Nigeria: Securing Public Trust, Confidence for Covid-19 Vaccines

14 January 2021

Scientists and world health authorities may have fought hard to develop a vaccine against COVID-19 within a record time, but the next stage and perhaps most important aspect of this battle is how to win people's confidence and acceptability for the vaccines.

Since the news of a breakthrough in the development of COVID-19 vaccines was reported, countries around the world, including Nigeria started making moves to secure these vaccines for their citizens.

At the onset, Nigeria joined over 196 countries to sign on to a collaborative initiative known as COVAX vaccine scheme that will help those countries with low income capacity to have relatively equal access to the COVID-19 vaccines when they are developed. The global initiative is aimed at working with vaccine manufacturers to provide countries worldwide equitable access to safe and effective vaccines, once they are licensed and approved.

COVAX currently has the world's largest and most diverse COVID-19 vaccine portfolio - including nine confirmed vaccines, with a further nine under evaluation and conversations underway with other major producers.

Nigeria's foray to acquire the vaccine was not surprising because it suddenly began to witness an upsurge in cases of COVID-19 Infections towards the end of 2020 after months of low reported cases. The country's slide into second wave of COVID-19 was attributed to non observance of non pharmaceutical protocols by the citizens. With the renewed threat of COVID-19, the federal government and other stakeholders in the health sector began to focus more attention at the option of securing vaccines to help avert an epidemic in the country.

To ensure that the vaccines are purchased at the earliest possible time, federal government first set aside the sum of N10 billion, followed later by another N400 billion allocated in the 2021 budget. While announcing plans by the federal government to procure vaccinnes for COVID-19, the Minister of Health, Dr. Osagie Ehanire said the first batch of the vaccines are being expected to arrive the country by the end January, 2021.

Concerns

Soon concerns began to mount over the arrangements put in place for the procurement of vaccines in the country. One of those who expresed worry over the level of commitment being made about acquiring the vaccines, is the Chairman of the committee on review of the strategies against COVID-19 pandemic, Prof. Adewole Tomori . He had expressed fears that the January timeline set by the federal government to secure the first batch of vaccines might not be met.

Tomori who spoke to THISDAY in an interview in December, said his position was based on the fact that the country is yet to decide on several parameters that is necessary before procurement of vaccines can be effected.

Prof. Tomori said that as at the moment, government is yet to decide on which of the nine available vaccine type is best suited for the country nor has it considered the number of vaccine doses that can be procured in the first batch.

He said: "For instance in Europe, their own vaccines regulatory authority has approved vaccines for use, they are not waiting for the World Health Organisation approval, it is a mere icing on the cake. There are not waiting for any other approval because they have developed a system that can take care of this. Nigeria as a country will not touch those vaccines until the WHO gives its approval. Is America or Europe waiting for the WHO?"

According to him, waiting for the WHO means that countries like Nigeria are going to wait to use the crumbs of vaccines after the developed countries have taken what they need.

Tomori said, "l learnt the government is budgeting N400 billion for vaccines but can anyone tell how many doses of vaccines the country is expecting or the brand of vaccines we want to procure at the moment? You see, we are just paying for underdevelopment".

Tomori further lamented that while America and countries in Europe have already developed an effective system of analysing the vaccines to know which one is good, African countries, including Nigeria are still waiting for assistance from WHO.

He added that at a time when other countries were taking a gamble and ordering for vaccines four months in advance, Nigeria is still waiting for WHO's approval.

On his part, the president of Nigeria Medical Association (NMA), Prof. Innocent Ujah suggested the beefing up of sensitisation efforts by the National Orientation Agency, especially at the grassroot to ensure that it counters all the misinformation and negative impression in the minds of the people. Ujah said that NOA should consider local means communication in various communities to raise the needed awareness about healthy practices aimed at containing the virus.

While expressing concern at the situation of things in the country, Ujah said there is an urgent need to convene a stakeholders meeting to discuss the current development with regards to the spike in the Infection.

Ujah said: "We need to convene a stakeholders meeting to discuss the way forward, it is not a one-off thing. We need to sit down to evaluate the situation. It is also important that leadership religious groups and faith-based organisations should be brought together from time to time to wide the scope of understanding of the implications of allowing the spread of the virus."

Measures

But just as Nigerians were begining to be agitated over the arrangements for acquiring vaccines, the federal government came up with what looked like timelines and procedures for procurement and introduction of the vaccines in the country.

The National Primary Healthcare Development Agency (NPHCDA) which has been assigned the responsibility to handle the roll out of the vaccines said the country is expecting to take delivery of 100,000 doses of vaccines by the end of January. The agency explained during a sensitisation programme for the media in Abuja last week that the first batch of the vaccines will be administered to a select group of Nigerians- 50,000 of them who will be given two doses of the vaccine each within 21 days.

The agency said that federal government has put in place a technical working group for COVID-19 vaccine headed by the Executive Director of the NPHCDA, Dr. Faisal Shuaib that will coordinate the implementation of the vaccination in the country.

It said the technical group, made up of all relevant ministries, parastatals and partners had concluded arrangements with suppliers of the vaccinnes, COVAX vaccines and GAVI.

Director of the Department of Diseases Control and Immunisation at the agency, Dr. Bassey Okposen who disclosed this during the virtual meeting with media stakeholders organised by NPHCDA last Friday, said health workers across the country will form the bulk of the initial beneficiaries of the vaccines.

