1. Why are vaccines needed to prevent COVID-19?

COVID-19 vaccines are medicines that prevent disease caused by the Novel Coronavirus SARS-CoV-2 by triggering an immune response.

Safe and effective vaccines for COVID-19 are needed because they protect individuals from becoming ill. This is particularly important for healthcare professionals and vulnerable populations such as older people and people with long-term diseases.

The COVID-19 pandemic is a global crisis, with devastating health, social and economic impacts. COVID-19 can cause severe disease and death. It has unknown long-term consequences in people of all ages, including in otherwise healthy people.

  1. How is the safety of the vaccines ensured during development?

COVID-19 vaccine development has been the fastest in the history of vaccine development. However, the development process has ensured safety.

The testing process has been the same as with other vaccines. All the 3 phases of vaccine trials are being conducted, with the same number of participants in the trial as traditional ones.

  1. What are the different vaccines types currently available?

According to WHO, there are 64 vaccines in clinical development and 173 vaccines in pre-clinical development. And 15 vaccines are in large-scale (phase 3) clinical trials.

  1. What COVID-19 vaccines are expected to be administered in the Maldives?

On 20th January 2021, India donated 100,000 doses of the Covishield vaccine to the Maldives.

Maldives is part of the COVAX facility which is a global partnership to provide safe and effective vaccines equitably to all participating countries. It is estimated for us to receive vaccines through the COVAX facility within the first quarter of 2021.

The government of the Maldives is also making arrangements to purchase vaccines directly from vaccine production companies such as AstraZeneca. An agreement has been signed with AstraZeneca to purchase 700,000 doses.

  1. What is the Covishield vaccine?

Covishield is manufactured by one of the largest vaccine manufacturers in the world, Serum Institute of India Pvt. Ltd.

Covishield has the same formulation that was co-developed by Oxford University and AstraZeneca to combat COVID-19.

  1. Why Covishield vaccine?

Research shows this vaccine is highly effective and safe to use. It can be stored at a normal fridge temperature making distribution easy. It is developed by AstraZeneca and the University of Oxford and the batch received on 20 January 2021 is manufactured by Serum Institute of India Pvt. Ltd.

  1. Is the Covishield vaccine safe?

Covishield is currently in Phase III (large scale)clinical trials en route for approval.

All vaccines used in the Maldives must be assessed and approved by Maldives Food and Drug Authority (MFDA)

  1. What are the side effects of the Covishield vaccine?

Some people may experience side effects after getting this vaccine, which are normal signs that your body is building protection

Common side effects include:

  • Tenderness, pain, warmth, redness, itching, swelling, or bruising at the injunction site.
  • Fatigue
  • Chills or feeling feverish
  • Headache
  • Nausea
  • Joint pain or muscle ache
  1. How many doses of vaccine is needed?

Number of doses depends on the vaccine.

For Covishield, AstraZeneca, Pfizer-BioNTech, Moderna COVID-19 vaccines, it is 2 doses.

  1. Who will get the vaccine first?

These recommendations to offer COVID-19 vaccinations to specific groups is due to limitation of vaccine supply.

Prioritization for COVID-19 vaccination is divided into 3 folds:

  1. Frontline Health and Social Care

People who work in the health sector who work with patients or come into contact with their waste/ secretions and social care workers.

  1. Those at high risk for developing complications

People 50 years and above

People between 18 to 50 years with the following risk factors:

  • Cancer, under treatment (any case currently on treatment or received treatment within last one year)
  • Diabetes mellitus
  • Heart disease
  • Stroke
  • Obesity BMI above 40
  • Immunocompromised patients
  • Stage 3 and 4 kidney disease
  • Chronic liver disease – cirrhosis
  • Thalassaemia / Sickle cell disease
  1. c) Frontline essential workers and residents traveling abroad

Teachers

Police

MNDF

Frontline staff at travel industry:

  • Airport frontline staff and travel (cleaners and waste management staff)
  • Counter staff at travel agencies
  • Airline crew (including cleaners and waste management staff)

Frontline staff in tourism industry

Domestic waste management staff

Crew members of sea transportation vehicles

  1. Will my child get the COVID-19 vaccine?

Since the vaccines in production are being tested only in specific groups, only these groups will get the vaccines.

Vaccine has not been tested in children under 16, so they cannot get vaccinated.

  1. Who is paying for COVID-19 vaccine?

Vaccine doses purchased by the state will be given to all Maldivians and migrant workers living in the Maldives at no cost.

  1. What is being done in Maldives to prepare for vaccine arrival?
  • Vaccine allocation framework done in accordance with country needs and international guidance:

Allocation framework identifies the order in which specific target groups will be vaccinated.

  • Cold chain system is being modified according to vaccine storage requirements.
  • Development of vaccine deployment plan.
  • Training healthcare staff to administer vaccines and manage any side effects.
  • Communication to engage the public to drive public demand and address misinformation/disinformation.
  1. What measures are being followed in the Maldives to ensure vaccines are safe?

Maldives will only use vaccines that have been granted approval by the Maldives Food and Drug Authority.

The cold chain will be maintained at the required temperature for each vaccine. We are working on expanding cold chain capacity with support from WHO & UNICEF.

AEFI monitoring: Adverse Events Following Immunization will be monitored for each individual case following vaccination. A system will be in place for monitoring, reporting and treatment of AEFIs according to international guidelines.

  1. Why did development only start after the pandemic was declared?

Vaccines can only be developed when the infectious agent is known.

Since SARS-CoV-2 is a new virus that had not been seen before, development of a vaccine to protect against COVID-19 could only be started once the virus emerged and its genetic make-up had been analyzed.

