The cabinet has decided to continue the public vaccination process despite nearing the halfway mark of available doses. The Chief Medical Officer reportedly advised the cabinet to pause at the half-way mark to save enough for the second dose. The cabinet notes state “the CMO proposed that one half of the total be stored so that the second dose can be on hand to be administered in May and in June 2021”. However, the cabinet decided, “seven to ten thousand additional doses will continue to be applied, with the expectation that at least 14,000 doses will be secured through COVAX of PAH0/WHO by the end of April 2021”.
See relevant cabinet notes from Chief of Staff Lionel Max Hurst below:
HURST REPORTS ON CABINET of March 10 2021
The Cabinet of Antigua and Barbuda met both virtually and face-to-face for almost seven continuous hours. Missing from this meeting was the Minister of Works who is recuperating at the MSJMC; all of his vitals are normal.
It is the practice of the Gaston Browne-led Cabinet to invite experts and officials to its meetings each week in order to enhance decision-making; two groups were invited to the meeting.
1. The Chief Medical Officer (CMO), the Principal Nursing Officer (PNO), The Director of the MSJMC Laboratory, the Person On Staff who has Responsibility for Organizing (POSRO) the services at the vaccine centers, and the Director General of Information (DGI) were all invited to Cabinet to provide updates and to be questioned by the Cabinet.
i. The CMO informed that 852 Covid-19 cases have been recorded in the state thus far; while 74 cases were detected in January 2021, 545 cases were detected in February 2021, and 75 cases thus far in the ten days of March 2021. The number of infections is not decreasing, the CMO reported. Obeying the protocols is a first step in decreasing infections, especially the wearing of masks.
ii. More than 18,000 doses of the AstraZeneca vaccine have been injected in the arms of the elderly, teachers, hotel workers and other select groups since February 17, 2021, when the first dose was administered; only 22,000 doses remain in stock. AstraZeneca is a two dose vaccine; and, since 40,000 doses were imported, and since no precise date for delivery of a second batch of the AstraZeneca is fixed, the CMO proposed that one half of the total be stored so that the second dose can be on hand to be administered in May and in June 2021.
iii. The Cabinet debated this important proposal and decided otherwise. Seven to ten thousand additional doses will continue to be applied, with the expectation that at least 14,000 doses will be secured through COVAX of PAH0/WHO by the end of April 2021. Antigua and Barbuda has contracted and paid COVAX for 40,000 doses; the AstraZeneca is in very high demand globally.
iv. The deaths which Antigua and Barbuda has experienced from Covid-19 have been complicated by NCDs (Non-communicable Diseases) which are prevalent among the adult population, the CMO reported. It is for this reason why those men and women older than 65 years have been selected for special treatment. Attention must continue to be paid to reducing NCDs among the population, the CMO asserted.
v. The Director of the MSJMC Clinic reported that the Covid-19 disease is not only respiratory but also cardio-vascular. Covid-19 infections will also affect the functioning of the heart and the system of veins which deliver blood to all organs. The administered vaccine tends to lower the chances of hospitalization and death. The challenge posed by waiting for the delivery of the next batch of vaccines is that people who are inoculated could be saved by not falling ill, may not require hospitalization, and may even continue to live. Administration of doses, that may be placed in storage, could save lives. However, not administering the second dose when due is also risky, since the efficacy may be lost (and that is unknown) and the inoculation may only work for a short period (and that is unknown). Based on an indication from the PAHO/WHO COVAX communications of delivery of 14,000 doses in weeks, the Cabinet determined that 7,000 to 10,000 of the 20,000 stored vaccines will continue to be applied to the elderly, the most vulnerable, and frontline employees from various sectors.
vi. The Director also noted that if the administration moved to import the vaccines that are now available–to wit: SputnikV, Sinopharm, Sinovak–their availability and cost would prove to be within Antigua and Barbuda’s means. If the nation waits until these vaccines have the approval of the WHO, they would then be gobbled-up by the large, well-endowed states and those vaccines would be placed outside of Antigua and Barbuda’s means. Now is the time to import them, the Director reported. The Working Group which he chairs acts in an advisory capacity and does NOT grant approvals. The approvals for use come from the Pharmaceutical Council. The Director indicated that he is aware of the dilemma faced by the Cabinet. These choices would not occur during “normal times”, he said; these times are not normal, it was agreed.
vii. The Minister of Health spoke of the calculated risk which the Cabinet must take. The Cabinet would be required to manage the risk.
vii. The Principal Nursing Officer addressed the need of a small number of nurses to receive remuneration that has been significantly delayed. The Prime Minister immediately called the Accountant General, confirmed that the warrants were in the Treasury’s possession, and elicited a promise to settle the issue within a few days.