Under total secrecy, the Government of Daniel Ortega received a donation of Sputnik vaccines on Tuesday (February 23), as a “symbol of friendship and solidarity cooperation between the Russian Federation” and Nicaragua, said the Vice President and State spokeswoman, Rosario Murillo. However, she did not explain how many doses were donated, nor did she detail how they will be distributed or why they were received under secrecy.
“This sample of vaccines which we receive with much gratitude, is duly safeguarded with the temperature conditions that these vaccines require,” Murillo said.
The arrival of the vaccine donation happened a day after a public event, which was held in commemoration of the assassination of Augusto C. Sandino. In his speech, Daniel Ortega claimed that rich countries were hoarding the doses of vaccines and that this prevented access for undeveloped countries such as Nicaragua.
In principle, the vaccines received from Russia will be applied to risk groups suffering from chronic diseases such as: renal insufficiency, heart disease and oncological conditions. However, Murillo did not mention health personnel as a priority.
“In the next few days and as soon as we have a precise date to receive the vaccines according to the programs we have with India, the Russian Federation and the WHO’s Covax Mechanism, we will be announcing the schedule of these national protection plans for our people,” she assured.
The Multidisciplinary Scientific Committee welcomed the arrival of this first vaccine donation. However, it urged the Nicaraguan authorities to share more details about the immunization plan and the doses that were received.
“More information is needed. We don’t know how many doses arrived and when their application begins. And before this happens, the protocols for the operational organization of the vaccination should be made public, in the sense of establishing the key elements of personnel training, the organization of the locations, and the possible side effects that this vaccine may have, the arrival to the prioritized groups and first establishing the order with which they are going to be covered. It should be sufficiently clear that an order of urgency will be established given the vulnerability or exposure of these groups,” said Dr. Carlos Hernandez, from the Committee.
This week, the Pan American Health Organization (PAHO) also emphasized that it is important for governments to be transparent and communicate how the immunization process will be carried out, and who will be the first to be vaccinated.
Nicaragua will receive 135,000 doses of AstraZeneca vaccine
In the next few days, the first batch of 135,000 doses of the AstraZeneca vaccine, also known as Covishield, will arrive in Nicaragua. The vaccines will be donated through the Covax Mechanism, as confirmed by the vice-president and State spokeswoman, Rosario Murillo. This vaccine comprises 26% of the 504,000 doses promised to be sent by the World Health Organization (WHO) during the first semester of 2021. However, she did not specify the exact date of arrival of the vaccines.
“In a few days we will receive the first 135,000 doses of the AstraZeneca covid-19 vaccine, manufactured by India and managed through the Covax Mechanism, Gavi and WHO. The confirmation came to us early this morning, when Minister Martha Reyes attended the weekly meeting dedicated to the Covax Mechanism”, said Murillo.
This would be the second type of vaccine that will arrive in the country, since Murillo informed that a donation of Sputnik V vaccines delivered by the Russian Federation arrived on February 23, 202. However, it is not known how many doses were delivered.
Ortega promised to immunize 3.7 million Nicaraguans
According to the latest information that became known about the vaccines last January 14, the Ortega government plans to acquire 3,800,000 doses of Sputnik V vaccine, 1.5 million doses of Moderna, and 2,163,800 doses of Oxford-AstraZeneca, plus the doses of Covishield vaccine to be delivered next month by the Covax Mechanism.
With these doses, the Ortega Government assured that it will immunize 3.7 million Nicaraguans and for this purpose, it will acquire 7.4 million doses. However, so far, the only immunizations guaranteed are the 2,697,056 doses, of which half a million will arrive in March, thanks to a donation obtained through the Covax mechanism.
Regarding the other procurement processes, it is not known whether it has evolved or stagnated, despite the fact that the Sputnik V and Covishield vaccines – as the Indian version of Oxford AstraZeneca is called – have already been approved for emergency use in the country.
Epidemiologist Rafael Amador explains that it is not known whether the country is at the beginning, middle or end of negotiations to acquire the vaccines, amid a context in which demand exceeds supply, and while many countries are making huge purchases, which surely, producers prioritize.
