Why counties are ill-prepared for Covid-19 jab drive

 As the Covid-19 vaccination drive starts in the counties, governors have hinted that they are not fully ready for the roll-out.

The Council of Governors (CoG) has called a meeting on Wednesday with the Health Cabinet secretary Mutahi Kagwe to address the issue, among other public health matters.

“There shall be council meeting to be held on Wednesday, March 10, at the council offices with several agenda, vaccine roll-out being one of them,” reads part of a CoG letter to Mr Kagwe.

The county chiefs said they are worried that health staff had not been sensitised on the vaccination process.

“We have called for several meetings with the national government to discuss the vaccine issue and they are not honouring our invites, they are bringing the programmes and we are not being involved,” says one of the governors.

For instance, in Murang’a there are about 1,200 nurses and only two have been trained.

“In Murang’a there are seven Level Fours and one Level Five hospitals. All the nurses have to go to the facilities to be given the jab. We need two weeks to train other nurses who will administer the vaccine because the two will be overwhelmed,” says a source at the CoG.

Dr Willis Akhwale, the chair of the Vaccine Advisory Task Force, told the Sunday Nation that in the coming week, at least one facility per county would be vaccinating and the two trained would be available to administer the vaccine.

Virtual videos

“As we plan to roll out to other facilities, training of others is ongoing virtually to be able to handle the numbers,” he said.

The Health ministry is training nurses through virtual videos and demonstrations.

Dr Akhwale denied the ministry did not involve the governors in the vaccination plans.

“The first meeting we had, we invited all the 47 county health executive members, a presentation of the plan was made and they were asked for their input since the vaccination would be happening at the county levels,” he said

Kisumu governor Anyang’ Nyong’o, who is in charge of the health docket, was invited for the second meeting where he made changes to the plan.

“It is the people responsible who are supposed to brief the rest on the plans since they were part of the planning system.

“In the initial stages, we did not have the time to prolong this to everyone. However, in the second phase, we have all the time till June, to interact and make the possible changes, let us not start wars that will derail the whole process. This is for the good of the public,” said Dr Akwale.

He urged all the healthcare workers to go get the vaccine in their registered counties to avoid being locked out.

According to the National Covid-19 Vaccines Deployment and Vaccination Plan 2021, the government plans to start with the priority target groups that include the frontline healthcare workers, teachers and police, military, prison and immigration officers.

Kenya received its first batch of Covid-19 vaccine on Tuesday night at a time that infections in the country were increasing and the positivity rate had hit 10 per cent, the danger zone, an indication that a third wave could be looming.

“Overall, things are getting better. It’s truly a great day for Kenya. We now have the equivalent of a bazooka or a machine gun in our fight against the virus,” said Mr Kagwe.

One million shots

The one million shots of AstraZeneca vaccine from the Serum Institute of India is only enough for slightly more than 500,000 people, requiring two doses eight to 12 weeks apart.

With the vaccination, the country is likely to protect all its frontline healthcare workers estimated at more than 450,000.

The vaccine will be administered in Level Four, Five, and Six hospitals estimated at five per cent of the total health facilities (about 479 — 284 public and 195 private).

The jabs have since been moved from the central vaccine hub in Kitengela, Nairobi, to the nine regional depots and vaccination centres across the country.

The AstraZeneca vaccine, according to the scientific report, is easy to handle and distribute due to its positive storage temperature of between two and eight degrees Celsius.

From the 1.2 million doses, the Health ministry has since distributed 492,000 doses strictly for the frontline workers to the 10 regions with Nairobi getting the highest at 174,000 followed by Eldoret, which got 60,000 and Nakuru 57,000.

Kisumu regional store got 54,000 doses, Mombasa 45,000 and Kakamega 42,000. Nyeri and Meru got 21,000 doses each, Garissa received 12,000 and Mandera 6,000 doses of the vaccine in the first week.

The doses were allocated to the counties based on the estimated number of healthcare workers, the storage capacity and the expiry dates of the vaccine.

“Going by the numbers given by the counties of their healthcare workers, we gave them the vaccine and then based on the storage capacity of the facilities. We didn’t want to send too many yet there was no enough storage capacity. We were also considering the demand for the vaccine. We didn’t want to send many to be stored for long until they expire,” said Dr Akwale.

He said the remaining batch would be distributed in the coming week.

“In this first phase, no one should pay anything to be vaccinated. Just walk to any facility so long as you are a frontline healthcare worker and get vaccinated,” he said.

The Eldoret regional depot will distribute to seven counties including Baringo, Elgeyo-Marakwet, Nandi, Trans Nzoia, Turkana, Uasin Gishu and West Pokot. Kakamega will distribute to Bungoma, Busia and Vihiga, Meru will supply Isiolo, Marsabit, Meru, and Tharaka Nithi.

Kisumu depot will supply Homa Bay, Migori, Kisumu , Nyamira and Siaya while the Nyeri one will supply Embu , Kirinyaga , Laikipia and Nyeri.

Garissa ( Wajir , Mandera and Garissa ) , Nakuru ( Bomet , Kericho , Nakuru, Nyandarua and Samburu ), Nairobi ( Kajiado , Kiambu , Kitui , Machakos , Makueni , Murang’a, Nairobi and Narok ) and Mombasa ( Kilifi, Kwale , Lamu , Mombasa , Taita Taveta and Tana River ).

“Our logistics team has acquired thermal blankets that will be used to maintain the temperatures of the vaccines as they are being moved from the cargo plane and being loaded onto the trucks that have also been fitted with a cold storage system, this is not our first time transporting vaccines,” said Dr Akhwale.

Most vulnerable

Kenya plans to vaccinate 30 per cent of its population (or 15.8 million) of more than 49 million by the end of June 2023 in three phases.

“During Phase One, the initial Covid-19 vaccine supply will be limited but it is anticipated that more will become available for distribution during Phases II and III,” says the document.

The first phase will involve 1.25 million people between February and June 2021, Phase II which will run between July to June 2022 will target the most vulnerable to severe death, the elderly and those above 18 years with comorbidities targeting 9.76 million people.

The third phase will focus on ensuring equitable vaccination of other vulnerable groups of persons of 18 years and above in congregations, hospitality and tourism industry. The phase will run between July 2022 and June 2023 targeting 4.9 million people.

“There are plans to increase coverage to 40 per cent of the population (20 million) once more supplies become available. It should, however, be noted that these phases are not exclusive and may overlap,” says the plan.

Two doses

From the plan, individuals will need to receive at least two doses of vaccine. During the rollout, the Health ministry will hold a second dose reserve to ensure that an individual receives the same vaccine.

Kenya was the fifth African country to receive the jabs through the World Health Organisation (WHO)-backed Covid-19 Vaccine Global Access (Covax) initiative after Nigeria, Ghana, Ivory Coast, and Angola. The scheme hopes to deliver more than two billion doses to people in 190 countries in less than a year.

Kenya’s Pharmacy and Poisons Board last week approved the AstraZeneca vaccine for emergency use.

The WHO has urged the countries to ensure that most health workers, if not all, have received their vaccine shots in the first 100 days of the year.

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