24 Mar 2021

When vaccine supplies are constrained, the initial position is to aim for reduction of morbidity and mortality, public health specialist, Dr Orapeleng Phuswane-Katse has said.

She said this on Monday when briefing Boteti COVID-19 committee in Letlhakane on Bostswana’s COVID-19 vaccination strategy.

She stated that the aim was to prioritise maintenance of critical essential services, and the workforce that had been placed at disproportionate risks to mitigate consequences of the pandemic.

Dr Phuswane-Katse said once the vaccine supplies increased, vaccination would help in reduction in transmission, and to further reduce disruption of social and economic functions currently caused by COVID-19.

She said substantial reductions in mortality and the pressure put on the healthcare system could be realised by direct protection of high risk groups, even when the viral transmission was ongoing within the population.

Target groups, she said, were adults aged 18 to 55 years, noting that females within an age range of 15 to 44 years had the highest prevalence of disease in Botswana.

The high burden of the disease in the subgroup, she said, was related to their high mobility, high person-to-person interactions, their caregiving responsibilities and their prominence in social, leisure and entertainment activities.

For males, she said their exposure was as a result of the nature of their work in logistics and transporting cross-border essential goods.

Dr Phuswane-Katse stated that the potential of an infectious disease to spread in a population was dependent, amongst others, on the frequency of contacts in the population.

She noted that in a pandemic, essential service employees such as health workers, ports of entry staff, law enforcement, paramedics, social workers, truck drivers and teachers were more exposed due to their professional activity.

She emphasised that frontline workers’ role was critical in the maintenance of a functioning healthcare system, noting that they provided care directly or indirectly to those affected by COVID-19 and to those who were medically and socially vulnerable in the different phases of the pandemic, especially when healthcare was under pressure.

Pregnant women, she said, were at higher risk of severe COVID-19 compared with women of child bearing age who were not pregnant, and that COVID-19 had been associated with an increased risk of preterm birth.

She said pregnant women should be vaccinated only if the benefit to a pregnant woman outweighed the potential risks. She gave the example of health workers or pregnant women that had conditions that placed them in a high risk group for severe COVID-19.

Breastfeeding, she said, was the cornerstone of nutrition for infant and young children and that it offered substantial health benefits to lactating women and their children.

She said it was unknown whether the vaccines were excreted in human milk, but that they were unlikely to pose a risk to the breastfed child.

The World Health Organisation (WHO), she said, has not recommended discontinuation of breastfeeding after vaccination. Dr Phuswane-Katse said the total number of expected people to vaccinate was 60 000, and that vaccination would be in three phases. ENDS