Enab Baladi – Diana Rahima

While health workers in northwestern Syria are gearing up to receive the first batch of COVID-19 vaccines, which the World Health Organization (WHO) affirmed it will deliver this March, fake news about the vaccine’s dangerous side effects are spreading throughout the region, with several questions as to health organizations’ role in debunking rumors clung to COVID-19.

The WHO said that the first batch of vaccine doses was intended to arrive in war-ravaged Syria on 23 February. Thirty-five to 40 percent of the vaccines would be made available in the first quarter of 2021, and 60 to 65 percent in the second quarter. 

According to the WHO, Idlib governorate and its surroundings would receive 336,000 doses, covering about 4 percent of the total population.

When will vaccination start in Syria?

Idlib’s health directorate will start its vaccination campaign in March. The directorate is expected to receive 850,000 doses of the Oxford-AstraZeneca COVID vaccine soon.

COVID-19 file official in Idlib health directorate, Dr. Hussam Kara Mohammed, told Enab Baladi that “Over the past months, the directorate worked with partner humanitarian organizations, as well as the WHO, as the primary partner, to ensure that all people in  the liberated areas will be vaccinated.”

Mohammed said that the vaccination plan will start in March, with administrating the vaccine to 60,000 health workers, being the most vulnerable group to COVID-19 infections.

He added that the final plan will then be implemented to vaccinate almost 20 percent of the population in northwestern Syria with 150,000 doses.

The directorate aims to vaccinate people who are at greater risk of dying from the coronavirus infection, such as people over 60, health workers, and those with chronic diseases.

The doctor confirmed that the vaccine that will arrive in the northwest regions is the British Oxford-AstraZeneca vaccine.

He also noted that the area fears the COVID-19 vaccine. However, vaccination will not be mandatory.

The staff of the Health Directorate will be among the first to receive the vaccine, according to Mohammed. He added that the vaccine would be subject to the directorate’s partial pharmacological control standards. The staff will be asked to present work authorizations and consent to receive the vaccine. 

Would health workers consent?

The ambulance operations coordinator in northern Syria, Dr. Abu al-Walid Salmo, told Enab Baladi, “At first, I completely rejected the idea of taking the vaccine because of the widespread pessimistic rumors and worries about COVID-19 vaccine side effects. However, after the director of Idlib’s health directorate and the head of Syria’s vaccination team confirmed the effectiveness of the vaccine and that doses will be brought from reliable sources, I decided to get vaccinated as soon as the doses are available.”

The COVID-19 file official in Idlib’s health directorate, Hussam Kara Mohammed, stressed that like all new vaccines, the COVID-19 vaccine faces a battle of fake news and misinformation. As a result, people feel hesitant to be vaccinated against COVID-19. Accordingly, the health directorate works via specialized teams to raise people’s awareness about the importance of the vaccine and ensure its effectiveness and safety.

According to Mohammed, the COVID-19 vaccine is safe and effective. Besides, allergic reactions from the vaccine are rare, and it is not fatal. It is 95 percent effective.

For his part, the head of the primary health care department in Idlib’s health directorate, Dr. Anas al-Daghim, said, “So far, I have not found any of the medical staffers hesitant to take the vaccine.”

Al-Daghim confirmed his intention to take the vaccine. It is like influenza (flu) vaccine for him since the vaccine has successfully undergone many clinical trials and lab tests.

Dr.Salah al-Saleh, a COVID-19 disease specialist at the Ziraa Hospital in Idlib, said that many rumors have been viral in the region, saying that the vaccine will change DNA.

Therefore, the Syrian American Medical Society (SAMS) held a symposium in which it denied these false rumors circulating about the COVID-19 pandemic. He confirmed that the source of the coronavirus vaccine that will be entering northern Syria is the UK.

People in northern Syria had a general reservation about the vaccination campaign due to the possibility of the Russian vaccine entering northern Syria. So, after this rumor was debunked, everyone must accept to be vaccinated in order to stop the disease cycle in the region, according to al-Saleh.

A health worker, who declined to be named, said that he would not initially get the vaccine because he contracted the virus in 2020. At that time, he feared infecting people around him, especially seniors and chronically ill patients. These people are considered at higher risk of catching COVID-19. 

He added that all health workers should take the vaccine to prevent infection risk because they are in close contact with patients. 

