In Nepal, the first COVID-19 case was detected on 23 January 2020, in a 32-years-old man who had returned to Nepal from Wuhan, China. After two months, in March 2020, the second case was reported. After the detection of the COVID-19 second case on March 23, the government announced a complete lockdown across the country with restrictions on incoming passengers, including Nepali citizens, from more than 50 countries in Europe, the UK and West Asia.

The cases of COVID-19 started to rise from April 2020 and peaked during September–October 2020, despite the countrywide lockdown, travel restriction, and border closures.

Meanwhile, the Ministry of Health and Population, Nepal (MoHP-Nepal) confirmed three cases of the United Kingdom (UK) variant of concern (VOC) B.1.1.7 of SARS-CoV-2 on Jan 18, 2021. The cases have been confirmed in individuals who had arrived in Nepal from the UK four weeks back. Nepal’s government has confirmed another delta variant of the coronavirus – B.1.617.2 in May 2021, signifying those three known variants of the virus are currently active in the country.

The success of the COVID-19 vaccination largely depends on Nepal’s ability to acquire COVID-19 vaccines from different countries and manage their logistics, distribution, and delivery. The steps were taken by the Government of Nepal on the supply and distribution of the vaccine are commendable. Though 72% of the population is enough to achieve herd immunity, achieving this target is an uphill the task for a resource crunch country like Nepal and management of COVID-19 in Nepal is further complicated by the newer variants.

(Source: COVID-19 vaccination campaign in Nepal, emerging UK variant and futuristic vaccination strategies to combat the ongoing pandemic – ScienceDirect).

COVID-19 Vaccination Coverage

Nepali citizens started getting vaccinated on January 27, 2021. More than 28.61 million total population of Nepal, 22.68% population recorded to have received both doses of the vaccination until 11th august. (Source: WHO)

If we talk about Gandaki province, out of than 2 million population only 22.92% have received the first dose vaccine, and 12.58% have recorded to complete their vaccination by receiving both doses. (Shrawan 30, 2078)

(Source: Health Directorate Gandaki)

Hurdles in COVID-19 vaccination drive

The expiry date of the unopened multidose vial of the COVID-19 the vaccine is six months from the manufacture date. Within six months, the vaccines need to be shipped from the manufacturing companies to countries worldwide. The adequate supply of the COVID-19 vaccines from central to regional and regional to local vaccine delivery outlets such as community hospitals, ward offices, and primary health posts is a challenging job. Because of this, the health care system has been burdened, and the healthcare providers’ workload is increased, while the health institutes are under-resourced in Nepal.

So, there remains a high chance of vaccine expiry, especially in under-resourced and marginalized countries that are not manufacturing the vaccine in their own countries and cannot effectively mobilize human resources like Nepal.

COVID-19 vaccine inequity seems between and within countries.  As per UNICEF’s vaccine data, more than 689 million doses have been administered as of March 2021, out of which only 0.1 percent of the vaccines administered have gone to low-income countries, whereas 86 percent of the doses have gone to high-and upper-middle-income countries.

At the current rate of vaccination, many high-income countries will be able to vaccinate 75 percent of their population in the next three to five months whereas, for the lower-income countries, it would take a few more years to reach the same percentage of the population.

So, strong political will, adaptive changes in national policies and regulations, timely allocation of available resources, priority setting for equitable distribution of doses, multi-sectoral management approach, and result-oriented collaboration with national and international stakeholders are key to successful vaccine deployment.

The most important thing is never to miss the opportunity to get vaccinated with whatever doses are available whenever. All the available vaccines are safe and have very few if any, contraindications even in pregnancy. We have to psychologically prepare ourselves for the likelihood that the pandemic will continue for many more months unless the vast majority of us in the world are promptly vaccinated. 

One thing is for sure all this will also pass. But we have to learn lessons to be better prepared for the next pandemic.