Bangladesh ready to roll out Oxford COVID vaccines after long wait

A year has passed in deaths, sorrow and crises as coronavirus pummelled the world, but it is now time for people to turn around, fight back and grow resistance with vaccines.

In Bangladesh, Prime Minister Sheikh Hasina will inaugurate the immunisation programme via video call on Wednesday afternoon through the inoculation of a nurse and 24 others at the Kurmitola General Hospital in Dhaka.

The vaccination registration process through mobile app and web application 'Surokkha' will also be launched in the ceremony. All who are willing to be inoculated have to register for their doses of the vaccine.

On Thursday, five hospitals will give vaccine shots to 400 to 500 people. Preparations to undertake the procedure are complete.

Dhaka Medical College Hospital or DMCH, Bangabandhu Sheikh Mujib Medical University or BSMMU, Kurmitola General Hospital, Mugda General Hospital, and Kuwait Bangladesh Friendship Government Hospital - all have set up specific booths to administer the initial vaccine shots. .

The hospitals also made arrangements to post-vaccination observation and provide emergency healthcare in case signs of possible side effects after a jab.

Bangladesh will administer the vaccine, developed and licenced by the UK’s University of Oxford and Britishp-Swedish drugmaker AstraZeneca and produced by the Serum Institute of India.

“This vaccine’s efficacy and safety confirm that it will be highly effective against COVID-19 and will have an immediate impact on this public health emergency,” Pascal Soriot, Chief Executive Officer of AstraZeneca, said after clinical trials in November last year.

Bangladesh received seven million doses of the vaccine, two million for free and five million as part of a contract with Serum, from India and the Directorate General of Drug Administration approved the vaccination of the masses after carrying out tests on samples from the lots.

Bangladesh will administer the doses to a specific number of people and keep them under observation in the initial phase following the World Health Organization protocol as no clinical trials of the vaccine were done in the country.

Health Minister Zahid Maleque said if things go according to the plan the nationwide vaccination campaign will kick off on Feb 7.

COMMENCEMENT IN KURMITOLA

The inauguration ceremony will begin at 3:30pm on Wednesday. After the first dose is given to a nurse, another 24 individuals, including frontline health workers, freedom fighters, teachers, doctors and journalists, will be given the shots.

According to Maleque, members of the police and the army are also supposed to receive the doses on Wednesday.

Upon visiting the Kurmitola General Hospital to inspect the preparation on Tuesday, Maleque said that the prime minister will watch the inoculation of the first five persons.

FIRST PHASE PREPARATIONS

Brig Gen Jamil Ahmed, director of Kurmitola General Hospital, said 100 members of his hospital’s staff will be given the shots the day after the inauguration.

Dhaka’s Mugda General Hospital has set up four booths for the COVID-19 vaccination drive. Photo: Asif Mahmud Ove

There will be four booths for vaccination at the hospital. A separate ward has also been set up in case someone needs hospitalisation due to side effects.

DMCH Director Brig Gen Md Nazmul Haque confirmed that the hospital is done taking preparations for mass vaccination. It has created a list of health workers to be vaccinated on Thursday after discussions.

The hospital will use the open space on the ground floor’s emergency department for the vaccination. There will be two booths for men and two for women.

Nazmul said the authorities have plans to gradually increase the number of booths.

Doctors, nurses, Ansar members, trainee doctors and nurses, among others, are on the list of first 100 people to take the jabs on the first day, according to him.

BSMMU Brig Gen Zulfiquer Ahmed Amin said the health directorate instructed them to give shots to 200 people and the hospital was fully ready to do that.

It will give vaccines to its own people on Thursday. Later it will begin the immunisation process of the citizens on the date instructed by the government, said Zulfiquer.

The hospital has prepared its medical convention centre for the vaccination. , Zulfiquer said they have a building opposite to the InterContinental Hotel and prepared it for vaccination.

SIDE EFFECTS

All drugs can cause side effects and some people may show signs of side effects upon taking the Oxford-AstraZeneca vaccine, COVISHIELD.

