Bangladesh plans mass COVID-19 vaccination. How will you get your shot?

As the new year brings with it the hope of vaccination against the coronavirus, people are seeking answer to questions such as when Bangladesh will get the doses and how they will get their jabs.

bdnews24.com has tried to seek the answers by interviewing the government’s health officials and suppliers of the vaccines.

The Directorate General of Drug Administration on Monday authorised the import and emergency use of the Oxford University-AstraZeneca vaccine, manufactured by the Serum Institute of India.

Other drugmakers, including US firms Pfizer and Moderna, China’s Sinovac and Russia’s Gamaleya Institute, have also developed coronavirus vaccines. But Bangladesh chose the Oxford-AstraZeneca candidate initially because of its easy transportation and preservation requirements, and availability.

The Directorate General of Health Services or DGHS has drafted a detailed plan on storing and distributing the vaccines once they arrive, initially focusing on the systems required for the Oxford vaccine. They are still unsure which vaccines Bangladesh will get rom the global alliance GAVI under the COVAX programme led by the World Health Organization.

The government plans to maintain a cold chain to store and transport the vaccine at temperatures between 2 and 8 degrees Celsius, said Meerjady Sabrina Flora, an additional director general of health.

It has not kept Pfizer-Biontech’s vaccine in the plans as it needs to be stored in -80 to -70 degrees Celsius.

“In plan B, however, we are considering Pfizer, Sputnik (Russian) and Moderna vaccines,” Sabrina said.

According to the plan, people over 18 years old will get the vaccines, with the health workers on the frontline of the fight against COVID-19 being ahead of the pack. Members of the general public will have to apply online by using their national ID cards, birth registration or passport.

WHEN WILL THE VACCINES ARRIVE?

The initiative to import the novel coronavirus vaccine began in the middle of last year.

On Nov 5, Bangladesh signed a deal with the Serum Institute of India and Beximco Pharmaceuticals for 30 million doses of the Oxford-AstraZeneca vaccine.

Serum Institute has signed a contract with Oxford-AsrtraZeneca, Gates Foundation and GAVI for producing more than 1 billion doses of the vaccine and distributing it among the poor countries.

In August 2020, Beximco Pharmaceuticals announced investment in the Serum Institute to ensure Bangladesh gets priority access to the Oxford vaccine. Beximco is now the exclusive supplier of the vaccine in Bangladesh.

As per the deal, the DGHS has wired Tk 6 billion in advance for the doses from Serum. It will cost Bangladesh $5 or about Tk 425 per dose.

Health Minister Zahid Maleque has said different things at different times regarding the arrival of the vaccine, but uncertainties and confusions ovrshadowed hopes of getting the vaccine anytime soon after reports in past few days said India was banning the export of vaccines for months. 

The government later clarified that the vaccine will be made available to Bangladesh as per the deal with the Indian firm. Beximco Pharmaceuticals said the vaccine will arrive in one month from the day Bangladesh approves it.

The government approved the Oxford-AstraZeneca vaccine on Monday, which means the first batch of the vaccine is expected by the first week of February. Health Secretary Md Abdul Mannan has also hinted the same.

STORAGE AND DISTRIBUTION

The DGHS said it will send the vaccines to the Upazilas after Beximco delivers the shots to the districts.

Serum Institute will send the vaccine to New Delhi and then upon being flown in Bangladesh, the vaccines will be stored in Beximco cold storage, said Nazmul Hassan, managing director of the pharmaceutical company.

Beximco has prepared a cold storage in Dhaka to store the vaccine, he said, adding that they also bought seven specialised trucks to carry the vaccines to the districts.

The Central Medical Store Depot is also prepared to take part in the storage and distribution of the vaccine.

Its Director Abu Hena Morshed Zaman said the cold storages for measles and rubella vaccines and antidotes of snake venoms are expected to get empty by Jan 24.

“We’ll be able to store more than 5 million vaccines there,” he said.

Every district has EPI stores under the Expanded Programme on Immunisation (EPI) of the government. Each of them can store 200,000 vaccines.

