Nigeria’s COVID-19 vaccine distribution plan off to a shaky start

Nigeria’s plan to distribute an initial 100,000 doses of Pfizer’s COVID-19 vaccines to 50,000 persons is off to a shaky start following what appears to be a murky distribution plan. For complete vaccination, each person is required to receive two doses of the vaccine within a 21-day interval.

The first phase of distribution is prioritising those identified as “frontline health workers”, further listed as immigration, airport, police and military on essential duties, those working in the labs and other medical practitioners. However, whereas the country is expected to deploy the vaccine in curtailing the spread of the virus, especially in the epicentres, the approach to the distribution of vaccines does not appear to reflect this urgency.

An initial publication of how distribution would be done had shown that Kano State, for instance, is getting the highest allocation of 3,557 doses whereas it has only 2,491 confirmed cases as at January 13, with 276 currently on admission. The state is number nine behind Lagos, FCT, Plateau, Kaduna, Oyo, Rivers, Edo and Ogun States in terms of confirmed cases and the number of those currently on admission (except for Edo, which has 238), and is getting more doses than even the total number of cases it has on record.

Katsina with the third-highest vaccine allocation of 2,361 is down at number 12 with 1,692 cases out of which only 50 are still on admission. Its vaccine allocation also exceeds the cases ever recorded.

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The sharing plan as currently made public presupposes Kano has more health workers than Lagos, FCT, Plateau and others below it and more essential workers across the identified strata of health, immigration, police, military and others.

“Whether Kano has more healthcare workers than Lagos, I wouldn’t know,” said a scientist who pleaded anonymity.

“The distribution could have been done purely on population bases, that is, the general population. However, given that they still intend to give more doses to states with a greater burden of infection, I want to give them a benefit of the doubt,” the scientist said.

Efforts by BusinessDay to get the National Primary Health Care Development Agency (NPHCDA), the agency in charge of distribution, to provide details of how the sharing plan was arrived at did not yield results.

Ohitoto Mohammed, head of public relations, NPHCDA, said he was not in a position to comment on how the agency devised the distribution plan, saying the director-general was in a better position to do so. When BusinessDay tried to reach the DG for clarification via the telephone, his line was switched off.

While the difference in quantities of vaccine doses to be distributed in this first phase may be marginal, it could be a pointer to how the country plans to distribute the larger consignment of 42 million doses it plans to administer later this year.

Innocent Ujah, president, Nigerian Medical Association (NMA), declined commenting on the appropriateness or otherwise of the distribution plan, saying the government must have used a yardstick to devise the distribution plan.

“It is not my job or responsibility,” Ujah said when asked for his view on the vaccine distribution plan. “The most important thing is we want all Nigerians to have access to the vaccine.”

Oyewale Tomori, a professor of Virology and former vice-chancellor, Redeemers University, also did not fault the distribution formula, arguing that what matters is basing allocation on the number of healthcare centres confronting COVID-19 in a state, rather than distributing by the highest infection rate.

However, going by Tomori’s own argument, the distribution plan is flawed. If allocation would be based on the number of healthcare centres confronting COVID-19 across Nigeria, then it would logically be the states where more cases are currently on admission. Using this parameter, Kano will only rank 8th (instead of 9th if based on total cases), while Katsina, Bauchi Jigawa and Niger will also not be getting as much priority, at least for now.

In order of vaccine doses to be distributed, the top 10 are Kano 3,577 doses with 276 on admission and 2,491 total cases; Lagos 3,131 doses with 7,679 on admission and 37,852 total cases; Katsina 2,361 doses with 50 on admission and 1,692 total cases; and Kaduna 2,074 doses with 367 on admission and 5,888 total cases.

Others are Bauchi 1,900 doses with 130 on admission and 1,100 total cases; Oyo 1,848 doses with 838 on admission and 4,546 total cases; Rivers 1,766 doses with 570 on admission and 4,124 total cases; Jigawa 1,712 doses with 33 on admission and 421 total cases; Niger 1,558 doses with 126 on admission and 508 total cases; and Ogun 1,473 doses with 302 on admission and 2,727 total cases.

FCT, Plateau, Edo and Delta States, which are among top 10 states by COVID-19 cases and the number of those still on admission, are getting less priority, at least in this initial phase of the vaccine distribution, unlike Katsina, Bauchi, Jigawa and Niger States with fewer cases.