Rational use of available vaccines to minimize deaths and severe disease due to COVID-19
We have received a copy of the letter issued by the DGHS on 2nd September 2021 regarding immunizing people 20 – 30 years of age in Hambantota with the Pfizer vaccine.
The Association Of Medical Specialists believes that it is the right time to draw the attention of the relevant authorities on following observations on the roll out of the Covid-19 vaccination in our country.
1. The priority of our immunization programme should be to save lives, and reduce hospitalization of Covid patients. For this purpose, we need to initially immunize the vulnerable; i.e.; those over 60 years and those with co morbidities. Though recommended, this policy was not implemented initially, resulting in the high death rate seen today. However, we appreciate the fact that the over 60 year group are now being immunized. In addition, a sizeable proportion of fully vaccinated people are also succumbing to Covid-19, or filling much-needed hospital beds and ICUs.
2. Further, it is very important to emphasize that the immunization has to be done in a scientific manner. The rational policy would be to immunize the unvaccinated vulnerables as a priority, and then to consider a booster dose to the fully vaccinated group who are at risk of severe disease. Data from Bahrain, and also from Prof. Malavige’s group suggests that, while people below 60 years mount a good immune response to Sinopharm, it is evident that a minority of people of more than 60 years do not produce an antibody response (seroconvert) and are at a higher risk of hospitalization and death, compared to those given Pfizer/Moderna/ Astra Zeneca (AZ) vaccines. In addition, certain groups (transplant recipients/cancer patients on therapy/ recipients of immunosuppressive drugs) do not mount an adequate immune response following two doses of vaccine. Both these groups should receive a third dose of AZ/Pfizer/Moderna vaccine to prevent such undesirable outcome.
3. We have a limited quantity of AZ/mRNA vaccines. In such a situation, we find the administration of the Pfizer vaccine to healthy 20 – 30 year-olds, who can effectively mount an adequate immune response with the Sinopharm vaccine is irrational and unscientific.
We believe that administration of Covid vaccines should be done with the advice of a competent body of experts, such as the ACCD of the Ministry of Health. Deviation from the advice of the ACCD has already cost many lives by offering Covid vaccines to 30 to 60 age group before completing the vaccination of above 60 year age group. We hope that, even at this late stage, decisions will be taken in a more rational manner based on scientific evidence.
We reiterate as a union of responsible medical specialists, decision makers should always adhere to the vaccine deployment plan prepared by ACCD and submitted to WHO.
Dr LakKumar Fernando Dr R Gnanasekeram
President-Association Of Medical Specialists General Secretary-Association Of Medical Specialists