14m Covid-19 doses at risk of expiry due to low uptake

The Ministry of Health statistics indicate that only around 54,000 doses of Covid-19 vaccines are being administered per day, a rate that would leave close to 14 million doses of vaccines which are due to expire in May, unutilised.

But the ministry officials told Daily Monitor that plans are underway to revive mass vaccination across the country this month to ensure no vaccine goes to waste. Mr Emmanuel Ainebyoona, the spokesperson of the ministry, yesterday said 16.7 million doses have been administered since the exercise started in March last year.

The number of administered doses implies that about 19 million out of the 36 million doses that the government has cumulatively acquired through donations and direct procurement, have not yet been utilised.

The vaccines are due to expire by May according to National Medical Stores (NMS). The computation excludes the recently received 500,000 doses of vaccines from the United Kingdom or any other vaccines received after February 15.

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Between February 15 and February 25, the statistics from the ministry indicate that 541,663 doses were administered, implying a vaccination rate of 54,166 doses per day.

This means in the three months ending in May (90 days), the ministry can only administer about 5 million doses of vaccines at the current rate of vaccination, rendering as high as 14 million doses from the current 19 million doses unutilised.

However, Ms Anifa Kawooya, the State minister for Health in charge of General Duties, downplayed the impending crisis saying it “is not true” some vaccines might expire. “We are are carrying out mass vaccination and the turn up is very good,” she said.

Mr Ainebyoona, while revealing plans to exhaust the vaccines, said they will also increase vaccination of children who are 12 years and above.  “Starting March [this year], we will be going back to areas where we did mass vaccination to administer second doses and make sure vaccines don’t go to waste,” he said.

The ministry last year conducted mass Covid-19 vaccination in Teso, Acholi, Lango and Kigezi sub-regions. The drive saw large numbers of people turn up for vaccination. The campaign was also launched in the eastern part of the country, greater Masaka and other border districts in January.

Mr Ainebyoona said a total of 13.8 million Ugandans have received at least one dose while 7.7 million (35 percent) of the targeted 22 million Ugandans are fully vaccinated. This is a shortfall considering the World Health Organisation (WHO) target that countries under it, Uganda inclusive, should have vaccinated at least 40 percent of their population by December last year to effectively contain the pandemic and guarantee recovery of the economy.

The WHO has also set a new target of fully vaccinating at least 70 percent of the population by June. Mr Ainebyoona said they are hopeful that they will hit the target.

Dr Joseph Okware, the director of health governance and regulation, said even as they increase efforts to exhaust vaccines, stopping vaccines from getting expired may not be avoided.

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“We have a programme to be discussed tomorrow [yesterday] in the national strategic meeting to do mass vaccination and that will help us to reach every corner of the country where people have not accessed the vaccine,” he said adding  that more than 20 million doses have so far been administered.

The strategic meeting is happening about one week after President Museveni ordered the ministry to increase efforts to ensure the target population is vaccinated as planned.

Mr Museveni, in a statement released by State House last week, asked the ministry to provide sensitisation messages to the public and encourage mass vaccination.  “We said 22 million people should either have gotten two doses of the other vaccines or one of Johnson and Johnson. Then a booster for those of my constituency 50 years and above. In my constituency, there are about 3.5 million, plus security personnel, teachers, health workers, boda bodas, bar maids/workers etc. This comes to over six million people for the booster. Let the people know,” he said.

The figure of the total number of vaccines administered (20m doses) which Dr Okware gave is contrary to what Mr Ainebyoona and official statistics from the Ministry are indicating. Mr Ainebyoona, however, said it is possible that some data of people who have received the vaccine have not yet been entered into the system.

Cause of low uptake

Health experts and behavioural scientists say the decline in infections and deaths in the country has made people relax on vaccination uptake.

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“When the disease is no longer threatening, naturally, human beings will drop in terms of vaccination. If the situation was the same as the [deadly] second wave of Covid-19 that was driven by delta variant, they would go for vaccination,” Dr Simon Kibira, a lecturer in the Department of Community Health and Behavioural Sciences at Makerere University School of Public health, said.

“If people are threatened that the disease is dangerous, people do something about it. The moment they feel that there is no threat and view the disease as a normal flu, people will ask themselves why they should go for the Covid-19 vaccine and not the flu vaccine,” he added.

His reasoning was not far from that of Prof Winston Muhwezi, a behavioural scientist who heads research at Advocates Coalition for Development and Environment.  “We also know that there are conservatives who see vaccines as deviation from their religion and putting theological connotation to it,” Mr Muhwezi said.

He said revolving information about Covid-19 vaccination could have made some people confused.  “At first they were talking about two doses and now they are talking about booster doses, the people start having questions in their mind. But generally, I see there are many people who question government programmes, which can be good but can also be counterproductive,” Mr Muhwezi said.

Dr Mukuzi Muhereza, a clinician in western Uganda, who was the former general secretary of the Uganda Medical Association, said access to vaccines is still a big problem in communities.

But Dr Charles Olaro, the director of clinical services at the Ministry, said: “We are working with civil society organisations. We have campaigns on radio calling upon people to go for vaccination.”

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