THE NUTS AND BOLTS OF VACCINATING A COUNTRY

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Rajendra Aneja lists some building blocks for seamless execution

“There is no magic in magic, it’s all in the details,” opined the master story teller, Walt Disney. As African countries ready to roll out the vaccines, this advice on the importance of detail, is relevant. Nations should now focus on the nuts and bolts of vaccinations.

The inoculations will require granular planning in scheduling, determining disseminating centres, communications to recipients, recruitment of adequate volunteers, safe storage and transportation of the vaccines, maintenance of records, monitoring side-effects, administering second jabs, etc. Ideally, all the information about every vaccination should be stored in computers, accessible to health authorities for follow-up.

Inoculating Public Workers: Countries should begin with determining the priority groups to be inoculated. Most countries have prioritised health workers, law enforcers like the police and the army personnel. These categories of public staff are easy to locate. They are in hospitals, police stations and army quarters. Doctors can visit these locations with vaccines. Inoculating these categories, should be a cakewalk.

Senior Citizens: The next priority group will be the senior citizens and the infirm. Many of them may have comorbidities. Ideally, senior citizens should be inoculated at their residences. This may require additional planning and efforts. However, it will save a lot of inconveniences to the frail. Senior citizens should also be able to register with the local hospital or municipal authorities, through family members. If the registration is made online, then the process should work without glitches. They can visit the hospitals on predetermined days for inoculations. Those who are unable to travel, should be inoculated at homes. Citizens living in Homes for the Elderly, should be inoculated at their centres.

Civilian Society: The challenge will be to vaccinate the below 60 years category of citizens. They constitute the majority in most nations. This group will have to be inoculated by geographical zones. Governments have census data and voting lists of the regions. Depending on the quantum of vaccines available, they will have to prepare schedules of vaccinations by locality and communicate digitally with recipients. They can allocate time schedules for specific zones and clusters of residences.

Recording Information: Health authorities should maintain meticulous records of the contact details, names, ages of people who are inoculated. This will also help to ensure that they return for the second jab, till we have vaccines which require just one jab. Recipients of the vaccines, should be given a document, certifying the vaccination.

Doses and Computer Modelling: A key element in inoculating the entire civilian population, will be to determine the number of doses required daily, for a plethora of vaccinating centres. The process would be akin to the demand forecasting models used by corporations, to forecast demand for a product in a geographical area.

The model would need inputs, like population, age-ranges, locations of people, indicative ratios of people coming for inoculations in surrounding neighbourhoods, transport availability, attitudes to vaccinations, etc. On the basis of these variables, health authorities can forecast the vaccine requirement by town or locality. Vaccines should be positioned at the centres, 24 hours prior to the inoculations.

Communications: Informing the time and place of the vaccination will be critical, to optimise the vaccination drive. If people squander time and effort to locate their vaccination centres or wait indefinitely for the jab, it will diminish productivity. Some citizens may simply return home.

Storage of Vaccines: The vaccines can be stored in the cold storages of hospitals and health clinics. The help of the private sector can be sought, for accessing their cold storage facilities.

Involve Private Sector: Governments should join forces with the private sector. Private hospitals should be permitted to vaccinate the public. Many large companies have medical facilities and doctors on their premises. They can have vaccination centres in their premises. In UAE, many companies arranged to inoculate their staff in the offices. Organising inoculations in offices and factories should be the norm, not the exception. This will enable rapid inoculation of employees and their families.

Training Health Workers: The recruitment and training of adequate number of health workers, to inoculate citizens, will be challenging. Even retired health workers, like doctors, nurses, etc., should pitch in. Health workers should also be able to deal with queries.

Vaccinate Slums at Site: In vaccinating crowded slums, it would be pragmatic to establish vaccination centres on sites. Vans with refrigeration facilities could stock the vaccine. Medical staff accompanying the vans could administer the doses. Meticulous record-keeping in slums should be mandatory, due to the large numbers to be vaccinated. Doctors and some ambulances should be present, to treat any person who has side effects.

Rural Areas: In the villages, local officials, village headmen and leaders should spearhead the vaccination drive, through public health centres. Private doctors in villages and small towns, should also contribute.

The resources of the private companies can be harnessed for accelerating vaccinations in villages. These companies have rural infrastructure of vans, promoters, warehouses, etc., which can be deployed.

Educational Institutions: Vaccination centres can also be started in the universities, colleges and schools. Parents of school children should be present, whenever kids are vaccinated.

Boost production of Vaccines: It is horrifying to see countries squabbling amongst themselves for vaccines. The focus of governments should be to provide incentives to vaccine manufacturers to boost their production exponentially. It would be provident for African countries to be self-sufficient in vaccines and establish production facilities in Nigeria or Kenya. In the current scramble for vaccines, many African countries, have been left in the lurch.

Be Ready for Future: There will come a time in about two years, when vaccines will be freely available in pharmacies. We could then buy any brand of vaccine and visit the family doctor to get vaccinated.

If there were enough vaccines being produced, we could even order them online. Pharmacy companies can pack “do-it-yourself” vaccine kits with instructions. Amazon could deliver vaccines, packed in ice packages, as they deliver chocolates in some countries. Hopefully, those days are not far away for countries in Africa.

Aneja was the Managing Director of Unilever Tanzania. He is an alumnus of Harvard Business School and the author of books entitled, “Rural Marketing across Countries and ‘Business Express’. He is a Management Consultant