gautam says that completing all four phases may take as long as late 2022, because the timetable for inoculations will depend on the availability of various vaccines in the world market. He added that all vaccines will be free to Nepali citizens will be procured through  government-to-government agreements, or through the WHO-GAVI’s COVAX program.

One government sources hinted that the second phase may be complemented by an additional Indian grant of 1 million doses of the Bharat Biotech Covaxin which has been approved for restricted emergency use in India.

Just to be sure, the Ministry of Health is said to be also trying to buy 1 million doses of the vaccines from India at a discounted rate, even though Covaxin has not yet completed third phase trials and has not been approved by the WHO.

The Chinese Embassy has confirmed that the 300,000 doses of its Sinopharm vaccines will be a gift, but has not given a specific time frame. Although the Sinopharm has regulator approval for emergency use in China, Nepali authorities have not yet done so.

Covaxin is India’s first locally produced vaccine and can be stored at normal refrigeration temperature of 2-8 Celsius, which makes it even more ideal for Nepal’s conditions. The Ministry is said to be sourcing 20% of vaccines in Nepal to from Bharat Biotech. This week the Indian company signed an agreement with Ocugen to co-develop and market the vaccine in the United States.

Because of the ‘vaccine divide’ with rich countries hoarding or reserving most of the available supply, poor countries like Nepal will need to coordinate closely with the World Health Organization-initiated COVAX, the only global inter-governmental initiative working with manufacturers to ensure Covid-19 vaccines are available to developing countries. Under COVAX, Nepal is expected to get 2.25 million Covishield vaccines from India.

The limiting factor for Nepal is that the vaccines should be available, affordable, of the kind that do not need extreme refrigeration, and a cold chain not less than 20 Celsius. The government has also asked those who can afford to buy vaccines to do so, and the money will be used to buy doses for people who cannot afford the injections.

Meanwhile, there were only 171 cases of coronavirus among 2,550 that were tested on Tuesday – 78 of them in Kathmandu Valley. There are now fewer than 2,300 active cases in Nepal, and number of patients in ICU has dropped to 61, with 14 of them on ventilator support. There were two days with no fatalities this week, and two patients died from coronavirus on Thursday – bringing the total so far to 2,033.

Overseas, three more Nepalis died of Covid-19 this week, bringing the total number of reported deaths in the diaspora to 330. According to Sanjiv Sapkota of the Non-resident Nepalese Association (NRNA) 58,695 Nepalis in 50 countries had tested positive for coronavirus as of 30 January.

As a new strain of Covid-19 sweeps Europe, the NRNA has issued guidelines on safety precautions, vaccines and also its side-effects. Sapkota, who heads NRNA’s Health Committee warned Nepalis abroad that even those who have been vaccinated can still transmit the disease, so continued precaution was necessary.

The new fatalities and infections among Nepalis were reported this week from the UK, Malaysia, Saudi Arabia, Portugal, Nigeria. This comes even as the Covid-19 cases in Nepal continued to drop.

Read also: A shot in the arm for vaccines in Nepal, Sonia Awale