By Kumudini Hettiarachchi
The COVID-19 vaccination programme has come under fire from senior medical specialists who are part of the independent expert panel of the National Medicines Regulatory Authority (NMRA), calling for an immediate probe on major flaws that could have prevented deaths.
The eight professionals are – Dr. Ananda Wijewickrama (physician), Prof. Neelika Malavige (immunologist), Dr. Rajiva de Silva (immunologist), Dr. Kanthi Nanayakkara (virologist), Prof. Channa Ranasinghe (respiratory physician), Prof. A. Pathmeswaran (community medicine physician), Dr. LakKumar Fernando (paediatrician) and Dr. Hasitha Tissera (epidemiologist). Some are also members of the National Advisory Committee on Communicable Diseases (NACCD) as well as the NMRA board.
In a letter to the Health Ministry Secretary sent on Friday, a copy of which the Sunday Times has seen, they said that during the past six months they had provided expert advice to the NMRA after carefully reviewing and evaluating scientific evidence on vaccines, while closely studying on-going vaccination programmes against COVID-19, both in Sri Lanka and overseas.
The experts cited glaring examples of “acts of omission and commission” that have derailed the well-planned vaccination rollout in Sri Lanka. These include advising healthcare workers to give only 10 doses from one vial of COVISHIELD AstraZenica vaccine at a time when it was publicly known that an additional dose could be extracted from a 10-dose vial. Giving such an additional dose had been recommended by regulatory authorities in countries such as the United Kingdom.
This, the letter said, led among other things, to wasting vaccine doses in Sri Lanka and resulted in a significant number of people missing an opportunity to get vaccinated; wasting of public funds; and unnecessary deaths of people (many deaths during the last few months could have been prevented if the vaccination programme was conducted as recommended by the NACCD).
In spite of pointing this out at many fora, including at the review committee discussion of the Task Force, the Chief Epidemiologist and other decision-makers at the Epidemiology Unit refused to even consider this. The Epidemiology Unit Deputy Director advised healthcare workers to draw the vaccine in an incorrect manner so that the extra amount of vaccine would not be left for use, the letter states.
It points out that it was only after a meeting on February 17, where the technical report of the National Medicines Quality Assurance Laboratory was tabled (which was produced after a request by one of the members of this expert panel to evaluate the AD – auto-disable – syringe) that the Epidemiology Unit decided to adopt this extra dose usage. “This delay resulted in the waste of more than 20,000 doses of the vaccine.”
The Epidemiology Unit also disregarded recommendations to give the vaccine to people above 60 years of age. This led to the death of several hundred of elderly people in the Colombo district, the experts allege.
The letter said among other things, there was a plan that identified the groups who need to be vaccinated in an order of priority. The first group was healthcare workers and then other front-line workers handling COVID-19. The next groups identified were people above 60 years of age and people with co-morbidities. This strategy was recommended to get the maximum benefit of the limited amount of vaccines available, by reducing severe disease and deaths.
However, they state, this recommendation was not implemented and after giving the vaccine to healthcare workers and other frontline workers, the vaccine was given to people between the ages of 30 and 60 years. Subsequently, with the intervention of the President, this was changed to those above 30 years of age.
The letter said that more than 70 percent of the deaths due to COVID-19 are of those above the age of 60 years. If the vaccine was given to people above 60 years, initially in the Colombo district and then in other parts of the Western Province, several hundred deaths could have been prevented.
“It is apparent that the disorganised nature and poor planning of the COVID-19 vaccination programme have led to loss of public confidence in vaccination programmes in the country. This is very unfortunate as previously the vaccination programme in Sri Lanka was hailed as one of the best in the world. Poor planning, ad hoc decision-making, disregarding expert opinion and inept administration of the programme are obviously responsible for this,” the letter states.
It added that a vaccination programme done free of charge which should have received praise is receiving the wrath of the public due to poor administration, planning and implementation. This is in addition to not getting the maximum benefit of the vaccination due to the same reasons.