Medical experts question whether more than half a million people who have been waiting for months for the second dose of their Astra Zeneca vaccine should be given an alternative of either starting anew or whether they should be given a mix and match solution using the Pfizer or Moderna vaccines.

If the government is unable to secure the vaccine they should consult the experts and authorize an alternative, said Dr VinyaAriyaratne who is a specialist in community medicine and the president of the Sarvodaya Movement. Last week Deputy Director General of Health Services Dr Hemantha Herath said if the anticipated stock of Astra Zeneca vaccines did not arrive in the country on 19th July, the authorities will decide on the next course of action.

Dr Ariyaratne points out that one option could be to start anew after an antibody level assessment although there is still no clinical data which is available to support this.  ‘If there is certainty about these vaccines arriving at the end of this month, then the best will be to wait for them’. Other medical experts point out that since efficacy levels of the first Astra Zeneca dose could be lower than 30 percent now, it will be best to re vaccinate with both doses. The second dose of the Astra Zeneca vaccine is usually given after 12 weeks.

A mix and match of vaccines will be the other option where those who have got the Astra Zeneca vaccine as their first dose can take either the Pfizer and Moderna vaccines, both of which have been approved by the National Medicines Regulatory Authority (NMRA) for emergency use. Earlier this week it was reported that the Advisory Committee on Communicable Diseases which is a part of the Ministry of Health, had approved the use of the Pfizer and Moderna vaccines by those who are waiting for their second dose of the Astra Zeneca vaccine. In June this year, the WHOs Strategic Advisory Group of Experts on vaccines said the Pfizer can be used as a second dose by those who have taken the Astra Zeneca as their first dose and itis unavailable for their second dose.  

At least 560, 000 people have been in limbo for months waiting for their second dose of the Astra Zeneca vaccine. The government has been claiming for a long time that the arrival of 1. 45million doses of the vaccine will be imminent.  The latest was that they will be coming to the country at the end of this month although now there is speculation that it could be pushed back further by another two weeks at least. The Japanese manufactured Astra Zeneca vaccines will be provided to Sri Lanka by Japan through the COVAX facility.

Sri Lanka’s Covid vaccination drive has been dogged by allegations of corruption and cronyism. According to a leading legal expert,lapses in the measures that have been taken to secure the vaccines and their administration could theoretically trigger rights claims underthe Sri Lankan constitution. Article 12 (1) of the constitution guarantees all persons the right to equality before the law and 14 A guarantees every citizen the right of access to any information which could be supplemented by the provisions of the Right to Information Act.

Medical experts have routinely criticized the government for not being proactive and for not ordering the vaccine last year when the rest of the world was scrambling to get quotas for their citizens.  They  accuse the government of relying on the Dhammika paniya , a dubious local concoction which the Health Minister was seen endorsing but was not approved by the NMRA.  

The indiscriminate administration of the vaccine violating justice and fairness has now become legendary and could be a major reason for its shortage. In May the Mayor of Moratuwa Saman Lal Fernando was arrested by Police for obstructing health authorities from vaccinating the public and for favouring his cronies. There have been media reports of Johnston Fernando and Keheliya Rambukwella who are frontline MPs in the government politicizing the administration of the vaccine for the benefit of their constituents. It is a public secret that the government and businessmen who are close to it have a stranglehold on vaccine procurement, preventing the private sector which has come forward to import the vaccines from securing it even for their employees.

The government’s lack of transparency about its Covid response, leading to the public not being able to plan for their future such as their livelihoods is also another area for a potential fundamental rights application in addition to any damages that can be claimed under a civil law suit. If the true state of affairs has not been disclosed it affects the peoples ability to make informed decisions and choices about matters which are important to their lives, this legal expert pointed out.  The people have a right to know if they have been misled. In case someone who is entitled to a vaccine because of their vulnerability loses out on it because it has been given to another and they are affected by it that person could potentially have a claim’.  



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