FREE ACCESS: Jamaica's Health Ministry Unresponsive to Requests About Post-Vaccination Deaths. Plus, Covid-19 Cases Hit Daily Records.
FREE ACCESS: Jamaica's Health Ministry Unresponsive to Requests About Post-Vaccination Deaths. Plus, Covid-19 Cases Hit Daily Records.
In keeping with our commitment a few months ago, 18º North is making posts on vaccination safety surveillance free after first fulfilling our commitment to our paid subscribers.
The information published is as of Sunday or the dates mentioned in the article. It was also a few hours before Prime Minister Andrew Holness said at a virtual press conference, there would be no new lockdowns in spite of spiraling Covid-19 cases.
“We are not going back to lockdown - so be calm. … The strategy is - go and take the vaccine - that is the strategy. We can’t hold you down and put the needle in your hand. If you get sick, take that responsibility,” he said. “Go and get vaccinated - argument done.”
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Against the backdrop of daily records for new Covid-19 cases in Jamaica, the country’s Ministry of Health and Wellness remains unresponsive to requests for data on post-vaccination deaths.
The latest request for the information was made at a virtual press conference on Jan. 6 at which the head of the country’s vaccination program, Dr. Melody Ennis, was said to be present. However, when 18º North asked for an update on post-vaccination deaths and a breakdown of serious adverse reactions by age, an announcement was made that she had already left the longer-than-usual press conference.
This would represent the fifth time that 18º North has requested this information since a Dec. 22 press conference where Dr. Ennis revealed that serious events supposedly attributable to vaccination or immunization (ESAVI) had just about doubled since the last report made available to 18º North which was dated Oct. 12, 2021.
Among the requests was for the fulfillment of an Access To Information Act (ATI) application made on Nov. 25 for the latest ESAVI report. However, the ministry has still not delivered the report even though the 30 day-period has passed, the time within which the ministry is legally obligated to fulfill the request or to explain why it hasn’t done so. To date, no reason has been given for the failure to deliver the report.
From the information Dr. Ennis did give on Dec. 22, the number of serious ESAVIs following administration of the Covid-19 vaccine in Jamaica stood at 165 then, up 96% from the 84 recorded in the October 12 report. While there may be multiple side effects recorded in each individual case report, and while reports received can sometimes reflect illness from an earlier period, the rise in serious adverse events between Oct. 12 and Dec. 22 outpaced the 40% increase in vaccine doses administered during that time. Between the vaccine rollout from March last year to Dec. 22, there were roughly 1.2 million doses administered, according to the ministry’s internal dashboard.
Overall ESAVIs, which range from minor side effects like fever and pain at the injection site to more serious events like deaths and hospitalizations, totaled 738 since the vaccine rollout on March 10 - up 41% from 524 in the Oct. 12 report. Dr. Ennis said “younger persons are in fact experiencing more ESAVIs”, in line with international trends. But she said that she did not have the age breakdown for the serious cases.
Dr. Ennis reminded the public that an ESAVI report doesn’t necessarily mean that the vaccine caused the adverse event. A committee usually studies the serious events to determine causation.
However, she didn’t reveal how many serious reactions have now been deemed to have been caused by the vaccine. In the October 12 report, that number stood at four after 20 of the 84 serious events were studied and closed. In that report, there were 23 post-vaccination deaths with 11 considered coincidental or revealing no causal association.
Since the vaccine rollout in March, AstraZeneca has accounted for about 67% of the adverse events reported, while that brand made up 63% of all doses administered as of Dec. 22. However, when it came to the serious cases, there was an outsized proportion - 86%, or 142 of 165 reports.
That equates to one report of a serious adverse reaction for every 5,300 doses approximately administered of AstraZeneca. In contrast, there was one report of a serious ESAVI for every 18,300 doses roughly of the Pfizer vaccine, or 20 of the 165 reports. Only two of the 165 serious adverse events were Johnson & Johnson, meaning there was one report of a serious reaction for every 37,400 doses roughly of that brand. One of the 165 stemmed from a reaction after the Moderna vaccine, a brand not currently available in Jamaica. That drug was administered overseas to a person, who “got very sick” upon returning home, Dr. Ennis said.
For the serious events, Dr. Ennis didn’t give the full range of symptoms but indicated that the number of reported blood clots, or thrombosis, had more than doubled to 21 from 9 following the AstraZeneca vaccine.
Reports of Bell’s Palsy, which is facial muscle weakness or paralysis, had moved up to four from three. And anaphylactic reactions, or severe allergic reactions, had risen to five from four. She said, of those anaphylactic responses, they are “all well.”
