The Sri Lanka Medical Association (SLMA) has called on the President Gotabaya Rajapaksa to pay special attention to giving the second dose to 600,000 patients who have already received the first dose of the Covishield vaccine to prevent the spread of the Covid 19 epidemic.In the shortage of Covishield Medical Associations points out the opportunity to inoculate them with Spoutnik V first dose as their second dose. In a letter sent yesterday SLMA to suggest an immediate clinical trial before administering Sputnik v for Covishield recipients and implement the vaccination following the trial data.
“We urge the Government of Sri Lanka to provide a solution to the 600,000 people awaiting the second dose of the Covishield vaccine as early as possible. We see that offering them the first dose of Sputnik V following a quick clinical trial of the efficacy of such a manoeuvre is a reasonable option to solve the issue. Monitoring antibody levels 2 weeks following vaccination with Sputnik V in about 100 people who have had the 1st dose of the Covishield vaccine may provide a reasonable answer to this question. The importance of documenting the adverse effects during such a clinical trial also needs to be emphasized. Further, we wish to highlight the need in future to reserve the second dose in instances where a second dose is in the schedule.” The SLMA says to the President.
It further states that
“We are appreciative of the decision taken by the Government of Sri Lanka to vaccinate healthcare officials and other frontline workers such as the police, the tri-forces etc., initially with the highest priority. However, we are of the opinion that the vaccination strategy as implemented at present is flawed and needs a composite review urgently. In a setting particularly troubled by a continuous short supply of vaccines, we emphasize the need for an efficient vaccination strategy targeting high-risk groups to achieve maximum control which would avoid the necessity for repeated lockdowns.
In cognizance with the data available from the rest of the world, the death analysis of patients from the MoH, Sri Lanka, indicates that 73% of deaths occur in people over 60 years of age and 83% of deaths were in people with co-morbidities. Research findings have clearly demonstrated that vaccination reduces deaths and complications in patients infected with COVID-19. Research evidence does not support the 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 the 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. Furthermore, we emphasize the need for a definitive roadmap providing the priority of vaccination in certain geographical locations.
The presence of a roadmap would help in gaining the confidence of our people on the vaccination programme. 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 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 main cities in those selected provinces or districts. An equal amount of vaccines could also be given to hospitals to immunize high-risk people with comorbidities. Along with vaccinating high-risk persons, people working in higher numbers in enclosed areas with longer shifts in economic hubs and other essential congregate settings also could be prioritized.
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