The unnamed health worker said that he does not want to get vaccinated tentatively because he knew that the number of people who have been reinfected with the virus is minimal. Once infected, the body produces neutralizing antibodies and resists further infection. 

Distribution plan

Healthcare workers will be the first in northern Syria to access the first doses of the vaccine. This includes medical emergency teams, triage officers, critical care doctors, nurses, cleaning staff, and other hospital employees. 

The names of those who agreed to get vaccinated have been registered, and those who are most at risk of exposure to COVID-19 will be vaccinated first.  

The number of medical staff is estimated to be 60,000. However, it is hard to know the accurate number of healthcare workers. For example, those who provide mental health and psychosocial support cannot be counted because they do not have medical certificates. 

The vaccine doses will be stored in refrigerators at 2 to 8°C and transported to northern Syria via the Bab al-Hawa border crossing. Then, the COVID-19 vaccines will be put in the refrigerators and depots of Idlib’s health directorate to be distributed to all northern Syria’s medical points. 

Myths and facts about COVID-19 vaccines

Dr. Mazen Kewara, Regional Director of SAMS, told Enab Baladi that doctors and healthcare professionals worldwide have conflicting opinions regarding the importance of the vaccine, its safety, and the vaccine priority groups.

There is no doubt that health care workers are more informed than the rest of society on research, studies, facts, and risks clung to the vaccine.

According to Kwara, there is nothing in the world that does not carry some degree of danger, even if it is tiny.

Nevertheless, country leaders and health systems worldwide must act fast and address the necessity of developing a vaccine for a fast-spreading dangerous disease such as the coronavirus because immunization is the only option to revive regular social and economic life.

People need to regain more quickly and permanently their fundamental freedoms of movement, to earn a living, attend events and gatherings, and make physical contacts.

On 22 February, SAMS organized a symposium on “Myths and facts about the COVID-19 vaccines” for doctors and health staff in the region. During the symposium, SAMS hosted an expert from the United States of America, who explained the vaccine’s significance. 

The doctors reviewed the latest facts, research, and scientific developments about vaccines and their different types. Besides, doctors learned about the myths and facts related to the coronavirus vaccine. The symposium has had positive impact on the healthcare workers in northern Syria because it shed light on the necessity of the vaccine rollout in order to achieve public safety objectives, Kewara said. 

Vaccination will not be mandatory

 Doctor Rifaat Farhat, an officer of Idlib’s vaccination program, spoke with Enab Baladi about the vaccine’s distribution mechanism. He explained that each individual will receive two full doses in two stages within about a month.

The coronavirus vaccine teams will be in the health centers constantly for 25 days. Thus, the beneficiaries can go there and get vaccinated. 

In the first phase, health care workers, civil defence volunteers, teachers, and hairdressers will be vaccinated.  The second phase includes people aged 65 and over and people with diseases more dangerous than the coronavirus. The total number of vaccine recipients is expected to amount to an approximate 850,000.

 Planned vaccinations for COVID-19 in northern Syria will not be mandatory; people have the option to refuse or accept the vaccine. 

UK’s vaccine AstraZeneca

The WHO-affiliated facility, COVAX, has allocated 1,020,000 doses of the UK’s Oxford-AstraZeneca vaccine to Syria.

On 15 February, the WHO listed the AstraZeneca-Oxford COVID-19 vaccine for emergency use, giving the green light for these vaccines to be rolled out globally through COVAX — a global initiative aimed at equitable access to COVID-19 vaccines.

In a 3 Febreuary document, COVAX Facility highlighted that the doses are non-binding and may be subject to change. The distribution of doses might need to be modified in light of the circumstances that “are difficult to expect, and the changes that are continually evolving.”

Head of Mission and WHO Representative in Syria, Dr. Akjemal Magtymova, said Syria is expecting an allocation of the AstraZeneca shots because it does not have the facilities to keep Pfizer vaccines in adequately cold storage facilities.

The WHO representative said to Enab Baladi that the success of the rollout of coronavirus vaccines in Syria depends on their availability and distribution, and it may initially cover only 3 percent of the population. She noted that the Syrian government’s application under the COVAX program would cover 20 percent of the population but that the supply of vaccine doses might not come immediately.

Magtymova indicated the need to take a staged approach. “Maybe first is three percent of the population, which could be mainly targeting the health workforce who are day in and day out meeting COVID patients, and then it will expand to … other categories of the population.”