“If I am not mentioning something (the acquisition of vaccines), you doubt if that is actually going to happen,” says Amador. The specialist adds that due to the lack of information, “it definitely makes you suspect that the process of acquiring the vaccine is going to take longer than projected. Hopefully not, but in that aspect the silence could be an explanation,” he said.
On February 1, Rosario Murillo informed that they were “securing vaccines through India, from the manufacturing plants in India (Covishield and Covaxin)”, for which they had already signed the necessary documents. She also confirmed that this country will donate vaccines – Covaxin – to Nicaragua.
Regarding the specific negotiations to guarantee the 3.8 million doses of the Sputnik V vaccine, which the Government proposed to purchase, on February 3, Murillo only said that there was progress in the negotiations with the Russian Federation and its respective institutes. The following day, Murillo justified not sharing an approximate period for the arrival of the vaccines out of responsibility.
“We do not state a date because everything can be delayed a day, two days, a week. We already see the delays that have occurred in Europe, for example, and we want to continue to be prudent, cautious, and responsible,” she said.
Epidemiologist Leonel Argüello, member of the Multidisciplinary Scientific Committee (CCM), considers that the Government has informed about the processes of vaccine acquisition in an incomplete manner.
“The population is uncertain because in the news they see how the rest of the countries in the Central American region are moving forward, and in Nicaragua we still don’t know when, where and to whom they will prioritize,” says the specialist.
Knowing the information about the vaccines is not only fundamental for mental health, Argüello emphasizes, but also to avoid falsifications of immunizations, to manage everything with more transparency, to monitor how the vaccination coverage is developing, “to educate starting now, because a percentage of the Nicaraguan population, which I don’t believe is low, has many doubts,” he expresses.
The recommendation of the MCC regarding vaccination against covid-19 is the creation of a national coordination committee for vaccination and a national advisory group, integrated by the Government and civil society. This should oversee the vaccination plan, logistics and budget, accountability of spending and monitoring, visualization of barriers and solutions, and alert-response and evaluation mechanisms.
But they also consider it necessary to design a risk communication strategy to identify and clarify rumors, false news, and provide transparent and adequate information on vaccines.
Lack of transparency and doubts about getting vaccinated
Epidemiologist Amador explains that vaccination is a matter of primary need for the population, which implies that the information must be transparent, clear and continuous so that people understand how they will participate in the immunization process.
“The success of the vaccination will depend, to a great extent, on the response of the population to what the government suggests,” he said. It is not necessary to wait until the vaccines come to start transmitting the information about immunization, he warned.
“Let’s remember that they are adults who decide to be vaccinated or not, they are not children that you take to be vaccinated. Problems that have occurred in other countries have already appeared in many media, they can happen here too, we have to make them visible in order to be ready to prevent them or to give a quick response,” Argüello said.
Alejandro Lagos, a physician who worked at the Minsa for more than twenty years, considers that the secrecy of the Government is “a habit”, and it won’t be until the last moment that they will announce the application of the vaccine, which contrasts with the recommendations of independent specialists and international organizations.
Lagos assures that on the part of the population, the lack of transparency affects the decision to be vaccinated or not, since there are several information gaps; one of them being what will happen if the person experiences an adverse reaction, he wonders.
Prioritized group without information
Although on February 11 the Minister of Health, Martha Reyes, assured that the priority group included health personnel, older adults with chronic diseases, young adults with basic diseases and later, the rest of the population, private sector physicians are unaware of information on how the immunizations will be applied to their guild, despite the fact that they would be the first to receive them.
“I don’t know that the health workers have been informed and for which ones -private or public- the vaccines will be, because here in Nicaragua they range from doctors to health volunteers or brigadistas. All this causes uncertainty in the health guild and this must be avoided, to do things in an orderly fashion, so that everyone knows when it is their turn (…)”, said Argüello.
Meanwhile, epidemiologist Amador said that he has no information either, “we have not been informed at all, not at all, about how it is going to be done for the sector that is not assigned or contracted by the public sector”, he said. For 2015, the Minsa counted 5794 physicians nationwide.
This article has been translated by Ana María Sampson, a Communication Science student at the University of Amsterdam and member of our staff*