A frontpage commentary by Antonia Howard
Claim: Did the Sierra Leone Government enforce compulsory vaccinations for employees of government institutions to accelerate the administration of vaccines before they expire?
Result: Insufficientevidence. Although one batch of the Oxford-AstraZeneca vaccine in Sierra Leone was to expire a month after the government enforced vaccinations, there is insufficient evidence to show this was the reason for the government’s regulation.
Background
The Government of Sierra Leone through its COVID-19 response body National COVID-19 Emergency Response Centre (NaCOVERC) issued a public notice on 17th June 2021 instituting measures to combat the third wave of the virus in Sierra Leone. One regulation stated that “Government ministries, departments and agencies will only be accessed by employees and members of the public with proof of at least one dose of COVID-19 vaccination.” Though not stated in clear terms, the notice was enforcing compulsory vaccinations for people especially employees who want to access the offices.
NaCOVERC say the decision was informed by the Word Health Organisation (WHO) reports and by an examination of the epidemiological data, which showed increasing cases of COVID-19 and related deaths. However, there were public speculations that the Sierra Leone Government was enforcing vaccinations because the vaccines available were about to expire.
Vaccine Availability
Sierra Leone received 96,000 doses of the Oxford-AstraZeneca vaccine on 8th March 2021 shipped through the COVAX Facility, a partnership between the Government of Sierra Leone, Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, United Nations Children’s Fund (UNICEF) and WHO.
On 20th March 2021, 42,000 doses of the Oxford-Astrazeneca vaccine were sent by the African Union’s African Vaccine Acquisition Task Team (AVATT) which redistributed 925,000 doses to 13 countries on the continent.
Two hundred thousand (200,000) doses of Sinopharm vaccines were donated to Sierra Leone by the Chinese Government and later in April an additional 40,000 doses from China’s Ministry of Defense to the Sierra Leone Defense Ministry specifically.
Altogether, Sierra Leone has received 378,000 doses of COVID-19 vaccines.
Vaccine roll out
The official vaccine rollout in the West African state started on 15th March 2020, targeting people over 70, teachers, firefighters, government officials and health workers. The launch ceremony of the vaccination campaign took place at State House in the capital Freetown where some government officials, including President Julius Maada Bio, were vaccinated.
According to Dr Tom Sesay, the Vaccine Pillar Lead for NaCOVERC, by 31st May 2021, before Sierra Leone released the new regulations under the third wave of COVID-19, 72,888 people had received their first dose and 17,502 people had received their second dose of vaccines. This makes up 1.44% of the population 18 years and above targeted for vaccination.
Vaccine Expiration Dates
The Sinopharm vaccines donated by China are due to expire in February 2023.
The batch of 42,000 Oxford-AstraZeneca vaccines received from the AU had an expiration date of 13th April 2021.
The batch of Oxford-AstraZeneca vaccines received from the COVAX Facility were to expire on 16th July 2021 – exactly one month after the notice was released.
Can vaccines be used after they expire?
The World Health Organisation advises against using any vaccine that has passed its expiry date and recommends that expired doses are removed from the distribution chain and safely disposed of.
In May, the BBC reported that Malawi destroyed almost 20,000 doses of the AstraZeneca (AZ) vaccine. Other African countries have also not been able to use up all their vaccine doses before the expiry date. A more recent report by the BBC claims up to 450,000 vaccines have been destroyed in nine African countries including Sierra Leone.
Verification
Sierra Leone’s NaCOVERC has denied destroying expired vaccines saying 29,000 vaccine doses were administered from the AU batch which expired in April and 13,000 which expired before they could be used have not been administered nor destroyed but have been stored away.
The same statement released by NaCOVERC confirms that all 96,000 AstraZeneca vaccines supplied through the COVAX Facility were administered before their expiry date of 16th July 2021.
In a press conference organised by the country’s Information Ministry on 21st July 2021, Dr Tom Sesay stated “we could have paced the utilization of the AstraZeneca vaccines but because they were to expire on the 16th of July, we had to expedite the use of that particular vaccine”.
This is not conclusive evidence to prove that the regulation for compulsory vaccination was imposed to amp up vaccine administration and beat the expiration date. However, it speaks to the pressure to use up the vaccines before they expire.
“The call on citizens to be vaccinated is to break the chain between case surge and hospitalization and eventually attain herd immunity. Invariably, as people get inoculated, even our donors will have a very positive impression of SL as a worthy recipient of COVID-19 vaccines, and prioritize us for more supplies. …because the 96,000 covax-donated AstraZeneca shelf life was considerably shorter than Sinopharm, we worked hard to exhaust that consignment before its July 16 expiration date and not to necessarily prioritize it over Sinopharm,” the Spokesperson for NaCOVERC, Solomon Jamiru, said when contacted for clarification.
As at 20th July, 2021, a total of 135,590 people had received their first dose of COVID-19 vaccination and 32,607 people had received the second dose. This represents 2.7% of the population over 18 years targeted for vaccination. This data compared to the end of May shows over 86% increase in vaccine administration during the period the regulations were enforced.
Conclusion
While it is true that the Oxford-Astrazeneca vaccine doses received from the COVAX Facility were to expire on 16th July 2020 – one month after the NaCOVERC’s public notice, there is not sufficient evidence to show this was the reason for enforcing vaccination for employees of government ministries, departments and agencies.
