- Making the covid-19 vaccine work will be a challenge
Russia has started vaccinating using the Sputnik V vaccine, although it is still in the process of being mass-tested. The Pfizer vaccine has been approved in the UK where vaccinations are well under way. Pfizer has approval in Canada, and has just received the same in the USA.
Pakistan hopes to have a vaccine ready to use by the first quarter of next year, perhaps the Chinese CanSino Biologics, a single dose vaccine which is going through its phase 3 clinical trials, with volunteers from several countries including Pakistan.
Whichever vaccine appears on the scene in Pakistan, one hopes it will be handled with due planning and organisation, and with a genuine view to help the people of the country instead of the privileged few. It is not something Pakistan can pride itself on generally, neither planning nor indiscriminate provision of benefits to all.
The ‘flu vaccine which, when available is expensive, and thus that puts it out of the reach of most people. This season it has not been available in Pakistan at all. This, despite warnings that this year in particular people need to be vaccinated against influenza.
Pollution this year has probably been worse than in previous years. As with the ‘flu, respiratory problems associated with pollution make people more susceptible to other infections. An added risk is that if a person is infected with covid-19, a cough will spread the covid-19 virus to all within range. Yet nothing much has been done to improve the quality of air in places like Lahore and Faisalabad, which is important in any case regardless of covid-19. Yes, some factories that (mind-bogglingly) use rubber and plastic as fuel have been shut down. Such shut-downs happen every winter. It gives rise to the obvious question: how did/do such ventures manage to exist and function in the first place?
But seeing how almost impossible it would be to make vaccines mandatory, it has been suggested that making them mandatory could be achieved on an institutional level. This question needs some thought. For governments that are in the habit of thinking, and planning, these points and questions are of crucial importance. Is Pakistan one of those countries?
Several things need to be prepared in advance for covid-19 vaccinations, proper storage facilities such as freezers, sufficient equipment such as protective gear and syringes, and oxygen. There has to be provision for emergency care in case of adverse reactions. There must also be facilities for proper disposal of the syringes used in the vaccination.
The population of Pakistan is about 220 million. Even if quarter of those people get vaccinated that means 55 million syringes in addition to the syringes used as a norm in the country. That is a lot of hazardous plastic waste. Nice thing if next year these syringes are used for fuel by those factories that have just been shut down. Also what an irony if, after getting a grip on covid-19 the incidence of HIV rises steeply because syringes were re-used, as happens.
Recently in Peshawar covid-19 patients died because there was insufficient provision of oxygen for their use. Given that one of the features of this disease is the need for oxygen in serious cases this is an almost incredible oversight.
Another factor to guard against is misinformation that spreads as fast as the disease itself.
The American CIA did Pakistan no service by using the callous, thoughtless methods they did in their hunt for Bin Laden, using the services of Dr Shakil Afridi, who however says he did not know that he had been employed by the CIA.
Dr Afridi conducted a hepatitis-B vaccination campaign in the area around the house where Bin Laden was hiding. The plan was to analyse the used syringes to look for any DNA belonging to relatives of Bin Laden.
A relative’s DNA was not identified, but the DNA of a man known to have close links to Al Qaeda was. Bin Laden was captured as a result, but the ones who lost out were the people of this country.
The religious brotherhood had long been spreading fears that vaccines were causing harm to people, and that vaccines were a tool by means of which ‘The West’ sought to render the people of Pakistan infertile. Well the people of Pakistan do not appear to be infertile in the least but the accusations about vaccination programmes being a Western tool were certainly borne out thanks to the CIA, although not exactly the way it was claimed.
The long and short of the incident was that vaccinations have taken a hit, as have the men and women charged with administering them. It has been many years since that event but since then the incidence of polio in Pakistan– which had dwindled– has risen dramatically.
The Taliban called for a ban on polio vaccines and action against those administering them. As a direct consequence many polio workers and security personnel protecting them have been killed.
Similar rumours and misinformation are likely to latch on to the covid-19 vaccine.
Indeed religious extremists have been a thorn in the side of the country since its inception, yet nothing has ever been done to curb them. Even something so innocuous as the adhan (call to prayer) which can be beautiful and a real call to prayer if well executed is obviously not within government control. It issues five times a day as loud as a horde of Mongols– badly pronounced and utterly unattractive.
Another point, by no means the last but a big one, is the question whether or not the covid-19 vaccine ought to be mandatory. Whatever decision one comes to, the same would apply to other vaccines such as the polio and other childhood vaccines unless it is medically advised against for some reason.
This is a debate which must be resolved. There appears to be a rule in existence making vaccinations ‘compulsory’ in Pakistan, yet like many other injunctions there is no follow-up and no one checks to see if this rule is upheld.
Is it even possible to uphold it? It is doubtful.
And yet. Manslaughter is a legal term for homicide. It is less culpable than murder since murder includes an intention to kill, while manslaughter does not. Yet manslaughter is punishable by law.
Not taking a vaccine can and does lead to a rise in the incidence of infection, as we have witnessed often but most recently now when there is as yet no vaccine against covid-19 and people persist in neglecting adequate preventive measures such as masks. Nobody intends to harm but harm does result.
How, therefore is not taking a vaccine any less than manslaughter?
But seeing how almost impossible it would be to make vaccines mandatory, it has been suggested that making them mandatory could be achieved on an institutional level. This question needs some thought.
For governments that are in the habit of thinking, and planning, these points and questions are of crucial importance. Is Pakistan one of those countries?