DR IAN CLARKE: Why Ugandans are hesitant to receive Covid-19 vaccine

I was privileged to have a Covid vaccination on Thursday at the launch of KCCA’s immunization campaign for health workers in public and private hospitals. Since I am Chairman of Uganda Healthcare Federation, which represents the private sector, I took the opportunity not only to get the vaccine myself, but to demonstrate my confidence in the AstraZenica vaccine, and give the lead to all health workers to protect themselves.

Since the vaccination campaign was launched, the uptake has been rather slow, primarily due to people questioning if the vaccine is safe. The situation was made worse by the President’s decision to wait and assess the situation before he takes the vaccination himself. This was a considered decision, since, as he noted, he is fairly well protected from the threat of Covid 19, and he therefore reasoned that he did not need to rush to make a decision. However, at the launch of the KCCA drive, I also noticed that the Minister for Kampala and other political figures were in no hurry to get vaccinated, and had many questions about the side effects of the vaccine.

This vaccine hesitancy was made worse because Europe paused in their roll out of the AstraZenica vaccine due to reports of blood clots. However, on Thursday night the European Medicines Agency released its report on the risk of blood clots, with the findings that blood clots are rare and the conclusion that the vaccine is safe. This has resulted in the EU restarting its immunization campaign. To give a comparison between the risk of being vaccinated compared to the risk of getting Coivd: the rate of blood clots was between 1 to 4.5 per million people vaccinated, therefore one could rightly say that the risk of a blood clot after vaccination is a one in a million. However, the risk of death after contracting Covid is 2%. This means that if a million people were to catch Covid, 20,000 people will die, while if one million people take the vaccine less than five people might get a blood clot. This is an exceedingly small risk compared to the risk of death from Covid.

Still, many people might say that they are prepared to take their chances since there does not seem to be much Covid around at present, and they don’t think they will contract it. This would be a reasonable approach if it were true, but the pandemic comes in waves, and the tide happens to be out at the moment. Therefore, even though Uganda may be getting off lightly just now, we can be sure that another wave is coming, most likely in April/May. I say this because there is no country that has been spared Covid. Kenya has just gone through a period where there were few cases, but now the numbers have spiked again. Tanzania had a policy of business as usual and there are no real statistics on record, but anecdotally the level of Covid and the number of deaths is high. Uganda is part of East Africa and will experience another wave.

This is now the ideal time to get those who are at high risk immunized i.e. health workers, those who are older, and those who have underlying medical conditions. If we have not vaccinated these groups by the time the numbers spike again we will see hospitals fill up, and intensive care units struggle. The United Kingdom has immunized over 25,000,000 people, which means they have vaccinated everyone over the age of 50, and as a result they have seen the numbers of serious cases of Covid fall. Since we have many fewer old people in our population it will be easier for us to achieve the same results with fewer vaccines. The government should also allow the private sector to get involved in providing vaccines since many people would prefer to go to private facilities even if it means they have to pay. Working together, the public and private sectors will achieve a higher rate of vaccinations – which is for the benefit of us all.