Although the government had decided to vaccinate all eligible people above 40 years of age in many districts including in the three districts of Kathmandu Valley, health authorities in Kathmandu and Lalitpur districts have started administering Covid-19 vaccines to everyone above 18.

“We have started vaccinating all people above 18 years residing in the district,” Badri Bahadur Khadka, chief of the Health Office Kathmandu, (previously known as district public health office), told the Post. “All people above 18 years can take the AstraZeneca vaccine from immunisation centers of the Kathmandu Metropolitan City and those in the municipalities of the district can take the Vero Cell vaccine.”

Initially, the Ministry had decided to jab all those above 18 only in 10 mountain districts—Darchula, Bajura, Dolpa, Humla, Mugu, Jumla, Rasuwa, Solukhumbu, Sankhuwasabha and Taplejung only following the arrival of 4.4 million doses of Vero Cell vaccine from China on September 17.

Officials at the Health Ministry said that given the small population sizes of the 10 districts and high vaccination costs, they decided to vaccinate people in other districts as well.

Along with all people of the 10 districts, plans were to provide vaccines to all students above 18 years old throughout the country.

“Plans were made by an expert panel by calculating the population size of the districts and the total doses the government has,” Sagar Dahal, the chief of the National Immunisation Programme, told the Post. “And vaccines were supplied proportionally to all districts throughout the country, as per their population sizes.”

Dahal said that he does not have an answer to how the health offices of Kathmandu and Lalitpur could provide jabs to all those above 18.

“Instead of saying 40 years, we would say vaccines will be provided to all people above 39 or 35,” an official at the Department of Health Services, told the Post, asking not to be named. “We do not have vaccines for people under 40 so we decided to vaccinate only those above 40.”

Officials at the Health Office Lalitpur said they also have been providing the jabs to everyone above 18. But health officials from Bhaktapur said only those above 40 are being vaccinated in the district.

“We do not get a vaccine to inoculate all people above 18,” Krishna Bahadur Mijar, chief of Health Office Bhaktapur, told the Post. “We have been administering the jabs to those above 40 only. We do not know how Kathmandu and Lalitpur health offices got vaccines to administer all eligible people.”

When asked if the Health Ministry supplied additional doses to the two health offices, Khadka, chief of Kathmandu Health Office said only around 105,000 doses—65,000 doses of Vero cell and 41,000 doses of AstraZeneca have been supplied.

“Over 48 percent of the population of the district has been fully immunised so far and we have started inoculating all those above 18,” Khadka said. “To reach herd immunity in Kathmandu, we still have to vaccinate another 20 to 25 percent of the population, so we are vaccinating everyone eligible.”

Khadka claimed that the population of Kathmandu district is only around 2.3 million and over 48 percent of the total population of the district have been fully vaccinated so far.

However, immunisation centers have not been vaccinating only the district residents but everyone coming for vaccination.

Experts say that the population size of Kathmandu is more than twice the number claimed by the Health Office Kathmandu. “How can Kathmandu officials claim that 48 percent population of the district is fully vaccinated by providing jabs to anyone eligible from any district,” Dr Shyam Raj Upreti, coordinator of the Covid-19 Vaccine Advisory Committee, asked. “And how can we say Kathmandu’s population is just 2.3 million? What about the floating population?”

It is estimated that over 6 million people reside in three districts of the Kathmandu Valley and around 4 million reside in the Kathmandu district alone.

Since, no one from the priority age group is barred from vaccination, experts say instead of finding the dropout populations, authorities find easy ways of using up the jabs by vaccinating everyone above 18 years.

“What we all know is a lot of people have not taken the vaccine and thousands of people who took the first dose have not taken the second dose,” said Upreti. “What is concerning is that the authorities concerned are not paying attention to find the dropout populations and those not taking the first dose of the vaccine.”

The Health Office, Kathmandu concedes that thousands of people, who took first doses of the Covishield and Vero Cell vaccines are not seeking second doses.

“We have to provide 240,000 Vero Cell doses for the second dose but only around 170,000 took the second dose,'' said Khadka, the chief of Kathmandu Health Office.

Earlier too, over 40 percent of those above 65 years, who took the first dose of the Covishield vaccine between March 7 to 15 did not seek the second dose. And neither the Health Ministry nor the local-level government agencies know what happened to that 40 percent.

“We cannot meet the vaccination target just by offering the jabs to all those eligible,” said Dr Jhalak Sharma, former chief of the National Immunisation Programme. “To achieve the target, we have to focus on community mobilisation and search for those who have not yet been vaccinated and vaccinate them.”

Experts say all people, who are aware of the importance of vaccination might have taken the jabs and due to apathy of authorities to launch the vaccination drive as a campaign, other people, who are in a dilemma or unaware of the importance of jabs are not seeking the jabs.

“Vaccines can be purchased or received through donations but without making efforts to convince people about the importance of the jabs, the vaccination target cannot be achieved,” said Upreti, who is also the former director general of the Department of Health Services.

So far, 6,793,456 people(over 22.64 percent of total population) have taken their first dose of vaccine and 6,165,052 people(over 20.5 percent of total population) have been fully vaccinated.

Nepal so far has received a total of 17,855,590 doses of Covid-19 vaccines.