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PAHO Director – Vaccine Hesitancy Continues to threaten the Caribbean


by Kevon Browne

St. Kitts and Nevis (WINN): “The pace of vaccination is not where we’d like it to be yet. In the Caribbean, for instance, we are seeing rising vaccine hesitancy,” said Dr Carissa Etienne, Director of the Pan American Health Organisation during the November 10 Regional COVID-19 press briefing.

Vaccine hesitancy for the COVID-19 vaccine has been around since the first vaccine was approved for emergency use by the World Health Organization and has continued to plague countries aiming for herd immunity.

However, Dr Etenne reported the possibility of the emergence of failings in the vaccination rates of vaccine-preventable diseases.

“The Expanded Program of Immunization, which is EPI, in the Americas has reported additional setbacks in routine vaccination. Our technical advisory group on vaccine-preventable diseases reported that the region is facing an impending crisis around routine vaccination, and ongoing attention must be given as a priority to sustaining and strengthening immunisation and other essential health programs. Declining immunisation coverage rates, accompanied by loosening or succession of public health and social measures, will predictably result in increases in many vaccine-preventable diseases such as measles. Influenza, whooping cough, tetanus, etc.”

Based on that statement by the Director, the region is set to possibly lose some of the gains made related to vaccine preventable diseases.

Coupled with the trend of COVID-19 cases, the strain on health care systems in the region could increase if the region’s drop off continues in vaccinating preventable diseases.

Additionally, Dr Etienne said the PAHO and United Nations Economic Commission for Latin America and the Caribbean (ECLAC) have been working on projections for the region over the next nine months and came up with three possible scenarios.

“In scenario A, if there is [a] low implementation of public health and social measures, at the same time as there was a low vaccination coverage, we could see high rates of community transmission continue generating sustained rates of hospitalisations and deaths. In Scenario B, we would have an epidemiological situation in which there could be a fluctuation of case incidents. Maintaining adequate levels of public health and social measures over time has proven to be difficult in many countries. So this, combined with low vaccination levels, will generate periodic increases in cases followed by hospitalisations and deaths, said the Director.

“An alternative is that while some countries may not be able to achieve high levels of effective vaccine coverage over time, coupled with [the] low implementation of public health and social measures, spikes and cases would likely arise periodically, and countries in these scenarios are likely to fall back periodically to Scenario A, fluctuating back and forth depending on each situation… Scenario C is the optimal one… where we see consistent and adequate implementation of the public health and social measures together with increased and effective vaccination coverage. And that will lead to a situation in which hospitalisations and deaths are reduced over time.”

The worst-case scenario is the possibility of COVID-19 becoming endemic because of persistent low vaccination coverage, high transmission rates and mutations that would continue to hamper recovery.

Within the Eastern Caribbean Currency Union (ECCU), three countries have made it past the WHO’s benchmark of having a 40 percent vaccination rate of the total population of their country, St. Kitts and Nevis, Antigua and Barbuda and Anguilla.

While the other members of the ECCU are just below the mark with Dominica are in the 30 percent range close to the benchmark, and St. Vincent and the Grenadines is on the lower end with approximately 18 percent coverage.


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