COVID-19 vaccine deployment: is Bangladesh ready yet?

Some countries have started COVID-19 vaccine roll out in the past few weeks and most people are wondering when the long-cherished first vaccine shipment will arrive in Bangladesh. As the policymakers continue their attempt to get vaccines from various sources, one critical question still needs to be paid the highest attention, "Is Bangladesh preparing well to roll out the vaccine once it becomes available to the nation?"

The government of Bangladesh has drafted a national deployment and vaccination plan to vaccinate 80% of the population in four stages. Unfortunately, as the crisis caused by COVID-19 is unlike any other crisis seen in the past, the country lacks infrastructure, logistics, resources and experience to accomplish this mammoth task. Population-wide vaccination requires the implementation of several factors, including but not limited to: increase capacity of the existing cold chain, recruit and train vaccinators, establish strong leadership, ensure proper coordination, launch awareness campaigns to address vaccine hesitancy.

Proper management of the cold chain is vital to maintain the required temperature in which the vaccine shall remain potent. Therefore, it is critical to increase the capacity of the existing cold chain as a huge part of the country's cold chain is occupied with the Measles-Rubella vaccine. Necessary measures should be taken to build new storage facilities, purchase equipment and logistics, confirm constant power supply in the storage and distribution sites, supply adequate storage vehicles and ensure careful handling as well as disposal of vials. Bangladesh can not just simply wait until the arrival of the vaccine to establish the cold chain capacity, as preservation at the right temperature is essential to maintain the quality and efficacy of the vaccine.

Limited success to ensure adequate tests and contact tracing, failure in the timely implementation of antigen testing, chaos observed during the distribution of PPEs make us nervous about the effective implementation of the vaccine deployment plan. Strong leadership is required to ensure that previously observed incoordination and miscommunication among different departments in the country do not hinder the successful implementation of vaccine deployment policy.

A high-profile implementation committee, led by a high-official from the Prime Minister's Office, should be formed to facilitate the effective implementation of the vaccine policy. The strict handling of the distribution process can prove to be successful in deploying the vaccine policy.

A monitoring cell should be formed to oversee if the vaccine is transported and stored at the right temperature. Designing an integrated and electronic national vaccination tracking and monitoring database, with minimal data input burden for frontline workers, would be invaluable for the strategic implementation process of the national COVID-19 vaccine deployment.

Bangladesh has taken the commendable step to sign a Memorandum of Understanding with Serum Institute of India (SII) to get 30 million doses of the University of Oxford/AstraZeneca vaccine. In addition, Bangladesh is expecting to get 68 million doses in 2021 from the GAVI Alliance (formerly Global Alliance for Vaccines and Immunisation) under the COVAX (The COVID-19 Vaccines Global Access Facility) facility. But Bangladesh must go for more vigorous vaccine diplomacy to get vaccines outside the COVAX facility, as the vaccines promised by SII and GAVI may not be sufficient to execute nationwide vaccination.

Dr Khondoker Raisa Samiha is an MPH Candidate (Health Policy) at the University of Alberta, Canada.

Email: ksamiha@ualberta.ca

Dr Shahriar Rozen is a public health professional, currently working as a Senior Policy Lead for the Alberta Ministry of Health, Canada.

Email: rozen@ualberta.ca

Dr Nazif Mahbub is the General Secretary of One Better World, Bangladesh. Email: nazifbd@gmail.com