Rwanda: Unpacking Rwanda's Plan to Distribute Covid-19 Vaccine

21 January 2021

The arrival of the Covid-19 vaccine is probably the most anticipated development in Rwanda, as the virus continues to wreak havoc in Rwanda and all countries of the world.

The questions on many people's mind include the number of doses the country intends to import, who will be eligible, how it will be administered, among many others.

The New Times spoke to the Director-General of the Rwanda Biomedical Center (RBC) Dr. Sabin Nsanzimana and below is some of what we know.

One million emergency doses expected

According to Nsanzimana, Rwanda has placed its order and the country is not only ready to receive its first batch of vaccine doses, but it is also ready to immediately begin the vaccination exercise.

He said that orders for the vaccine doses were made from different manufacturers because the government is not purchasing only one specific vaccine but open to receiving any that has been approved for scientific emergency use by the World Health Organisation (WHO).

"We ordered for one million emergency doses and we are waiting but anytime soon, we hope that by February or even earlier than that, we could have the first round of vaccinations," he said.

Eight million people to be vaccinated

Rwanda's vaccination plan is expected to span a period of two years. To vaccinate 60 percent of the total population, the government will need $124m.

"These funds will of course include vaccines and other logistics like operations and other medical elements that are required to complete the package. It's a two-year plan that will be targeting getting this vaccine to about 8 million people," he said.

Most vaccines are from Europe

Nsanzimana explained that the biggest chunk of the vaccines that Rwanda is purchasing are beings manufactured in Europe.

The vaccines are being distributed based on a regional kind of arrangement that the manufacturers made with several continents including Africa.

"We are working with the Covax vaccine coalition where countries got together in a mechanism that will accelerate access, production and price negotiation. If you go through this Covax facility, for one dose that costs about $19, you can get it at less than half," he said.

Co-led by the Vaccine Alliance (Gavi), the Coalition for Epidemic Preparedness Innovations (CEPI) and WHO, Covax aims to accelerate the development and manufacture of Covid-19 vaccines, and to guarantee fair and equitable access for every country in the world.

Under Covax, all participating countries, regardless of income levels, have equal access to these vaccines once they are developed. The initial aim is to have two billion doses available by the end of 2021.

Nsanzimana says that the government intends to acquire 20 percent of its vaccines (20 percent of our total population in Rwanda) through Covax.

"It is through them that we acquired the 1 million from Pfizer and we are looking at other manufacturers who are also into Covax. We will be receiving the vaccine in phases and this one million is the first phase which is called the emergency phase," he said.

Vaccine transportation and storage

Nsanzimana says that most of these vaccines require a complex transport mechanism. The ones that will be received first require minus seventy degrees Celsius as a storage condition. They have different ways and requirements for transport.

While Pfizer and Moderna (some of which Rwanda is getting in the first phase) require special conditions, the others like AstraZeneca vaccine that is manufactured in India do not.

He said that whatever the case, Rwanda is ready. He attributed this to the recently purchased five freezers that can go up to minus eighty degrees adding that the country had others waiting at provincial level.

"We already had other existing ultra-cold freezers in each province and we also bought small containers that can help move the ultra-cold vaccines to the districts for a day or even up to a week in case there is a vaccination routine. You don't need to have the ultra-cold conditions maintained but you need a few days of them in ice where they can stay really cold for a reasonable number of days at a site," he said.

Who will be vaccinated?

The vaccination is expected to be done in phases. In the first phase, the vaccine will go to front-line workers in healthcare including but not limited to those working in treatment centres and Intensive Care Units (ICUs).

This phase will also see the vaccination of people above 65 and those whose immunity is weak and is likely to easily be compromised like those with cancer, diabetes, HIV and other serious diseases.

However, Nsanzimana also explained that the government is also considering other groups because of their vulnerabilities like correctional facility inmates, people in refugee camps and security personnel that are exposed to the risk of the virus in one way or another.

"We have people who are definitely going to be prioritized because of particular criteria but of course within all these groups, there are also those who will be given the vaccine before the others too," he explained.

How will the vaccine be administered?

The vaccine will be administered as an injection in the arm. It will be split into a dose of two injections and they will be administered three weeks apart. There is however one vaccine that may be administered at once but it's still at mid-phase of development but all the other vaccines will be administered the same way.

Ex-Covid-19 patients to be considered

According to Nsanzimana, although someone who has been infected with Covid can develop antibodies or immunity from being exposed to Covid, it cannot be determined how long that could last and this means that the person could be re-infected.

"We know that it is rare but it is possible for someone who has had Covid to contract it again especially if you had one strain and then you get another strain. That's why a vaccine can still be important for those who have been Covid-19 positive and those who are negative," he said.

People below 16 not a priority

Nsanzimana explains that while everyone can take these vaccines, some have an age limit from 16 upwards.

"This is because with Covid, the older you are, the greater the risk of contracting the virus. Younger people, 16 and below are not really that much concerned," he said.

Vaccination staff already trained

Nsanzimana says that the personnel that will administer these vaccines have already been taken through refresher vaccination courses to ensure that they are ready to start as soon as possible.

"We have very experienced staff up to the health centre level all over the country that have been trained and received refresher training regarding everything to do with vaccination and preparation and we are ready. Whenever the vaccines reach the airport, we will offload and immediately start vaccinating," he said.


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