The case for prioritising the elderly | Daily News
COVID-19 vaccine:

The case for prioritising the elderly

Sri Lanka will import a new stock of AstraZeneca vaccines from the Serum Institute of India
Sri Lanka will import a new stock of AstraZeneca vaccines from the Serum Institute of India

The Council of the Vaccine and Infectious Disease Forum of Sri Lanka has appreciated the decision made by the Government to buy nine million doses of Covishield vaccine from the Serum Institute of India (SII) to be given to Sri Lankan citizens. We noted that 500,000 doses gifted to us by India under its ‘Vaccine Maitri’ programme have been given to health care workers, Security Forces personnel and social workers involved in the care of the COVID-19 patients and their contacts. We have also observed that the remaining vaccines have been distributed to many Medical Officer of Health (MOH) areas to be given to all adults between 30 years to 59 years of age.

Our opinion as well as the opinion of the World Health Organization (WHO) is entirely different on this issue. According to the WHO protocol, the first priority is given to the health care workers and the next priority is given to people over 65 years and people with co-morbid and Non-Communicable Disease (NCD) features. Countries such as Israel have vaccinated elderly persons over 65 years and people with co-morbid features first, before giving the vaccine even to health care workers. The reason was to bring down the mortality rate. In fact, Israel, which leads the world in the rate of vaccinations, has seen very good results within three weeks with a significant reduction in the number of deaths and also new infections.

Israel’s Health Ministry on Saturday said that the Pfizer-BioNTech vaccine (which is the brand of vaccine Israel uses) was 98.9 percent effective at preventing hospitalizations and death caused by COVID-19. The rate of COVID-19 infections also declined 95.8 percent among people who received both shots of the vaccine, it said, adding that the vaccine was also 98 percent effective in preventing infections that prompted fever or breathing problems.

“The vaccine dramatically reduces serious illness and death and you can see this influence in our morbidity statistics,” the Times of Israel online newspaper quoted Health Ministry Director-General Chezy Levy as saying.

New Zealand, the country which topped the recent Lowy Institute of Australia COVID Performance Index (where Sri Lanka was placed tenth) has also decided to follow Israel by giving the vaccine first to the elderly population before giving the jabs to health care workers. In England, the first country to launch vaccinations, the first-ever jab was given to 91-year-old Margaret Keenan.

In fact, the primary purpose of this vaccination process is to avert deaths. The vaccine efficacy generally ranges from 70–84 percent, signifying a possibility of getting the COVID-19 infection despite vaccination. But with the Oxford/AstraZeneca vaccine (Covishield), it is observed that the mortality reduction is almost 100 percent. That is the primary aim of this vaccine programme. The vaccine may also significantly reduce transmission of the virus, according to analysis of trial data by the University of Oxford, which developed the shot with the British drug-maker. Swabs taken from volunteers in the UK arm of the trial showed a 67 percent reduction in transmission after the first dose, the report showed.

However, the Health Ministry’s decision to give the remaining vaccines from the initial stock to members of the public between 30–59 years is meaningless. It does not avert deaths among the elderly. The basis of this decision by the Health Ministry is not very clear. The number of doses left would be only 200,000 to 300,000. With such a limited number of vaccine doses, it is not possible to protect the population of Sri Lankans aged between 30–59 years. In fact, this limited number of doses should have been given to those who are over 65 years of age. That would have averted a significant number of deaths due to COVID-19.

There is a growing suspicion among the public, which is unavoidable and excusable. The decision to give the vaccine first for the 30-59 years old category has created a wrong impression among public that the vaccine should not be given to the elderly over 60 years, as it is unsafe. We have heard that it is already happening and many people may become reluctant to give the vaccine to their elderly relatives.

When the new consignment of vaccines becomes available for the elderly people in the next few weeks, it may become difficult to convince the public that the vaccine is safe for this segment of the population. They might ask, “Then why didn’t you give the vaccine to the elderly last time?” We hope that the Ministry would come out with a convincing answer.

Saving lives is of paramount importance. Therefore, if the elderly are not vaccinated, the entire purpose of the COVID vaccination programme would be in vain.

(The writer is President, Vaccine and Infectious Diseases Forum of Sri Lanka.)