Covid jab uptake hits record high

More Ugandans took Covid-19 vaccines in September and October than in each of the past five months since vaccination started on March 10, our analysis of official statistics shows.

Of the 2.5 million vaccines so far used in the country, about half were administered in September and the first 18 days of October.

According to the Ministry of Health data, the highest uptake of the jabs (668,982) has been recorded this month days after Uganda back-to-back received 5.5 million vaccines, showing a positive correlation between higher vaccine stock and rising jabbed population.

Before that, the highest number of Ugandans had been inoculated in September, incidentally the month when President Museveni threatened to sack resident district commissioners and chief administrative officers of districts with stockpiles of donated vaccines that were due to expire at the end of that month.

Following the executive scare, top officials superintending local governments went into overdrive, mobilising locals and expanding vaccine outlets to reach the highest numbers and exhaust vaccine supplies.  
In Kampala, Health ministry officials had blamed the less-than-satisfactory national vaccination rates in the preceding months on poor mobilisation by last mile authorities for the devolved exercise.

At the start of the vaccination drive in March, as low as 90,196 people got the shots in 21 days – a number more than seven times lower than this month’s uptake of 668,982 doses within 18 days and counting.

At the time, sceptical Ugandans were hesitant to get scarce AstraZeneca vaccine amid disinformation and misinformation as well as international media reports that few recipients had developed adverse effects, with some dying of unexplained blood clot.

Health Minister Ruth Aceng, alongside top officials of her ministry and the World Health Organisation, took the jab on the day of the nationwide vaccination launch as a reassurance to the population about the safety of the jab, but most Ugandans held out.

Then weeks later, President Museveni said he was still undecided on which of the vaccines --- AstraZeneca, Pfizer, Sputnik, Sinovac and or Cuban version --- to get and in social media posts and opinion articles in print, some Ugandans claimed to take a cue.

However, Mr Museveni and the First Lady Janet got the first dose of AstraZeneca toward the end of March and nearly triple more people were vaccinated in April and even a higher number in May, with the latter month’s bump a result of mass vaccination campaign at Kololo Ceremonial Grounds in Kampala to save the last due-to-expire stock.

Public trust on vaccines
In an interview yesterday, Prof David Serwadda, the government chief advisor on Covid-19 vaccine, said as few people, including political leaders took bold step to get vaccinated, the public gained trust.

“The more people get the vaccine, like your friend, mother or relative, you are also more likely to get it. It also reduces the fear and anxiety because the more people get it and don’t feel ill, the more confidence people build in the vaccine,” he said.

With Uganda’s first stock of the 964,000 AstraZeneca doses received in March nearly exhausted in May, the number of people vaccinated in June, during which Uganda received only an additional 175,200 donated vaccines, plummeted to 189,250.

By this time, a more aggressive and deadly second wave of the pandemic swept through the country, leading to a June 18 second nationwide lockdown and a dash for vaccines. This increased the number of people receiving the jab in July by about 100,000 alongside good news of the arrival in the month of more than half a million vaccines.

President Museveni partially lifted the second lockdown at the end of July 30, including ending a ban on inter-district travel.

However, the official statistics show that vaccine uptake in August was much lower than in July amid declining coronavirus infections and deaths, suggesting threats of dying from the pandemic nudges more people to file for inoculation.

Caught at the cross-hairs of huge vaccine stock and fewer jabbed population, bureaucrats returned to the drawing board for answers to ramp up inoculation rates and decided, among other things, to issue threats of job losses and access denials to staff in some government agencies.

Now the uptake is seven-fold higher than the lows of March.  Health officials attribute this to establishment of new vaccination centres and outreaches and increase public confidence in the vaccines due to increased mass sensitisation.

This comes at a time when the government is racing to inoculate at least 7 million people, up from the initial 4.8 million threshold target, out of the overall planned vaccination of 21.9 million to put the pandemic under control and fully reopen the economy.

Covid positivity rate
Currently, the pandemic’s positivity rate, which is the number of positive results from total tests, is down at 1.3 percent from the highs of 21 percent in June.  

