Dr Ian Sammy, head of the Accident and Emergency Department, Scarborough General Hospital receives a dose of the Oxford-AstraZeneca vaccine in Tobago from nurse Beryl Samuel-Gray on Saturday.

The Ministry of Health (MoH) has an ambitious target of getting one million people vaccinated in Trinidad and Tobago by the end of the year, according to a document outlining the ministry’s COVID-19 vaccination campaign for 2021.

Through vaccination, the ministry intends to slow the contagion, prevent infection spread by achieving herd immunity where 75 per cent of the population is vaccinated, “flatten the curve,” and return to “normalcy.”

The MoH plans to roll out the COVID-19 vaccine in two phases with groups ranked by priority and risk of COVID-19 contraction to achieve this task.

In Phase One, the first group of people to receive vaccines are “High Risk/High Exposed Health Care Workers,” which began on February 17. Progressing through the prioritisation list, the next group of people would be “Frontline Public Health Care Workers” in Group Two, then public and private “Direct Health Care Providers” in Group Three.

In Group Four, the public outside of the medical sector begins to receive the much-anticipated jab as “Patients with Chronic Illnesses,” then the elderly, meaning people aged 60 and above, in Group Five.

Phase Two begins with Group Six, the essential and special frontline workers.

According to the MoH document, this includes “Teachers, Oil and Energy Workers, Police, Army, Coast Guard, Regional Corporations’ Sanitation Workers, Prison Officers, Customs and Immigration Officers, Port Authority, the Airport Authority, WASA, T&TEC, etc.”

Groups Seven and Eight include the institutionalised and those incarcerated, meaning “Patients in Mental Health Facilities” and “Prisoners,” where outbreaks have already occurred due to cramped conditions. Last on the totem pole of priority is the rest of the general population in Group Nine.

There will be four groups, totalling nearly 400,000 people, who will not be vaccinated, according to the plan. This includes pregnant women, estimated at around 15,000, and breast-feeding mothers.

Also excluded are children, meaning people under the age of 18.

This group accounts for 27.996 per cent of the population or 382,630 people as of 2020.

The final group includes the immunocompromised, determined by physicians across the country.

To achieve herd immunity, that is with 75 per cent of the population vaccinated, 738,071 people will have to get the shots, requiring 1,476,143 vaccines for T&T.

If every person above age 18 is vaccinated, 984,095 would need to receive the COVID-19 shot, totalling 1,968,190 doses.

There are no specific dates outlined where T&T will be shifting from one group to another.

Deyalsingh on rollout dates

Speaking exclusively to Guardian Media, the Minister of Health, Terrance Deyalsingh explained “the dates will depend on when the vaccine reaches.”

According to the Minister, who confirmed the validity of the document to Guardian Media, the document was created due to outpouring support from the private sector.

“When we made the announcement of the vaccines, a lot of entities from the private sector and chambers started to contact myself or the ministry wishing to be a part of this national effort.”

The plan’s details were first unveiled at a roundtable discussion by Dr Stewart Smith who is coordinating the private sector response according to Deyalsingh. The Ministry intends to engage the private business sector to complement and scale up the MoH’s voluntary vaccination campaign. Namely, the MoH is seeking private sector engagement to increase vaccine capacity, speed up vaccine rollout and improve vaccine communication to the public as vaccinations are completely voluntary and free to the public.

Where will the

vaccines come from?

The Ministry of Health is looking at four major avenues for vaccine procurement.

Through the COVAX facility, the ministry expects between 100,000 and 120,000 doses of the AstraZeneca vaccine. Trinidad and Tobago’s Government paid US$1.477 million, or TT$10 million to COVAX on September 29, 2020, as a downpayment. The total allocation from COVAX is expected to cover 33 per cent of the population, spanning 20 per cent of Phase I doses and 13 per cent of Phase II doses.

Through the African Union or African Medicines Council, T&T has been allocated 226,000 doses of an unspecified COVID-19 vaccine based on the document.

CARPHA will determine the final amount out of the CARICOM allocation from the African Medical Supplies Platform.

CARICOM also has an initiative with India, where the ask is for 250,000 Covishield vaccine doses. Notably, Barbados received 100,000 vaccines from a similar venture with India’s Serum Institute, from which the Bajan Government gifted 2,000 vaccines to T&T, kicking off T&T’s vaccination campaign.

Lastly, the Government is engaged in direct bilateral discussions with five vaccine manufacturers. A confidentiality agreement is already in place with Pfizer, and discussions have occurred with Moderna, AstraZeneca, Sinopharm, and Johnson and Johnson.

Vaccine distribution in T&T

The Ministry aims to have vaccination distribution occur at the nation’s hospitals and at 20 health centres and district health facilities. There are three sites under the Tobago Regional Health Authority, seven in the South West Regional Health Authority, three in the Eastern Regional Health Authority, and seven in the North West Regional Health Authority. The MoH is also looking at having mobile vaccination, particularly for homes for the elderly and potentially other mass vaccination sites.

In the private sector, the Ministry is looking to partner with several private hospitals across the country, with a number of clinical and non-clinical stakeholders and businesses involved.

The rollout plan notes that a participating private hospital will administer the COVID-19 vaccine to their frontline healthcare workers, patients meeting the criteria and support the private business sector in vaccinating staff. The Ministry of Health will be supplying equipment to external partners for vaccine administration, storage, and the required administrative documents such as vaccination cards and required forms.

Who has received the

vaccines to date?

Speaking at a virtual press conference on Saturday, Health Minister Terrence Deyalsingh confirmed 400 healthcare workers were vaccinated as of Friday afternoon, with the second batch of 600 people to be inoculated within the next few days.

120 frontline health care workers were vaccinated in the North Central Regional Health Authority last Wednesday, 96 last Thursday, and 76 last Friday.

The South West Regional Health Authority vaccinated 108 people, and the Tobago Regional Health Authority received 200 doses to vaccinate 100 frontline workers on Saturday.

Chief Medical Officer, Dr Roshan Parasram said those who have been vaccinated would receive their booster shots eight to twelve weeks after the initial inoculation. He also noted because research showed booster shots administered closer to the twelve-week date, appointments will be scheduled closer to that time.