Around 35,000 vaccines can be stored in ILR refrigerators in each Upazila. Cold boxes will be used to carry the vaccines to the union level, said DGHS officials.

PRIORITY TARGETS FOR VACCINE

The government has devised a plan to vaccinate around 140 million people, or 80 percent of the population, against SARS-CoV-2, the dominant stream of the coronavirus that causes COVID-19.

People on the frontline in the fight against the coronavirus pandemic have been prioritised in the plan to be executed in five stages in three phases requiring around 180 million doses, as a person requires two jabs, according to the DGHS.

In the first phase, the shots will be given in two stages, according to the draft plan. Over 5.1 million people, or 3 percent of the population, will receive the doses in stage 1 and over 12 million, or 7 percent of the population, in stage 2.

In stage 2 of the first phase, people aged over 60 and those with morbidity will be prioritised.

The Health Services Division plans to vaccinate more than 17.2 million people, or 9 percent of the population, in the second phase.

The third phase also has two stages - first one for inoculation of 34.5 million, or 20 percent of the population, and second one for 69.1 million, or 40 percent of the population. In the last phase, the DGHS plans to vaccinate 60 million people.

The first consignment of the vaccine from India will deliver 5 million doses, which can be administered to 2.5 million people. People should have the second dose four weeks after the first one.

The first batch of vaccine will be given to the health workers, who are the front liners in the combat against the coronavirus pandemic, said Dr Mushtuq Husain, member of the coronavirus vaccine distribution preparation committee.

“They will be followed by the law enforcers. We’ll decide whom to prioritise following a list,” he said.

Besides the health workers, frontline law enforcement personnel, other uniform and defence forces, freedom fighters and essential workers, among others, will also get the vaccines in the first phase.

HOW TO APPLY FOR YOUR SHOT

General people will have to apply online with their national ID, birth certificate or passport to secure the shots.

Management information Service (MIS) of the DGHS, Ministry of Information Technology and a2i will run the registration service for vaccine distribution.

Habibur Rahman, director of MIS at the DGHS, said the work to develop smartphone apps for the registration is ongoing.

Whenever a citizen applies for the vaccine through the app, they will be grouped. The selected will be notified through a text message about the date, time and place for their shots. Teletalk has initially been selected to send the SMS.

The government is considering an option that allows employees of government and private organisations to apply through their organisations.

Identity confirmation of the recipient has been made mandatory to ensure proper use of the vaccine, registration and determining the age, said Meerjady Sabrina Flora.

WHERE THE SHOTS WILL BE GIVEN

Coronavirus vaccines will be distributed in the same manner as the Expanded Programme on Immunisation (EPI) is done, said the DGHS.

At first, the vaccines will be administered by the DGHS workers, including the medical technologists, at the hospitals and Upazila health complexes. Later, it will be expanded to the union level, and other health workers and volunteers will be involved in it.

According to the draft of the national COVID-19 vaccine distribution and preparation plan, 20,800 health workers and 41,600 volunteers will work for administering the vaccines.

At least 5,469 porters and 8,869 supervisors will work to carry the vaccines to districts, Upazilas, municipalities and city corporation areas.

A team of six, including health workers and volunteers, will work in each centre, with 24 officials at divisional level and 16 at the national level overseeing them.

As many as 6,500 vaccination centres will be established across the country. Union Parishad offices will house 4,600 centres while Upazila health complexes  will have 600 more. The hospitals will have 400 centres in total.

The authorities plan to give the shots in the first fortnight of each month, said Sabrina Flora. It will take around a year to vaccinate 150 million people, she said.

“It may take more time. It’s not the issue of our preparedness, but we need to secure the necessary doses of the vaccine.”

WHO WON’T GET THE SHOTS

No one under the age of 18 years can receive a coronavirus vaccine as the Oxford-AstraZeneca candidate has not been tested on children under 18, said the DGHS. Also, pregnant and nursing mothers cannot have it.

Those allergic to drugs should be careful too.

People who have already contracted COVID-19 and recovered can receive the vaccine, said Sabrina Flora.