Despite doubts, Nepal sticks with AstraZeneca jabs

A health worker in Jumla administers Covidshield AstraZeneca vaccine to an elderly this week. Photo: LAXMI NGAKHUSI/UNICEF NEPAL

Over 1.6 million Nepalis have so far been inoculated against the coronavirus, all of them with the AstraZeneca vaccine that several European countries have suspended because of fears of blood clots.

With a turnout of 65% of frontline workers, vulnerable groups and people over the age of 65, Nepal has completed the second phase of its Covid-19 vaccination rollout with the Covishield vaccine either donated or bought from the Serum Insitute of India.

“We have managed to protect the groups most vulnerable to Covid-19 from the possible second wave,” Shyam Raj Upreti, head of the Government Covid Vaccine Strategy told Nepali Times. “The fact that there have been no serious side effects has increased the acceptance level of the vaccine among the masses and health practitioners themselves.”

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However, reports of some EU nations, Thailand and other countries suspending the use of the AstraZeneca Oxford vaccine because of serious blood clots among some recipients may result in vaccine hesitancy among the remaining population. Covishield is the brand name of the Indian-made version of AstraZeneca.

Germany, France, Italy and Spain suspended the vaccine program , following in the footsteps of by Ireland, the Netherlands, Denmark, Norway, Sweden and Latvia discontinuing the vaccine earlier this week. Austria has temporarily paused the use of certain batches. Thailand is the first country in Asian nation to halt AstraZeneca shots.

The suspensions have baffled public health experts who warn that there is neither enough data to justify the decision, nor evidence to blame the blood clots on the vaccine. It is especially worrisome because some European countries suffering their third wave of Covid-19 desperately need the vaccines.

“To date, the vaccine has been safe in this part of the world, so its benefits far outweigh the risk,” said epidemiologist Lhamo Yangchen Sherpa, while cautioning that serious side effects should be monitored and their underlying causes studied.

The suspensions in Europe, however, may be a blessing in disguise for countries like Nepal which have faced delays in shipments of AstraZeneca from India because of the rise in global demand. The price of the 2.2 million doses that Nepal had ordered from the Serum Institute also went up to $5 because of the shortage. It bought the first lot for $4 per dose.

Nepal has approved two coronavirus vaccines for emergency use, Covishield AstraZeneca and China’s Sinopharm. So far, the government has only administered Covidshield and Nepali experts see no reason to discontinue the vaccine without a real causal link between AstraZeneca and the blood clots.

With only about 600,000 doses in stock, Nepal needs to procure another 1.5 million shots if it wants to provide second doses starting from 20 April for those who inoculated in the first and second phases. Vaccine availability will also determine when the third phase aimed at people in the age group 55-64 age group will begin.

“There is every likelihood that politics is involved in this decision to suspend AstraZeneca in the EU. We know that this vaccine is very safe, but it protects us from Covid and its more serious symptoms,” says Buddha Basnyat of the Patan Academy of Medical Sciences.

Nepal has yet to receive another 1 million doses of Covidshield it ordered last month. Serum Institute of India was unable to deliver it on 15 March as expected. Similarly, Nepal received only 348,000 doses of Covishield vaccine under the COVAX initiative on 7 March of the promised 2.2 million doses. The next batch was not expected before May, but it could now be shipped earlier because of the suspensions.

China, on the other hand, has increased its gift of Sinopharm vaccines to Nepal from 500,000 to 800,000 but there is a delay in procurement with Beijing insisting that Nepal send a plane to collect it .

The shortfall in supply and procurement challenges have forced the Health Ministry to allow private companies to import other vaccines, including the Covaxin manufactured by Bharat Biotech in India.

The vaccination drive and fewer daily positive cases have given Nepalis a false sense of security. Youth are out and about, shopping malls, cinema halls and dance bars are crowded, schools and offices have stopped maintaining physical distance.

At a time when neighbouring India is experiencing a possible second wave, public health experts say the public has to be even more vigilant and follow safety precautions. Even those who have been vaccinated must remember that they can still be a carrier.

Lhamo Yangchen Sherpa’s advice is: “The pandemic is not over, we can’t let our guard down. Vaccinate if possible, increase testing and continue to mask up, wash hands and maintain distance.”