#BTColumn – Vaccination imperative (Part 2)

The views and opinions expressed by the author(s) do not represent the official position of Barbados TODAY.

by Guy Hewitt

Accepting that lockdowns are neither socially nor economically desirable, appreciating that COVID-19 is not nocturnal but infects anytime, anyplace, and aware of the psychological fatigue after 18 months of dismal headlines, physical restrictions and social isolation, vaccines must be the central tool in any COVID-19 pandemic strategy.

While there are some concerns about the few so-called ‘breakthrough’ COVID cases among the fully vaccinated, reports indicate that those fully vaccinated are still highly protected against severe infection, hospitalisation and death caused by the virus.

In countries with very high vaccine coverage, such as Iceland with more than 90 per cent and the UK at nearly 90 per cent, much-reduced numbers of deaths are being experienced. Out of 51,000 COVID deaths in England between January and July 2021, only 256 occurred among the fully vaccinated. Similarly, in countries with moderate to high vaccine coverage, like the US and Canada, deaths are again almost exclusively among the unvaccinated.

For people who understand that widespread vaccination is our best strategy for beating the pandemic, the near two-thirds of our population who aren’t fully vaccinated become part of a ‘pandemic of the unvaccinated’ which the government should urgently address.

Too much time was lost in discussing whether a vaccine mandate (no vaccine, no work) could work. I am sure it is unconstitutional in Barbados but more so, it is counterproductive in the long run. Evidence indicates that vaccine mandates increase vaccination rates, but they can also drive a wedge between the vaccinated and the unvaccinated.

If the goal is to reach herd immunity, this approach could backfire. In any vaccination strategy, it’s important to differentiate between the vaccine hesitant, who are on the fence for legitimate reasons whether mistrust or fear over side effects, and the vaccine resistant, who identify as antivaxxers.

The latter is usually a much smaller group and almost impossible to persuade but it’s the former group we must be careful not to push away because they are key to getting the pandemic under control.

The vaccine hesitant must be won over for two important reasons. The first is waning of immunity, an issue that has already affected Israel, an early vaccine adopter.
Preliminary data published by the Israeli government showed that the efficacy of vaccines administered in January was considerably less than for those who had been fully vaccinated by April, suggesting that immunity gained through vaccination depletes over time.

The vaccine hesitant will not only have to be convinced of taking the vaccine but possibly booster doses over time.

Another reality of a vaccine mandate is already emerging in the US. Reports are circulating of increased demand for fake US Centers for Disease Control and Prevention COVID- 19 vaccine cards in the wake of the federal vaccine mandate.

The average cost of a fake CDC card doubled to $200 following President Biden’s announcement that federal employees and others would be required to get the vaccine.

This can’t be a zero-sum game. Everyone must feel that they have won. Because the Delta variant spreads easier than the original virus, the proportion of the population that needs to be vaccinated to reach ‘herd immunity’ protection could be upwards of 80 per cent the virus could remain among us, and harmful outbreaks could emerge as antibody levels fade.

If patterns of resistance continue, even down to the level of neighbourhood, a significant gap in vaccine uptake could likely lead to hotspots of infection and possible reinfection.

If we are serious about safeguarding our society and economy, our vaccination rate must move drastically from just hundreds to thousands per day. Achieving this will require a robust and coherent vaccination strategy which should include:

•  New authorisations on who can administer the COVID-19 vaccines. Doctors and nurses alone are insufficient and create a bottleneck in delivery. We must authorise as many healthcare professionals as possible: retired doctors and nurses, pharmacists, dentists, community health workers, trainee health professionals and other relevant personnel to administer vaccine.

•  Moving the delivery of vaccinations out of the realm of public healthcare bureaucracy and into the realm of commercial operations. The urgency for vaccination is such that it must be accepted that this is not like running a standard healthcare programme but more like running a production line. High volumes of vaccines must be available to a steady flow of people arriving for them.

•  Vaccination distribution must be at diverse and accessible locations. All health clinics, doctors’ offices, pharmacies, should be encouraged to deliver the vaccine, especially to the hesitant, and mobile clinics placed in inaccessible areas or where infections are high. Vaccinations must be available in everyday areas: supermarkets, malls, bus stands, and the like.

The vaccine hesitant must not be given any additional reason to say ‘no.’ • Given the logistical complexity, someone probably from the private sector, with a speciality in logistics and a commitment to Barbados, needs to be tasked to head a vaccination task force.

The task force should be made up persons able to get the job done. The person in charge should have a proven track record able to garner widest possible support and not be a beneficiary of patronage or the politics of inclusion. It can’t be politics as usual.

• A national COVID-19 public education campaign crucial to increase public knowledge and confidence in and uptake of vaccines. A network of trusted national and community messengers and consistent, fact-based public health messaging across all media, would help the public make informed decisions about COVID-19, including steps to protect themselves and their communities.

They should also reinforce basic prevention measures such as hand-washing, mask-wearing and social distancing.

Politicians, especially working across the political divide, could play an invaluable role taking to the streets to build public confidence in both vaccination and political representation.

As I said previously, we need leadership to inspire us with an understanding that we must all exceed our expectations if we are to remain great. Barbados can and must do so much better. May the Lord protect us and continue to be the people’s guide.

Guy Hewitt is committed to Barbados and the DLP and can be reached at guyhewitt@gmail.com