It explained that the team is planning to introduce COVID-19 vaccine with the sole aim of interrupting the transmission of COVID-19 in all parts of the country,". Okposen said that there are many vaccines currently available globally for dealing with COVID-19 but that country is zeroing down on two options, the COVAX scheme which is coming through the GAVI - Global Vaccines and Immunisation that we are used to in the country.

He said that through GAVI, poor and low income will be able to access the COVID-19 vaccines when they are ready, adding that apart from the COVAX scheme, Nigeria also has other alternative sources to obtain the vaccines, like the Russians and United Arab Emirates.

According to him, the technical group is working out plans to also source vaccines from these countries as an alternative platform to get enough vaccines for citizens.

Speaking on the timelines for the introduction of the vaccines, Okposen said as soon as the vaccines arrive the country, there is going to be some kind of prioritisation in order to optimise the limited resources available, adding that the arrangement will be based on global best practices, especially for the frontline health workers, airport workers, immigration, security men who are on essential duties.

He said the segment of the society that will be prioritised are the elderly, those above ages of 50 and those that have comorbid conditions like asthma, diabietes, heart disease and hypertension.

Okposen said that the agency is targeting to vaccinate 70 per cent Nigerians between this year and next year.

While explaining the handling and distribution mechanism for the vaccines, NPHCDA had explained that immediately the vaccines arrived Abuja, they will be taken to the National Strategic Cold Store in Abuja where they will be kept in the ultracold chain freezers for storage. It said before being loaded to the freezers, a sample of the vaccines will be taken by officials of NAFDAC for analysis and eventual certification in line extant laws.

The agency said that it will not release the vaccines to any state untill they are sure that the states are ready to implement the vaccination. According to the agency, as soon as each state is ready to implement the vaccination, NPHCDA will transport supply to them within 24 hours. It further explained that the implementation is going to last for five days in each state when the vaccinne will still retain it's potency.

Fear of Acceptance

But as the government is busy sorting out issues about the procurement of vaccines for this novel virus, another hurdle appears to be building up in the area of acceptance of the vaccines by the Nigerian population. Several views have been expressed by some Nigerians and people from other parts of world over the safety of the vaccines.

Even though health authorities in the United States and Europe had given some of the vaccines so far developed a clean bill of health, the doubt over their safety still persist in the minds of many people. Unsubstantiated claims of negative after effects of the vaccines have continued to surface in the social media.

But what is really worrisome in Nigeria is the recent campaign being spearheaded by a well-known politician and a Senator who had taken to social media to allege that the version of COVID-19 vaccines currently in the market is a death sentence to any one that takes it.

There are also those who came up with the insinuation that some developed countries may be planning to use the vaccines to inject diseases into Africans or to render them impotent, thereby reducing the population. Whether we accept these rather weird postulations or not, they are indeed going to have a lot of impact on the acceptability of the new vaccines by the people, hence the need for a counter advocacy to change the narrative.

Okposen said that it is important to use the occasion of media sensitisation event to clear the fears about the safety of those that will take the vaccines, stating that as far the agency is concerned, the COVID-19 vaccines to be administered are "safe and effective".

According to the director, a lot of work is going on to ensure that the vaccines that will be introduced in Nigeria is safe and effective.

Priority

However, in a bid to promote positive acceptance of the vaccines being introduced, NPHCDA said President Muhammadu Buhari; Vice President, Prof. Yemi Osinbajo and other top government officials may be the first set of people to be administered.

The agency said health workers will also be among those that will take first shot in order reassure everyone that it has no negative effect. Speaking at media briefing by the Presidential Taskforce on Control of COVID-19 in Abuja, the Executive Director of the NPHCDA, Dr. Faisal Shuaib, said as part of strategies to roll out use of vaccines to contain the spread, the agency will be prioritising health workers and some strategic country leaders.

He said that the agency intends to make a public show of the president's vaccination to help create the needed awareness. Shuaibu said: " In terms of the prioritisation, yes I mentioned that we are prioritising health workers and some strategic country leaders. I would like to see a situation where the President, Vice President, the Secretary to the Government of the Federation (SGF), and other critical leaders come and take the vaccines in the full glare of the public to demonstrate that this vaccine is safe.

"So we have to make provisions for those. Even in developed countries, we have seen that apart from the prioritisation of health workers, you have to also identify critical leaders that you don't want to be wiped away by the virus. As much as possible, we also do not want to leave our leaders vulnerable to COVID-19, and it doesn't mean that we want to prioritise politicians - that is not correct."

Concerning how long the protection of the vaccine will last, he said, "one thing that we are aware of is that this vaccine is new. So we do not have absolute information about how long they will last because the vaccines are just a few months old. It is only a question of time before we know exactly how long their immunity will last."

New Variant

Shuaib also spoke on the prevalence of the new variant: "It is only so far in the United Kingdom that we are aware of the predominant strength of the new variant. I want us not to be so much obsessed about this new strain.

"What the manufacturers have indicated is that even if there is a need to tweak the vaccine, it is not going to be a major problem in terms of what needs to be done to provide a vaccine against these new strains".

Shuaib further said that technology has advanced to be able to produce vaccines in such a short time as to counter whatever new strains of the virus that are available.

Summarily, beyond the measures being taken by the NPHCDA to win the acceptance of Nigerians on the introduction of the vaccines, the federal government should put all its public information mechanism at work immediately.

For instance, the Nigerian Television Authority (NTA) and the NOA have a duty to champion the campaign to educate Nigerians especially those at the grassroot on the need to embrace the vaccine as one of the potent means of avert the disaster posed by the pandemic. Also leadership of faith-based organisations and civil society groups should be enlisted by government to help in explaining the positive gains of embracing use of the vaccines.

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