WHEN Zimbabwe launched its national COVID-19 vaccination drive in February this year, health and child care minister Dr Constantino Chiwenga announced that the target was to vaccinate at least 10 million Zimbabweans in order to attain herd immunity. Just recently, information, Publicity and Broadcasting Services Minister, Senator Monica Mutsvangwa told Journalists during g a post cabinet media briefing that government was still optimistic of reaching the herd immunity target by December.
By Michael Gwarisa
However, over the past seven months since commencement of the national vaccination initiative, a number of factors have come in the way of the vaccination program leading to a slow uptake of vaccines by the citizenry. Conspiracy theories, misinformation and ignorance have all worked against the vaccination drive. Even though Zimbabwe is one of the countries with the highest vaccination numbers in the SADC region, back home only close to two million citizens have been fully vaccinated from a population of over 15 million people.
At the prevailing vaccination rate whereby we are vaccinating between 10 and 20,000 daily, prospects of inoculating 8 million people over the remaining three months remain a huge challenge. To attain herd immunity, at least the country should vaccinate between 100,000 per day for the remaining three months. Whether that is possible or not, only time will tell.
The past few months have shown that voluntary vaccination though effective, is proving to yield meaningful results in our settings. This has been exacerbated by the huge information and knowledge gaps rampart in our midst. The information gaps have given room to mass production of false and unverified information around vaccines and vaccination. Unlike the first world nations where some countries have already vaccinated more than 70% of their populations without the need for using force, the Zimbabwean and African vaccination picture at large tells another story.
In Zimbabwe compulsory immunization is provided for in respect of children see Section 42 of the Public Health Act. There is therefore no explicit provision on compulsory immunization for adults. But it can however be inferred in other provisions of the Public Health Act.
Recently speaking on mandatory vaccinations, Zimbabwe’s leading Health Policy Expert, Nigel James said based on the state’s obligation to the general well-being and healthcare of the public, there can be a justifiable limitation on one’s right to choose whether or not to be vaccinated in response to a formidable epidemic disease.
It is important to distinguish between vaccination of people as a “medical necessity” and “practical necessity. Those vaccines classified as “medically necessary” would be those that are the only known viable defenses against diseases taking hold in a community. “Practically necessary” vaccines are those to which there are alternatives, but which alter-natives are, in practice, not used by a significant number of people. t is important to indicate whether the COVID-19 vaccine is classified as being medically necessary to fight the virus.”
Public Health experts and other Civil Society players believe that mandatory vaccination will not work but rather government should come up with a coordinated communication approach to vaccination program that does not leave room for confusion and misinformation. With adequate information, people can make informed decisions about the type of vaccines they want and decide on whether or not they should get vaccinated.
Challenges Standing in the way of Voluntary Vaccination:
Informalization of Economy:
In July, when some companies and government departments announced that only vaccinated employees would be allowed to work, available data from the Ministry of Health Daily Situation Reports indicate that vaccination figures jumped threefold during that period. However, following easing of lockdown restrictions recently, the vaccination momentum is dying despite government having scaled up vaccines’ availability. Now that majority of the working populace have received their vaccines, there remains another group likely to be left out in Zimbabwe’s vaccination matrix. The informal sector.
Even though official government figures put the unemployment rate at 5.73% in 2020, independent data places the unemployment figure between 90% and 95%, which means majority of Zimbabweans are directly or indirectly working in the informal sector. Vaccinating those who operate on the streets and informal markets is likely tom be a challenge for government as this population lacks the will and a coordinated working environment conducive for carrying out national activities such as vaccination.
There is currently discord with regards to mandatory vaccination for church congregants. Even though government maintains that the ban on unvaccinated congregants still stands, the temporary relief that was granted by the High Court recently also throws confusion in the mix. This is despite the fact that the ministry of health recently entered into a vaccination partnership with churches under the “Marah” church vaccination program. The mandatory drive has to some extent made some take up the jab though against their will. However, with prevailing confusion, some might opt not to get jabbed.
Loopholes In Health Sector: (The Black Market Herd Immunity Effect)
The presence of loopholes in the health sector also threatens the attainment of herd immunity in Zimbabwe. The emergence of Vaccination Cards merchants presents an imminent and huge challenge to the vaccination drive. You might be surprised that if a head count is to be done on the streets of Harare, Bulawayo and other major towns, one may be shocked to find that 10 million Zimbabweans already pose as fully vaccinated citizens. On the black market, Zimbabwe has already attained herd immunity. More people on the streets now hold cards showing that they have been fully vaccinated and yet they have not been anywhere near a vaccination site. The loopholes and porous storage systems in most of the country’s health institutions will present a challenge to the vaccination drive and if not checked will derail the vaccination processes.
The current communication strategy however still leaves potential vaccine recipients with unanswered questions especially around the side effects to look out for, the reactions amongst a host of other grey areas. To break the current vaccine hesitancy, there is need for change in the vaccine message communication strategy. Political leaders and non-scientific people should take a back seat and allow trained and certified medical doctors and public health experts to lead the messaging. People have a general tendency of doubting and mistrusting politicians. A wise man once said if a politician was to tell you that it’s raining outside, you need to go out and get soaked and then believe that its indeed raining.
Even though seeing politicians taking a leading role in encouraging vaccination, to an ordinary person, it appears nothing more than a political gimmick. People trust doctors, nurses and other healthcare workers. Give them a leading role in mobilizing people to get vaccinated and see if they will be need for mandatory vaccination.