After immunising over 1.6 million Nepalis against Covid-19, the government now plans to administer the rest of the 600,000 jabs that it has in stock for second doses starting 20 April. But it needs at least another million shots to cover all those who inoculated in the first and second phases, as well as to complete the inoculation of those 55 years and above.
The Health Ministry is banking on the remaining 1 million doses of the AstraZeneca Covidshield that it purchased from the Serum Institute of India. That consignment was not delivered on 15 March as promised after an Indian court banned export of vaccines before demand at home is met.
The next batch of Covishield vaccine under the COVAX initiative is also not expected before May. However, the current suspension of vaccinations in Europe, Thailand and other countries may ease the worldwide shortage somewhat.
“We will go ahead with second doses as planned, but the third phase aimed at the age group 55-64 will depend on vaccine availability and as of now we don’t have dates on when they are arriving,” admits Shyam Raj Upreti, head of the Government Covid Vaccine Strategy told Nepali Times.
The Chinese government, on the other hand, has increased its gift of Sinopharm vaccines to Nepal from 500,000 to 800,000, but China has insisted that Nepal send a plane to collect it from Beijing.
The shortfall in supply and procurement challenges forced the Health Ministry to allow private companies to import vaccines, including the Covaxin manufactured by Bharat Biotech in India.
“The private sector can help bridge the gap in procurement limitation as well as allow people with the means and the interest to get vaccinated, but all this must be monitored and regulated,” says Sher Bahadur Pun, a virologist at the Teku Hospital.
Average coverage was 73% of the eligible population in the first two phases, all of them with the Covishield AstraZeneca vaccine. However, media reports of the suspension of that vaccine in European countries this week due to fears of blood clot among some recipients may increase vaccine hesitancy in Nepal.
The suspensions have baffled public health experts who warn that there is neither enough data to justify the decision, nor adequate evidence to blame blood clots on the vaccine. The fact that there have been no serious side effects in Nepal had increased the acceptance level of the vaccine in the public and among frontline health workers in Nepal.
“The EU might have different standards from ours but it might be a good idea to monitor serious side effects,” says epidemiologist Lhamo Yangchen Sherpa. “However, the vaccine has been safe in this part of the world, so its benefits far outweigh the risk.”
Some experts think the suspension of the vaccine campaigns in Europe may actually be a blessing in disguise for Nepal, which is facing delays in shipments of Covishield it ordered as well as remaining doses under the COVAX initiative from the Serum Institute. That delay and the heftier price tag was blamed on a rise in global demand.
So far, the government has only administered Covidshield in Nepal and health authorities here see no reason to discontinue the vaccine without a real causal link between AstraZeneca and the blood clots.
“The EU decision to suspend AstraZeneca is very random and counterproductive, it was probably influenced by politics,” says Buddha Basnyat of the Patan Academy of Medical Sciences. “There is evidence this vaccine is safe and protects us specifically from severe symptoms of Covid-19.”
Meanwhile, reassured by the vaccination drive and a dramatic drop in infections, Nepalis have gone back to normal, and many have forgotten about precautions.
With parts of India hit by a second wave with over 37,000 new cases and 171 additional deaths on Wednesday, experts have advised the Nepal government not to let up on communicating the need to mask up and avoid crowds.
“Officials here have stopped testing and are focusing only on vaccinating but even those who have been inoculated must remember that they can still be carriers,” Lhamo Yangchen Sherpa told Nepali Times from Achham. “We have to continue to take safety precaution as if the pandemic is not over, which it is not.”