Dhaka’s Mugda General Hospital has set up four booths for the COVID-19 vaccination drive. Photo: Asif Mahmud Ove

According to the website of Serum Institute, one of every 10 persons given the shot may experience body aches, warmth, redness, itching, swelling or sores where injected, fatigue or sickness, chills or fever, headache, nausea, flu, etc.

Occasionally there may be some unusual side effects, such as dizziness, loss of appetite, abdominal pain, perspiration, swollen lymph glands, and skin rashes in one of every 100 persons given the vaccine.

Bangladeshi experts said the COVISHIELD causes no severe side effects.

The Directorate General of Health Services said the vaccine was not tested on individuals aged below 18, so they cannot participate in the vaccination programme.

Pregnant and breastfeeding women have also been ruled out while caution will be maintained on those with drug allergy.

DMCH’s Dr Nazmul said individuals who were inside four weeks of testing negative after being infected once would not be given the vaccine until the four-week period was over.

The hospital has prepared a place to observe participants for 30 minutes after the shots. The place has chairs and beds.

“If someone shows signs of struggle, we will treat them as per protocol,” Nazmul said.

NO FEAR

Kurmitola General Hospital Director Jamil insisted vaccines were not a new phenomenon in Bangladesh and should not be a cause of too much anxiety.

Bangladeshis have taken all vaccines under the Expanded Programme on Immunisation since birth, he said. “We have the experience of taking many vaccines. COVID vaccine may be new, but as we have taken other immunisation doses before, it is nothing to fret over.”

He pointed out that as there was no alternative to these vaccines in combating the pandemic, there should be no confusion regarding it either.

“We have been expecting the vaccine for a year. So there is nothing more delightful than finally receiving the drug.

“No vaccine was ever developed in the world which caused no side effects. Some causes more, some less. We’ve acquired [COVID vaccines] going through many steps. We saw nothing which may be a cause of fear,” he added.

Dr Arif Mahmud, Head of Medical Services at the Evercare Hospital, said there were some reports of COVID vaccine side effects in India and Norway, which caused fear among the people. Investigation revealed that it was not due to the vaccines, but the dead had other health issues, he said.

The waiting room for those who will take coronavirus vaccine at Dhaka’s Mugda General Hospital. Photo: Asif Mahmud Ove

Dr Arif insisted that people can receive this vaccine without fear. “If any problem emerges, it can be resolved,” he said, noting that the health ministry has formed a team to look after side effect issues.

“Even if someone takes the vaccine and returns home, the health workers will have his or her phone number. They will follow up three days later. I am hoping that nothing severe would happen,” he added.

REGISTRATION

Besides the app, citizens can also register online on the Surokkha web application at www.surokkha.gov.bd.

They will need to provide necessary information, such as NID number, date of birth and mobile phone number, before clicking “verify”.

The citizens will also need to provide health information, such as if they are comorbid, or suffering from diabetes, high blood pressure, cancer or kidney complications, or have been infected by the coronavirus.

The authorities have made 18 types for the registration. Upon selecting a type, the citizens will need to input NID number, date of birth and mobile phone number.

The types include citizen registration, officers and employees of the government’s Health and Family Planning Department, approved private health and family planning officers and employees, all directly involved government and private health care officers and employees, heroic freedom fighters and heroines, frontline law enforcement agency, military and paramilitary defence forces, essential officers in governance of the state and frontline media workers.

The other types are elected representatives, frontline officers and employees of the city corporations and municipalities, religious representatives of all religions, engaged in burial, government officers and employees at the forefront of emergency electricity, water, gas, sewerage and fire services, government officials of railway stations, airports and seaports, government officials involved in emergency public service in districts and Upazilas, bank officers and employees, and unskilled migrant workers.

Citizens will be informed about the vaccination after verification of the information provided by them during the registration. They will receive SMS containing the date and name of the vaccination centre. The authorities will choose the vaccination centre for a citizen on the basis of their current address.

After receiving the SMS, the citizen will need to download the registration card with a one-time password sent to their phone. They will need to take the Surokkha registration card and NID card to the centre.