However, previously used technologies and experiences are used in the development of the vaccines.

  1. Will vaccines be mandatory?

It is not mandatory.

Given the measures we need to take to control the disease, if more people take the vaccine, it would mean that we will be able to return closer to normal.

On an individual basis, if you get the vaccine, you are reducing the chance of being infected and reducing the chance of passing it on to high-risk people.

  1. Will there be side effects after COVID-19 vaccination?

Yes, you may have some side effects. This is a normal sign that your body is building protection, but they should go away in a few days.

Common side effects include:

  • Fever
  • Tiredness
  • Headache
  • Pain or swelling at the site of injection

If you have concerning side effects or your side effects persist, please report to the nearest health facility or contact 1676.

  1. How long will immunity from a vaccine last?

It is not known how long the immunity conferred by a COVID-19 vaccine will last when the vaccine is first authorized.

This is because more data is needed from ongoing and additional studies in the long term to understand how long protection lasts after vaccination. Most modelling studies show effect of vaccines can last for a year.

  1. Can vaccines protect people against the virus when it has mutated?

Viruses typically mutate. A mutation is when the genetic material in the virus changes. Mutations happen at different rates in different viruses. They do not necessarily affect how well a vaccine works against a virus but the vaccines are expected to be effective.

The scientific community and regulators are closely monitoring how SARS-CoV-2 (the virus that causes COVID-19) changes over time, and how well COVID-19 vaccines can protect people against COVID-19 caused by any new variants of the virus that appear.

Vaccines against some viral diseases remain effective for many years after their development and provide long-lasting protection. These include vaccines against measles and rubella (German measles).

Vaccines against other viral diseases like influenza (flu), on the other hand, need updating every year to remain effective. This is because the flu virus mutates often and to a large extent, with new variants appearing with each flu season.

  1. What percentage of the population needs to get vaccinated to have herd immunity to COVID-19?

Experts do not know what percentage of people would need to get vaccinated to achieve herd immunity to COVID-19. Herd immunity is a term used to describe when enough people have protection either from previous infection or vaccination that it is unlikely a virus or bacteria can spread and cause disease. As a result, everyone within the community is protected even if some people do not have any protection themselves. The percentage of people who need to have protection in order to achieve herd immunity varies by disease.

  1. If I have already had COVID-19 and recovered, do I still need to get vaccinated with a COVID-19 vaccine when it is available?

COVID-19 vaccination will be offered to you regardless of whether you already have had COVID-19 infection. This is because the current scientific evidence does not suggest immunity from infection to last long. You are not required to have an antibody test before you are vaccinated.

  1. Can I get vaccinated if I have any COVID-19 symptoms or have not recovered?

Anyone infected with COVID-19 should wait to get vaccinated until they have recovered and after they have met the criteria to discontinue isolation.

  1. Why do I have to register for vaccination?

It is to ensure that we have the most up-to-date information about where you currently live and your health conditions so that HPA can reach you and make decisions on prioritising your vaccination. The place for you to go for vaccination will be set based on this information.

Although some of your information may already be recorded in Haalubelun, it may have changed.

  1. How will vaccine hesitancy be addressed?

Vaccine hesitancy is a global problem and an emerging problem in the Maldives as well. There are internationally recognized ways to deal with that.

We are working on proven strategies to combat misinformation and disinformation, such as providing verified information on all aspects of the disease and vaccines to the public in addition to directing people to seek information from verified sources such as HPA, WHO & UNICEF.

  1. When can I stop wearing a mask and or stop practicing physical distancing after I have been vaccinated?

There is not enough information currently available to say if or when we will stop recommending people to wear masks and stop physical distancing to help prevent the spread of the virus that causes COVID-19.

Experts need to understand more about the protection that COVID-19 vaccines provide before making that decision. Other factors, including how many people get vaccinated and how much the virus is spreading in communities, will also affect this decision.

  1. Can a person with G6PD be vaccinated?

Yes.

  1. Can a thalasseamia patient be vaccinated?

Yes.

  1. Can a person on a mild dose of steroid be vaccinated?

It depends on the type of the vaccine, duration of steroid use and underlying conditions.

It is advised to consult with a healthcare provider before getting the vaccine.

  1. Can you receive or donate blood after vaccination?

You can donate 4 weeks after vaccination.

  1. Can a diabetic person (on medication or not on medication) be vaccinated?

Yes, if not acutely sick.

  1. When can you resume steroids after COVID-19 vaccination?

It depend on the type of vaccination and steroid dosage.

  1. Can a person on blood thinners be vaccinated?

It is advised to consult with a healthcare provider before getting the vaccine and would need to provide blood test results.

  1. Can a person on antibiotics or immunosuppressants be vaccinated?

It is advised to consult with a healthcare provider before getting the vaccine.

  1. If I have gotten the first dose of the vaccine from abroad, can I get the second dose in the Maldives?

It will depend on the type of vaccine, when you were vaccinated and availability based on prioritisation.

  1. Can a person who has common allergies to medicines or food get vaccinated?

Yes, but people who have common allergies must inform before vaccination as they would have to be monitored at the vaccination center.

  1. Will people who have gotten the vaccine have to quarantine?

Currently, research is being carried out to determine the duration of immunity for different COVID-19 vaccines. With sufficient information, specific guidelines will be shared.

  1. Will people who have completed COVID-19 vaccination from abroad be required to get vaccinated again?

No. However, research is being carried out to determine the duration of immunity for different COVID-19 vaccines.

Sources: https://www.ema.europa.eu/ https://www.cdc.gov/ https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19-vaccines https://www.pfizer.com/news/hot-topics/the_facts_about_pfizer_and_biontech_s_covid_19_vaccine