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Review ‘flawed’ vaccination plan, SLMA urges President

04 Jun 2021

  • Wants priority for people above 60 and those with comorbidities

  • Says no benefit in vaccinating people in high mobility in hotspots

By Buddhika Samaraweera   Pointing out that the Covid-19 vaccination strategy as implemented at present is flawed and needs a composite review urgently, the Sri Lanka Medical Association (SLMA) in a letter to President Gotabaya Rajapaksa yesterday (3) emphasised the importance of targeting high-risk groups. The letter has requested the President to prioritise adults older than 60 years old, followed by people with comorbidities between 30-60 years, instead of vaccinating people with the highest mobility in so-called hotspots. “Death analysis of patients from the Ministry of Health indicates that 73% of deaths occurred of people over 60 years of age and 83% of deaths were of people with comorbidities. Research findings have clearly demonstrated that vaccination reduces deaths and complications in patients infected with Covid-19. Research evidence does not support benefits of vaccination to reduce transmission of infection unless a large majority of the population is vaccinated. As such, there is clear and compelling evidence to support prioritisation of vaccination of older adults more than 60 years, followed by people with comorbidities in the age group of 30-60 years. However, there is no appreciable benefit in vaccinating people with the highest mobility in so-called hotspots, as is currently carried out in the Sri Lankan setting,” the letter read. The SLMA also pointed out the need of a definitive roadmap providing the priorities of the vaccination drive in certain geographical locations, as the presence of a roadmap would help in gaining the confidence of the Sri Lankan public concerning the vaccination programme. The selection of grama niladhari divisions of high-risk locations for vaccination cannot be recommended, as the infection would have already spread and the majority would have developed immunity by the time the vaccination programme is carried out, the letter stated. It was also mentioned in the letter that the opinion of experts with regard to selecting the geographical location is to select high-risk provinces or districts and to vaccinate high-risk people in crowded areas such as the main cities in those selected provinces or districts. An equal amount of vaccines could also be given to hospitals to immunise high-risk people with comorbidities. Along with vaccinating high-risk persons, people working in larger numbers in enclosed areas on longer shifts in economic hubs and other essential congregate settings could also be prioritised, it added. They also urged the Government to provide a solution to the 600,000 people awaiting the second dose of the Oxford-AstraZeneca Covishield vaccine (manufactured by the Serum Institute of India) as soon as possible. In that regard, the letter further read: "We see that offering them the first dose of the Sputnik V vaccine (manufactured by the Gamaleya Research Institute of Epidemiology and Microbiology of Russia) following a quick clinical trial of the efficacy of such a manoeuvre as a reasonable option to solve the issue. “Further, we wish to highlight the need in the future to reserve the second dose in instances where a second dose is in schedule.” They had also brought a few other matters to the attention of the President. Physicians indicated that the brunt of the outbreak is now concentrated in the main hospitals and that all wards are well over their full capacity with symptomatic patients. There are many Covid-19 patients on the floors of medical wards, it stated. Information from the intensive care units (ICUs) indicated that other than the dedicated 82 ICU beds, another 70 patients are treated in ordinary ICUs at the time, and the SLMA stated that this situation compromises the care given for patients with non-Covid-19 issues. In the letter, they urged the Epidemiology Unit to pay more attention on the surveillance indicators and to present the data of the relevant indicators in order to arrive at meaningful decisions. They have requested the President for an appointment to be granted to discuss this issue further. Attempts to contact Epidemiology Unit Chief Epidemiologist Dr. Sudath Samaraweera for comment regarding the SLMA's concerns pertaining to the Epidemiology Unit, proved futile.


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