Those, who will not be able to register online or through the app, will need to visit the hospital for help, said ABM Khurshid Alam, director general of health services.

PRIORITY TARGET GROUPS

The government plans to inoculate 80 percent of the country’s population, or around 138.24 million people. According to the national COVID vaccine distribution and preparation plan, the doses will be administered in five stages under thee phases.

Dhaka’s Mugda General Hospital has set up an observation centre for the participants of the COVID-19 vaccination drive. Those taking the first doses will need to stay at the centre for a week. Photo: Asif Mahmud Ove

Based on the primary plan, the health directorate has created a list of distribution reflecting the availability of the vaccines over the months

As many as 452,027 doctors, nurses and other health workers at government facilities will get the vaccine first.

Around 600,000 health workers of the private facilities will also get the vaccine in the first phase.

The priority list also includes 210,000 freedom fighters, 180,457 members of the military and civil defence forces, 25,000 government employees essential in running the state, 25,000 journalists, 89,149 public representatives, 75,000 officials and other employees of city corporations and municipalities, and 37,500 funeral workers will get the vaccine doses in the first month.

The others who will get the vaccine in the first month include 200,000 workers of the utilities, sewerage services, fire service and airports, 75,000 of the ports, 60,000 unskilled expatriate workers, 200,000 government staffers engaged in emergency work at districts and Upazilas, and 10,932 from the national sports teams.

STORAGE AND DISTRIBUTION

The two million doses which India shipped as a gift are preserved in Tejgaon’s Expanded Programme on Immunisation or EPI storage.

The 30 million imported doses are arriving via Beximco Pharmaceuticals, the sole distributor of the vaccine in Bangladesh, across six months.

Beximco has stored the first five million purchased doses at its warehouse. It will send the imported doses to district-level authorities in six phases.

The company has purchased seven special trucks to transport the vaccines around the country, while more were on their way.

The DGHS will be in charge of distributing the vaccines to Upazila level after the EPI receives and stores the drugs in their storages in the 64 districts. From there, the doses will be transmitted to 483 Upazila-level storages.

The vaccines will be preserved in ice-lined refrigerators in EPI storages. For transportation to the Upazila-level facilities, the authorities will use cold boxes. Officials said they have several thousand of cold boxes, so there will be no need for special trucks.

The government will conduct the drive through 6,500 centres across the country.

The 4,600 Union Parishad offices, 600 Upazila health complexes, hospitals with 20 or 10 beds, and 400 general hospitals, specialised hospitals, medical colleges, and infectious diseases hospitals will be used for the vaccination.

In city corporation areas, 800 centres will be set up at specialised hospitals, medical colleges, infectious diseases hospitals, ward councillor officers and city health centres.

There will be 100 vaccination centres at various other facilities, including the Combined Military Hospitals, Police Hospital, Secretariat Health Centre, and Parliament Secretariat Health Centre.

Initially, the vaccination will continue at the hospitals and Upazila health complexes. DGHS medical technologists and other workers will carry out the drive.

As many as 20,800 health workers, assisted by 41,600 volunteers, will be directly involved in the drive.

For transportation of the vaccine, the government will use 5,469 porters and 8,869 supervisors.

PRIVATE HOSPITALS

The government will inoculate around 600,000 health workers of the private facilities in the first phase, but nothing has been said about conducting the drive at private hospitals.

Mujibur Rahman, the additional health secretary, declined to reveal details. He said the names of the vaccination centres will be announced once the campaign is launched.

Square Hospital Director Wahiduddin Mahmud said they are prepared to join the drive, but have received no instruction from the government.

Radda MCH-FP Centre, an international NGO that vaccinates people, has not heard from the government either.

Ahsan Habib, a director of the organisation, said they receive vaccine doses under EPI through the city corporations.

“We'll receive the COVID-19 vaccine jabs through the city corporations as well if we get any,” he added.

“We'll be able to give the doses from the day government tells us. But we haven’t heard anything,” said Dr Arif of Evercare.