Covid Cases Now Exceed 100,000 in Jamaica
Separately, at the press conference on Thursday Jan. 6, Chief Medical Officer Dr. Jacquiline Bisasor-McKenzie confirmed that with the emergence of the Omicron variant, Jamaica’s fourth wave of Covid-19 began on Dec. 20.
A daily record of 1,593 new cases were reported for Friday bringing the total number of cases to 101,056, and breaching the 100,000 mark for the first time.
There were six deaths, pushing the cumulative total to 2,495 since the onset of the pandemic in Jamaica in March 2020.
Dr. Bisasor-McKenzie said Covid beds are “slowly going up”, putting added pressure on the larger hospitals, which are already at over 80% capacity for general admissions.
With the reproductive rate now at 2.4 when the desirable rate is well below 1, this means that if it continues along this line “we are going to see a rapid increase in the number of cases,” Dr. Bisasor-McKenzie said.
Dr. Bisasor-McKenzie presented a slide showing projections for as many as 11,500 cases and as many as 413 deaths during the peak week of this fourth wave, which, she said, we could see in about three weeks. That compares to 5,018 cases and as many as 163 deaths during the peak week of the third wave. (Based on the slides, a range of 137-163 deaths was provided and appears to be because some are under investigation.)
More Children Catching Covid, But Schools Re-Opening for Face-to-Face Anyway
The CMO added that, with more people catching Covid-19 in this wave, more children are also being affected and becoming hospitalized. However, proportionately, they’re accounting for about the same percentage of new cases as they did in Wave 3. Against this backdrop, Education Minister Fayval Williams, who also addressed the press conference, revealed that more than 60% of schools, or 680, have re-started face-to-face learning, and 92% of schools have been approved by the health ministry to re-open as well.
Some high schools have also re-opened. Minister Williams indicated that her ministry was walking back its original guidance that secondary schools could only restart in-person learning if 65% of the school’s population was vaccinated since, as of December, only 32% of students at this level were fully vaccinated.
“In light of where we are in the pandemic in terms of the percentage fully vaccinated, where we are right now, the 65% might not be a target that we should maintain,” Minister Williams said.
Vaccination Remains Important to the Covid-19 Response
Dr. Bisasor-McKenzie stressed that because of the highly-transmissible nature of the Omicron variant it was urgent to get the over-60 vaccinated who still remain among the most vulnerable to becoming ill from the disease. Less than 40% of the 60-79 age group is fully vaccinated while only about 20% of the overall population has completed their full regimen of doses.
She said, overall, more than 98% of those who have died from Covid since March last year are unvaccinated, and therefore vaccination remains important to the Covid-19 response.
“Vaccination is offering a very high level of protection to our population and this is just one way of showing that it is best to be vaccinated,” she said.
She also added that the level of those critically ill hasn’t increased yet, and “this could be as a direct result of the vaccination and the fact that we have vaccinated a number of our elderly persons.”
High Levels of Vaccine Hesitancy Remain
Still, the health ministry may struggle to convince holdouts in the population to get vaccinated. A recent poll conducted by Northern Caribbean University (NCU) shows that 80 percent of persons did not trust or were ambivalent towards the government's vaccination drive. Two thirds indicated that the government did not listen to or respond to the concerns of citizens regarding Covid-19 vaccines and about 64% believed that the government was not using enough time and resources to reassure citizens that conspiracies about the vaccines are not true, as reported by Radio Jamaica.
The WHO’s Safety Surveillance Manual on Covid-19 Vaccines states that, “Communication that is transparent, timely, empathic and acknowledges uncertainty can help boost people’s trust in health authorities, which in turn can positively influence people’s willingness to be vaccinated.”
However, though the health ministry has repeatedly said it takes its guidance from the WHO, and though Dr. Bisasor-McKenzie had committed to the Jamaica public on April 14 that “we will be transparent in our reporting” on adverse events, it has put forward a presentation only once to the press on the topic, and that was on the same day back in April. Every other time the topic has come up, it’s been prompted by a question from a journalist.
Health Minister Dr. Christopher Tufton also seems to be pushing for a more hostile approach toward the unvaccinated.
He said at the Jan. 6 press conference that the time has come to “frown on those who have not” taken the vaccine, and signaled there could be more invasive measures to come.
“If it means screening in terms of access to your personal space, whether your home or your special event or at the workplace, I believe we need to get there,” he said.
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Editor’s Notes:
This version of the article has been updated to include the level of critically ill patients and the perceived benefit of the vaccine, according to the Ministry of Health & Wellness. It also adds the number of post-vaccination deaths as of Oct. 12.
Dr. Ennis did not reveal the exact date of the report from which she was pulling information on ESAVIs when she spoke on Dec. 22. She had only referred to the data being for the last week. Therefore, the data on doses pulled from the ministry’s internal dashboard was as of Dec. 22.
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