Six million doses of Pfizer, J&J jabs expiring

The shortcomings in the Covid-19 vaccination campaign in the country have caused the expiry of vaccines worth Shs173 billion and more vaccines worth Shs160 billion are again at risk of expiry in three months, the Daily Monitor has established.

Details in Health Minister Jane Ruth Aceng’s briefing prepared for Cabinet sitting at State House Entebbe on Monday, show that six million doses of Pfizer and previously in-demand Johnson&Johnson (J&J) Covid-19 vaccines are expiring between this month and August.

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A similar quantity of jabs, again comprising Pfizer and J&J, as well as Sinopharm, will expire within a year from August 2022, if not used.

These ongoing and expected end to the shelf life of the vaccines, most of it donated by mainly the United States government and the European Union, adds to more than one million vaccines removed from cold storage were “wasted” in northern Uganda due to low uptake.

 Cabinet discussion and records are confidential, but a senior minister, who attended Monday’s meeting, quoted her colleague, Dr Aceng, as having said: “An additional 6,123,408 doses worth $43.1m (Shs160b) are at risk of expiry by September.”

When asked about the expired vaccines yesterday at an event in Kampala, the Health minister said she did not readily have exact figures about vaccines that are due to expire.

“To-date, Uganda has received more than 47 million doses of vaccines, she said, “But we also have nearly 1.2 million doses that if we don’t use by the end of August, they risk getting expired.”

This figure is a fraction of the vaccine quantity running out of shelf life as detailed in the minister’s written brief to Cabinet.

Source of vaccines

Whereas she didn’t reveal whether the expiring vaccines were those received through donations, or purchased by Uganda government, Washington has been a major donor of Pfizer and J&J vaccines. Six million are set to expire by August, about two months from now.

The government, according to the Health ministry, spent Shs86b to procure Sinopharm and J&J vaccines. 

The US embassy in Kampala could not readily respond to our email inquiries about its comments regarding the imminent expiry of Covid vaccines paid for by American taxpayers, and possible advice to Uganda government on how to ramp up vaccination.

In a statement last week, the embassy, after another donation of vaccines, noted that it would support the government to deliver vaccines to communities to boost utilisation.

“Covid-19 hasn’t gone away yet. Neither has US support. The US delivered 2.5 million Pfizer vaccine doses to Uganda this morning. That’s 18 million [doses of] US-donated doses to Uganda. We are supporting again vaccination campaign, helping vaccines reach more people. Get your jab, boost today!” it noted.

Uganda’s Health ministry, which is the political overseer of national vaccination mandates, have struggled to explain the expiry of donated vaccines when millions of Ugandans remain unvaccinated or partially jabbed, yet in the past, government officials, including President Museveni, publicly accused developed Western nations of hoarding Covid vaccines.

Official statistics indicate that 74 percent of the 22 million Ugandans targeted for inoculation against the pandemic have been jabbed, with half being fully vaccinated. Up to 89 percent of health workers, ranked among priority groups for their exposure to patients, are vaccinated.

“To open schools safely [in January, this year after a two-year closure], 98 percent of teachers [were] vaccinated and … 87 percent of the elderly people vaccinated. We take this to be significant progress,” said Dr Daniel Kyabayinze, the National Covid-19 vaccination coordinator.

He added: “We attribute this to mass vaccination, sensitisation and buy-in from leaders. We have done two nationwide mass vaccination [campaigns] where we vaccinate in communities. Social media and mainstream media helped us to achieve this.”

Officials of Health ministry, who deflect responsibility for the less-than-satisfactory vaccination performance to local governments that provide frontline execution, have come under increased criticism --- including at highest levels of government --- for doing less to mobilise the population for vaccination against the pandemic that has killed nearly 4,000 citizens.

Technocrats in the ministry have not shared their vaccination mobilisation strategy and there are no paid-for adverts in broadcast, print and online media from which majority Ugandans get information.

