Uganda is moving to expand its cold chain storage capacity as it introduces new vaccines in its routine childhood vaccination programme and and handles more COVID-19 vaccines.
This week Uganda added over 1,300 solar-powered refrigerators, vaccine carriers, and walk-in refrigerators to manage the cold chain for vaccines and to stop wastage. Expansion of the vaccine program will now include yellow fever and later on meningitis one of the reasons Uganda needs to expand its cold chain capacity.
According to the national drug regulator, the National Medical Stores (NMS) the country’s cold chain capacity for drugs that require temperatures between 2- 5 degrees is at 300 million doses, that of between -15 and -25 degrees is at 35 million doses whereas the coldest of -50 to -80 degrees that they have been using to store COVID-19 vaccines like Moderna and Pfizer/BioNtech COVID-19 vaccine is 45 million doses.
Health Minister Dr. Jane Ruth Aceng said with the new equipment, they are securing more cold chain space of 115 million doses for vaccines and other drugs that require temperature ranges of 2-5 degrees and five million doses for those that require temperatures -15 to -25 degrees.
Aceng this week flagged off $8.3million worth of refrigeration equipment to districts and health facilities that have been experiencing challenges storing key drugs, especially vaccines that require very low temperatures. Already more than 500,000 Moderna COVID-19 vaccine doses have gone to waste following the failure by the Ministry of Health to use them within thirty days after being removed from the required cold chain of -80 degrees to remain potent.
Dr. Daniel Kyabayinze, the Incident Commander of COVID-19 at the Ministry of Health said that the vaccines that require very low temperature were taken to the Acholi region in anticipation that people would use them in vain. They later thought of shifting them to the Kigezi region, but it was too late for them to be used since the thirty days had elapsed.
The expired vaccines were part of a donation from the US government received through the COVAX facility. Kyabayinze blamed the wastage on the anti-vaccination crusade by sections of people in Northern Uganda.
So far, Uganda has received more than 32.6million doses of different COVID-19 vaccines and expects more eleven million doses by the end of March. By end of December last year, Ministry of Health figures showed that about 20million doses had been utilized although the latest figures released on Thursday afternoon shows that only 12.2million doses of the different vaccines have been administered.
This means more than seven million doses cannot be accounted for. However, Kyabayinze says that about two hundred and forty thousand doses of the AstraZeneca vaccine were withdrawn from facilities a few days before expiry. Vaccines made under emergency approval are given only six months duration before they expire.
Amidst the expiration many city dwellers are hunting for vaccines. So far only 4million people have been vaccinated fully accounting for 18.2% of the target. Also, vaccination is being banked on as one of the ways that will lead to a reduction in new infections.
The current new infections recorded per day is still high averaging 1200 cases. According to results released on Thursday (13.01.2022) , 591 from 7278 samples tested COVID-19 positive.
This trend is however projected to decrease, according to Eng. Muwanguzi, who heads Science and Technology Management at National Planning Authority. He said their model is showing that cases will be on the decrease in the next two weeks even when schools have reopened and restrictions on bars and the arts industry eased. He says this is explained by among others vaccination and the fact that hospitalization has remained low despite high cases.
For other vaccines, Dr. Jane Ruth Aceng announced introduction of the yellow fever vaccine on its routine immunization schedule. This will bring the number of immunizable diseases under this program from thirteen to fourteen. She said they are finalizing plans to start dispensing the jab which until today is given in one-off campaign mode in high-risk districts and yet it’s a requirement for travel in many countries including neighboring Kenya and Tanzania.
Dr. Alfred Driwale, the Uganda National Expanded Programme on Immunization (UNEPI) says this new stock comes in handy when they are grappling with an increasing number of unvaccinated children. For just polio, the ministry said a total of two million children had missed vaccination by August last year.
Driwale says apart from measles whose uptake until recently has been the lowest, they are now seeing through their monthly surveillance reports that BCG, the vaccine against leprosy and severe forms of TB is the least accessed by children.
The country is undertaking a nationwide campaign following confirmed polio cases that were detected in Kampala and in neighboring South Sudan.The three-day vaccination against polio among children aged five years and below, started on Thursday.
The campaign targets 8.7 million children and aims to also reach children that have been missed in routine immunisation. By the end of August, the Ministry of Health said that up to two million children had missed polio vaccination, something that is partly attributed to disruptions caused by the COVID-19 pandemic.
The new exercise will be conducted door-to-door, and that it will be carried out concurrently with ongoing COVID-19 vaccinations. She was clarifying earlier claims that ongoing COVID-19 vaccination at selected facilities across the country will be halted, to pave way for a polio drive.
Kitgum District Health department is targeting to vaccinate more than 40,000 children aged below five years during the first phase of the polio vaccination exercise.
The Acting District Health Officer Dr. Henry Okello Otto says Kitgum District is one of the border districts with South Sudan and therefore renders it a high-risk area and the health department plans to vaccinate over 48,000 children to improve their immunity against polio. According to Dr. Okello, the exercise will be carried out door-to-door and at all existing health facilities in the district.
The Kitgum Resident District Commissioner William Komakech reiterates that the district is vulnerable and they will not offer room for complacency due to the significant polio resurgence risks that continue to exist through cross-border transmission. Komakech however also stressed that whenever similar campaigns are initiated some people raise vaccine safety concerns.
He warned persons who would emerge while opposing the campaign saying the government will take necessary actions in ensuring that all children enjoy the right to good health but also essential to keep Uganda free from polio.