As Nigeria prepares to take delivery of COVID-19 vaccines, there are lots to be put in place to ensure the safe landing and judicious administration of the vaccines. EDET UDOH reports.
As Nigeria expects to obtain its first shipment of COVID-19 vaccines in few weeks, a committee has been set up with the responsibility to, among other things, choose the most appropriate vaccine for the country from the existing vaccines since different temperatures are required to protect vaccines.Prior to the acquisition of a safe and effective covid-19 vaccine for the citizens, President Muhamnadu Buhari had signed up with the Global Vaccine Alliance Initiative (GAVI). Also with Global Access Program (COVAX) co-led by the World Health Organisation (WHO).
Contrary to the health minister, Osagie Ehanire’s earlier announcement that the government would receive 20 million doses of the COVID-19 vaccines, the federal government said it is expecting 100,000 doses of vaccines for the vaccination of the first set of 50,000 frontline health workers after pre-qualification by WHO and safety revalidation by the National Agency for Food and Drug Administration and Control (NAFDAC).
Vaccine approval
NAFDAC has oversight of regulatory checks and approvals for public delivery and the use of medicines and other critical health technologies, including vaccines, within the country. All vaccines would therefore need to be registered with this agency whose job it is to ensure that they meet the necessary standards for safety, quality and efficacy.
How COVID-19 vaccine approval is fast-tracked ?
Given the extraordinary circumstances and devastating impacts of the COVID-19 pandemic, vaccines have to reach people across the country, as quickly as possible and work safely and effectively. NAFDAC would be prioritising COVID-19 vaccine applications and have procedures set in place to accelerate the approval process.
Pre-qualificationNAFDAC would equally be leveraging on WHO’s long-established prequalification procedures. Such leveraging facilitates the efficient registration of WHO-approved vaccines in low- and middle-income countries. Nigeria would also be relying on decisions by major national and regional regulators, including the US Food & Drug Administration (FDA) and European Medicines Agency (EMA), which have committed to maximising transparency surrounding the approval of COVID-19 vaccines. This means that vaccines that have already gained approval from these external regulators would qualify for NAFDAC’s fast-track domestic review process for regulatory approval and licensing. Such a fast-track approach is likely to see reviews completed in just 15 days rather than several months, according to NAFDAC’s director-general, Mojisola Adeyeye.
Vaccines to be administered in phases
The vaccine, according to federal government, would be administered In phases – 40 per cent of Nigerians (80 million) by the end of this year and another 30 per cent (60 million) next year, bringing the number to 70 per cent (that is 140 million) of the country’s estimated population by December next year.However, the figure is a far cry for a population of over 200 million compared to South Africa which has taken delivery of 1.5 million doses for 750,000 of its citizens, since two doses are needed for the vaccine to offer the needed benefits.It has been reported that President Buhari, vice president, Yemi Osinbajo and other top government officials would be the first to take the vaccine on live television once the vaccines arrive the country.
Promotional demonstration
The chairman of the Nigerian Governors Forum, Governor Kayode Fayemi, had during a meeting with the president in Abuja announced that governors will take the vaccine on a live television to demonstrate to the citizens that the vaccine works.He also noted that the president had agreed to convey to the Presidential Task Force on COVID-19 the need to use influencers such as religious leaders, entertainers and athletes to engender the confidence of citizens at the state and local levels.This, according to the governor, would help to address the cultural and religious concerns around the vaccine.In spite of this arrangement, prominent politicians have, in the last few weeks, been reported to have travelled abroad to get vaccination ahead of the drugs availability in Nigeria, even as infections and deaths spiked across the country, and as many residents shun adherence to prescribed protocols.
Gatekeepers sensitisation meeting
The National Primary Health Care Development Agency (NPHCDA) as part of preparation for effective vaccination exercise organised a zoom meeting with the media and top notch healthcare professionals in attendance including foremost virologist, Prof Oyewale Tomori; executive director, NPHCDA, Dr Faisal Shuaib; director of advocacy and communications, Eunice Damisa; NPHCDA director of logistics and health commodities, Hajiya Kubura Daradara; director, primary healthcare systems development, Dr Usman Adamu, among others.
Dr Bassey Okposen, a director, during the zoom meeting, said 100, 000 doses of BioNTech-Pfizer vaccines would be coming into the country.He explained that under the first phase of immunisation, government was targeting 50,000 health workers and each person is required to be administered two doses and the second dose would be administered 21 days after the first dose.Okposen, who is also chairman of the technical working group for COVID-19 vaccines during the virtual media engagement, said the country was working very hard to ensure the vaccines are available after undergoing WHO’s pre-qualification and NAFDAC’s certification.
Vaccine safety/preservation/efficacy
He stated that for the pre-arrival, a lot is ongoing to ensure the safety of vaccines, saying the national logistics working group was working to receive them and ensure they are safe and effective.“There would be surveillance sites and most of the vaccines have been proven to have 95 per cent efficacy. There are approaches to reach out to Nigerians to tell them that these vaccines are for them and out of good intentions of government.
“We would train health workers to be used for the vaccines and ensure vaccines are safe for Nigerians. We need to let our people know that the government would not do anything that is harmful to Nigerians,” he assured.He noted that it would take close to 10 years for Nigeria to achieve herd immunity and appealed to Nigerians not to reject the vaccines when they arrive. “We hope to vaccinate 40 per cent of Nigerians by end of this year and 30 per cent next year. We should have been able to immunise 70 per cent of Nigerians by December next year.“Frontline health workers would be given first consideration. The vaccines would be given in two doses. First dose in second week of February and second dose 21 days after. We have mapped isolation centres and health workers in these places.“We are looking at a four-phase introduction. There would be 100,000 doses in the first phase, 10 per cent in the second phase, 17 per cent in the third phase and 12 per cent in the fourth phase.“If the vaccines come earlier than late January, the very first one that will come would be distributed to 13 sites in state capitals and one site in local government areas. The health workers would be immunised at these identified sites.”
NCS cleared to take delivery of vaccines
On his part, Daradara said, “We have issued notification with our clearing agent, NAFDAC and Nigerian Custom Service (NCS). When the vaccines arrive, they would be taken to the National Strategic Cold Chain Store in Abuja. Before loading the vaccines, NAFDAC officer that would accompany the vaccines would take random samples from every batch for testing.“The vaccines would be stored in ultra cold chain at -60 degree Celsius to -80 degree Celsius. We are not going to release the vaccines to any state until we are sure they are ready for implementation.“At the state level, the vaccines would be stored in dry ice at +2 degree Celsius to +8 degree Celsius for five days. Considering the vandalisation of some cold chain stores in some states, we are providing security for the vaccines from the point of entry until they are administered.”
Pregnant women may not take the vaccine
On whether the vaccines would be given to pregnant women, Okposen said, “The trials on effect of the vaccines on pregnant women have not been done. “The decision is left for the physician to weigh the risk for his or her patient. However, there are ongoing clinical trials that is monitoring pregnant women from the beginning to end of pregnancy.”
Getting the vaccine to volatile areas
He assured that there would be no problem of getting the vaccines to hard-to-reach areas since they would come in limited quantities, adding, “We would make sure that all persons exposed to the virus get the vaccines first. First, the frontline health workers, the elderly from 50 years and above, those less than 50 years, but with co-morbidities and the states with very high risk, like Lagos and Abuja.“There is an ongoing process detailing people that would receive the vaccines and the vaccines that would be given to Nigerians, safe and effective.”
Nigerians who spoke to Blueprint on their preparations for the vaccination expressed varied views. While some said they are anxiously waiting for the vaccine, others said they will not take it.
