EDITORIAL COMMENT: Fix vaccination logistical glitches

At the start of the national vaccination programme against Covid-19, the main problem was a reluctance by a lot of people to take advantage of the offer of free vaccinations and so there was a slow start.

The drivel put out on social media by anti-vaxxers, plus the nonsense put out by those who believe any Government programme should be treated with severe suspicion, did not help. 

But then the numbers started coming forward, and now the growing problem is more logistical, trying to fit everyone who wants to be vaccinated into the programme.

There is a growing queue of people who now want to get into the programme and have their first jab, and are being told at many vaccination points that with priority being given to those coming for their second jab, the ones who were first vaccinated four weeks earlier, they will have to wait.

But at the moment roughly equal numbers of first and second jabs are being given, so those wanting a first jab are not being excluded, just queued.

There is no shortage of vaccines. As President Mnangagwa stressed on Wednesday when he addressed the Zanu PF Politburo, supplies of vaccine are adequate for the programme. 

He stressed again that another 500 000 doses were coming this month from China in a new commercial order.

In previous briefings, the Government said quite clearly that the programme as presently set up would be ordering 500 000 doses a month, enough for 250 000 people to get both jabs, with the Ministry of Health and Child Care looking at how the programme could be speeded up.

But it is clear at the moment that the Chinese government is prepared to release the 500 000 needed each month, and the Government is committed to making the necessary payments, to keep the present programme on course. So the supply chain is in place.

By Wednesday 1 040 214 jabs had been given, with 682 242 first jabs and 357 972 second jabs. So far Zimbabwe has received 1 735 000 doses of vaccine, including the special gift of 100 000 doses from the Chinese People’s Liberation Army for the Zimbabwe Defence Forces, and we assume that the military medical staff are now working their way through army and air force units and using that gift fully.

So out of the total deliveries so far, there are still 694 786 doses left. From that total 324 270 have to be reserved for those who have had their first jab, but are now waiting for the four weeks required for their second, leaving stocks of 370 516 for newcomers to the programme, enough for just over 185 000 people to get both jabs and with another 250 000 able to be vaccinated when the next delivery arrives.

Even with the greatest care, there must have been some waste, syringes dropped and the like, but the distribution system at present is such that all the doses issued to each vaccination team are fully used before the nurses pack up, so the waste level must be very low.

But as we move forward, with rising demand and more and more Zimbabweans “immunised” against the fake news on social media, we appear to have reached the stage where the programme can be made more efficient by introducing a booking system for newcomers to the programme.

Such a system is already in place for second doses. Each vaccination team knows exactly how many second doses, and the particular vaccine that must be ordered from stores, for every day simply by looking at the records for that centre as to how many first doses were given exactly four weeks earlier. The second dose people have their appointment on the vaccination card. 

There is the minor problem that with most people being given one of the two Chinese vaccines we could easily run into the logistical hassle that second dosers at a point need one type of vaccine and first dosers would be given another.

People need to understand this as well as accepting that there is a bulge of second dosers since four weeks ago there were far more first doses than second doses given.

It would now appear to be useful to have a simple system put in place to allow those wanting their first dose to register at each vaccination point and be given their date. Cimas, which is co-ordinating the programme funded through private sector donations, has already started doing this, with various degrees of success, and if you not on the list for that day you are told to register and come back on your appointed day.

The job is largely clerical, rather than using trained nursing staff. Each team knows how many people it can vaccinate in a shift. From that the second dosers are deducted and what is left is the number of first doses that can be given. 

The easiest system would be, considering that everyone now has a mobile phone or has access to a mobile phone, is for a list of vaccination points and SMS numbers and people asked to SMS their name and ID number to the centre for their area. 

The mobile line companies will probably be delighted to help out with the necessary SIM cards and free air time needed. The clerk can then allocate appointment dates, at least for the next couple of weeks. 

But even if the system is people dropping by their local centre and getting their booking, this would be better than nothing and would at least ensure that those registering were the more enthusiastic so limiting the number of no shows. It would also mean that if there was a gap the drop-in would be lucky.

Of course, Zimbabweans being Zimbabweans, there will be the nuisance of some people trying to register at two centres, and it needs to be made clear that this is totally unacceptable.

And it would be necessary to make it exceptionally clear that anyone trying to wave some banknotes around to get an early booking would go to the bottom of the list as well as having an unpleasant chat with the police.

The new app now available, ZimCovid Safe, is regrettably a first draft. The information is accurate, with summary figures, the last month of official statements, and data on vaccines in use. 

So unlike social media users app users can find out the true position. But the map showing vaccination centres only shows the private clinics in the programme; it needs to be updated to show the public centres as well although most people know where their nearest public clinic is. 

We are still, in many ways, in the early days of the national programme. There are organisational issues now arising that can easily be sorted out as we move forward. 

Supply chains are now in place, there is growing enthusiasm for the programme, and what is left are the logistical constraints arising from the use of more than one vaccine, the number of people each team can process in a day, and the ratio of first and second doses that each team can manage. These will always be there and a more formal organisation can minimise inconvenience.

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