For the first time since February, Covid-19 vaccines that Nepal bought are arriving from next week.

The government has purchased 4 million doses of vaccines from China under a non-disclosure agreement with an affiliate of the state-backed pharmaceutical giant Sinopharm.

A Nepal Airlines plane is set to fly to Beijing Thursday, which will bring around 1 million doses of vaccine in the first consignment. Flights are also scheduled for July 15 and July 22, each of which is expected to bring 1 million doses, according to Health Ministry officials.

But public health as well as immunisation experts have said that they are concerned about the vaccine storage, management capacity of authorities and mass communication strategy.

“If we do not make plans and preparations to start immunisation immediately after the arrival of the first consignment of vaccines, there will be problems in storage too,” Bhogendra Dotel, former director at the management division of the Department of Health Services, told the Post.

While in the case of the Covishield vaccines, with which Nepal started its immunisation drive in January, each vial contained ten doses, Chinese vaccines take more space as one vial contains one dose.

But Health Ministry officials say that storage space will not be an issue.

“We can easily store over one million doses of BBIBP-CorV vaccines in Kathmandu itself,” Dr Jhalak Gautam, chief of the National Immunisation Programme, told the Post. “We have vaccine storage facilities in all provinces, we can store it there too.”

The Health Ministry also has a large container to store vaccines in its central store, and the cold room of the Tribhuvan International Airport can be used to store around 800,000 doses of the Sinopharm vaccine. The airport facilities had been used to store vaccines provided by China under a grant assistance.

Experts have also stressed removing confusions in the general public and launching an awareness campaign for successful immunisation drives.

“A lot of people were infected during the second wave of the pandemic, and authorities have not said anything about when people can take vaccines after the infection,” said Dotel, the former director. “People above 65 who have received the first dose of Covishield could also seek immunisation with the Chinese vaccine.”

Some 1.4 million elederly citizens who were inoculated with the Covishield vaccine from India in March are yet to get their second dose as the Serum Institute of India, the vaccine manufacturer, is yet to deliver 1 million doses that Nepal has paid for after India put restrictions on exports as the country faced a second wave in April. Nepal had also hoped for vaccines from the World Health Organization-backed COVAX facility but the delivery from it has been delayed too. It is unclear when the over 65s will get the second dose.

Gautam concedes that people who have been waiting for a second dose of Covishield could seek immunisation, which will be a challenge for authorities to identify. Another challenge will be the obstruction in roads due to the floods and landslides.

Authorities’ decision on vaccine eligibility and communication has not been up to the mark in the past.

When China provided 1 million doses of Covid-19 vaccine last month, the Health Ministry said that it would be given to all those between the ages of 60 and 64. But at the last moment, realising that vaccines would not be enough for this age group, it decided to inoculate those between the ages of 6o and 64 in Kathmandu Valley and those between 62 and 64 outside the Valley creating confusion in health workers as well as the general population.

“We know our capacity and limitations,” Dr Mingmar Gyelgen Sherpa, a former director general at the Department of Health Services, told the Post. “Authorities have made a gross estimation of the target population but estimation can be made of particular districts. Micro-management is needed to administer the vaccine.”

Although it has not been decided who will get inoculated with the new vaccines that will arrive from this week, officials at the Health Ministry said jabs will be given on the basis of age and most probably people over 55 could get the jabs in the next phase. It is estimated that there are around one million people between 55 and 59 years.

Those above 59, who have not yet got the jab, will also get the Chinese vaccine and preparations are in place, according to Gautam.

“We have rolled out vaccination drives within a week after their arrival in the past,'' said Gautam. “All of our mechanisms are in place. We will try to roll out at the earliest this time too.”

Nepal already lags far behind in immunisation compared to other countries, despite being among the first countries to start Covid-19 vaccination. As vaccination is the only reliable means to contain the menace of the pandemic, doctors said that authorities should make every effort to inoculate people at the earliest.

Public health experts have warned of the growing risk of infections as the lockdown restrictions are gradually being lifted.

“Positivity rate is still over 25 percent, which means infection rate is still high and what is declining is only testing,” Dr Biraj Karmacharya, an epidemiologist, told the Post.

With the authorities relaxing restrictions enforced in many districts throughout the country, including in the Kathmandu Valley, crowds have been increasing in the market areas and more worryingly safety measures are not being followed despite the increasing risks, according to doctors.

On Saturday, 1527 people tested positive in 5,837 polymerase chain reaction tests, a positivity rate of over 26 percent. Similarly, 801 others tested positive in 4,296 antigen based tests performed throughout the country. In the last 24 hours, 19 people died of the coronavirus infection. The total tally stands at 643,580 with 27,716 active cases. The death toll is 9,198.

“Authorities should expedite the immunisation programme and also pay attention about the growing crowds in the market and possible surge in the new cases,” said Karmacharya, who is also the department head of the Community Programme at the Dhulikhel Hospital. “We should not think that risk has not lessened. It has increased instead.”

Nepal launched its vaccination drive on January 27 with the one million doses of Covishield that India had provided under grant assistance. It also received 348,000 doses from the COVAX facility. Of the 2 million doses of vaccines that Nepal bought from the Serum Institute half has been delivered.

China had provided 1.8 million doses of BBIBP-CorV vaccine developed by an affiliate of the state-backed pharmaceutical giant Sinopharm.

According to the Ministry of Health and Population, 2,604,866 people have so far received the first dose of the coronavirus vaccine and of them 757,962 received both doses.

The government has decided to inoculate 72 percent of the 30 million population, as 28 percent are the children under 14 years of age.

Officials at the Health Ministry said that the government is still trying to secure a deal to purchase more vaccines from other countries and companies as well but due to limited storage facilities, it is impossible to bring all vaccines at once.

But at the moment, experts say that communication is the key to a successful vaccination drive.

“Authorities concerned should make people clear about it, which will ultimately help to erase confusion,’ said Dotel, former director at the Management Division. “Strategy for vaccination should be made and authorities should follow the strategy strictly.”