This, according to scientists, means reduced threat of the disease, although they warn of a third wave unless the population adheres to the standard operating procedures (SOPs) and get vaccinated.

About 2 people have received their first dose while an additional 600,976 have been fully vaccinated, according to the Ministry of Health.

With more vaccination points opening and increased mass vaccination, the number of people vaccinated in September hit a record high 529,053 people and in the last 18 days of October as high as 668,982 were vaccinated.

Officials in Kampala’s City Square and Old Taxi Park, two improvised sites for vaccination, said they each day on average inoculate more than 3,000 yet the capital has 20 vaccination centres massed by people mobilised through government outreaches and by private sector players.

In addition, people are being targeted for vaccination at bars, places of worship and open markets across districts, according to health officials.

But some experts warned the government to develop quick strategies to break into circles of anti-vaxxers who may be a big impediment to the continued success of the exercise once self-recruited individuals are all inoculated.  

In September and October, Uganda received more than 4 million doses of Pfizer, Moderna, Johnson and Johnson, Sinovac and AstraZeneca vaccines through donations and direct procurement, widening the choices for people intending to take one or the other jab. 

Prof Serwadda said: “There are more vaccines available now, more than what we had anticipated ourselves. That means we have more vaccines to distribute widely across the country and increased access by people in communities.”

Health Minister Aceng said the public is responding “very well’’ to new vaccination centres being established across the country to bring vaccines closer to people. Previously, Covid-19 vaccination was mainly conducted at health facilities that are more distant, for example, for the elderly most at risk yet least mobile.

“We have realised that the youth are more agile and come very quickly. The elderly [persons] are asking that we should follow them to where they are because of challenges of transport and accessibility, but they do want to get vaccinated,” she said last week.

Some scientists differ on the approach of mass vaccination, arguing that the youth who are the majority turning up to be jabbed are less likely to develop severe illness if they catch the virus yet they are depleting the limited vaccine stock otherwise better used for priority groups such as the elderly, health workers, security personnel and those with comorbidities who are either more exposed or immune-suppressed. 
 
However, proponents of the strategy argue that waiting for no-show vulnerable populations could lead to vaccines expiring unused, plunging the country into public health and financial problems alongside disappointing vaccine donors.

Revised vaccination plan
In her comments last week, minister Aceng said they,  in a revised plan, intend to create vaccination points in places where there are large congregations and Covid transmission hotspots such as Teso sub-region to reach the most at risk.
In an interview last Sunday, Prof Serwadda said: “If you don’t have to go very far to get your vaccine or if you don’t have to wait very long to get the vaccine, you are more likely to go and get a vaccine”.

He, however, appealed to the Ministry of Health to keep on sensitising the population about vaccination.  “In any public health intervention, you have early adaptors –people who easily get to be changed and so you get an uptake and there are people who are so resistant to change for various reasons and so, there is tendency [for uptake] to level off,” he said.

Dr Alex Ario, the head of National Institute of Public Health of the Ministry of Health, said there should be increased sensitisation especially among religious people. He claimed that many of them hold negative attitudes towards Covid-19 vaccination.

Vaccines procured and donated between March and October 

Vaccine and source                           Doses received, being distributed
AstraZeneca, France, October 21                         808,800
J&J procured by govt, October 19                        464,800
Sinovac, China, October 19                                   700,000
J&J procured by govt, October 7                           196,800
AstraZeneca, Ireland, Sep 30                          335,000
AstraZeneca, Belgian, September 23             153,900
AstraZeneca, Frence, September 23    501,153
Pfizer, US, September 20                             1,674,270
Moderna, US, September 6                          647,080
 AstraZeneca, Norwegian, August 30    128,560
AstraZeneca, UK, August 19                     299,520
AstraZeneca, Norwegian, July 31             286,080
Sinovac, Chinese, July 31                           300,000
AstraZeneca, Frence, June 16                   175,200
AstraZeneca, Indian, March 7                     100,000
AstraZeneca, COVAX, March 5                    864,000
    
                                         Total                        7,905,363
 

 
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