The apparent inaction, added to an avalanche of misinformation and disinformation, has allowed fears to grow amid allegations that vaccines are unsafe and could alter the genetic structure of recipients or their off-springs.

Last year, when the first batch of the single-shot J&J arrived in the country, officials rationed it to Uganda’s who-is-who before successive stocks were trucked upcountry, prompting many disillusioned Ugandans to abandon the vaccine uptake when it became available.

There were also allegations then, which remain unproven, that some health workers pocketed bribes to inoculate Ugandans with J&J or as an inducement to allow latecomers jump the queue for the life-saving jabs.

In her briefing to Cabinet colleagues at a sitting that Vice President Jessica Alupo chaired, Dr Aceng noted: “The low rate of utilisation of the vaccines started when the 3rd wave was controlled and the economy reopened in January 2022, which affected the [seriousness of the] risk perception. This was compounded by the myths and misconceptions in the social media and worsened by the negative activists who are decampaigning vaccination.”

Our analysis of the statistics prepared by the Ministry of Health found that the monthly average of administered doses declined from 2.6 million around January to April when the country was facing its third wave of the pandemic, to as low as 1.2 million doses in May.

National Covid-19 Vaccination Coordinator, Dr Kyabayinze, attributed the high uptake of the vaccines at the start of the year to the mass vaccination approach and the high rates of infections, which increased risk perception.

By then, the government had also threatened to fire unvaccinated employees, while some of its institutions moved to block access to unvaccinated guests. However, no employee was fired over vaccination status and access blockades to government offices for unvaccinated visitors collapsed along the way as it became clear the decisions lacked legal backing.

“Uganda started its vaccination campaign in March 2021 but with little success because we had a very limited number of vaccines. But having utilised these vaccines at a very slow pace, we changed tactics to away from vaccinating people at static sites to accelerated vaccination where we were doing mass campaign going region by region,” Dr Kyabayinze said.

Uptake of the Covid vaccines increased shortly after President Museveni publicly took the jab, or when infections and deaths were highest.

When these dropped for several months, and Health ministry lifted residual standard operating procedures (SoPs), including masking mandates in uncrowded public places, majority Ugandans dropped the safeguards that kept infections low.

Health ministry now says the cases have started going up, with sporadic death and average daily infections at 100, up three-fold, and 4.8 positivity rate.

Vaccinating children

To ramp up vaccination, the Health ministry, following immediate stiff opposition and likely litigation, walked back on proposals to mandatorily inoculate children aged between five and 17.

The first line of resistance, surprisingly, was the Ministry of Education, which argued that no child would be vaccinated by force, or at any of the schools it runs.
This fall-out between Education and Health ministries became a point of discussion at the Monday sitting of Cabinet, which resolved that children can be vaccinated, but with the consent of parents.

A handful of parents had reported that their children vaccinated at schools against Covid-19 without authorisation had suffered severe effects.
Health minister Jane Ruth Aceng yesterday denied reported forcible inoculation of children, saying they yesterday vaccinated more than 300,000 children “who were voluntarily brought by their parents for vaccination, children with comorbidities and those without comorbidities. Personally, I have vaccinated my 12-year-old daughter.”

“We caution Ugandans to take heed, we have the tools now in the country to prevent the pandemic from going out of proportion. We have vaccines, you have your mask, keep social distancing and sanitise,” she said, referring to rising Covid-19 cases in the country.  
Sources that attended Monday’s Cabinet meeting told this newspaper that minister Aceng told colleagues that they were pushing for vaccination of all children to exhaust the vaccines before they expire. We were unable to confirm this with Dr Aceng.
She said no child will be vaccinated by force, or against the parent’s will.

“For those who are not ready, nobody is forcing you to take your child for vaccination. However, vaccines are safe and effective, and they are good. They will protect your children from a multi-system disorder that we see affecting children when they get infected with Covid even if they have experienced symptoms or not,” the minister said.