Vaccinating the elderly against Covid faces myriad challenges

Covid-19 vaccination

Some of the elderly people at Kibera Day Care Centre who narrated about their Covid-19 vaccination experience. Only 9.3 per cent of people aged 58 years and above have been fully vaccinated.

Photo credit: Evans Habil | Nation Media Group

When Anne Musanga, 70, from Kibera, Nairobi, got her first Covid-19 vaccination jab on April 23, she knew that after 12 weeks, she would receive her second and final one, thus ensuring her safety as far as the pandemic was concerned.

But this was not to be. According to Musanga, her blood pressure shot up after the vaccination and she was immediately put on medication. Her medical records show that her blood pressure was 171/83 mmhg.

Her second dose, which was supposed to be administered on June 26, has since not happened as she is yet to get a nod from her doctor.

“I was advised to first complete my prescription and to go through consistent medical check-ups before I am allowed to take the next dose,” she says.

Suspicions

On the other hand, Molly Aluoch Oloo, a 73-year-old grandmother from Katwekera village in Kibera, got her first dose of the vaccine in April and her second one in July. She says she was initially hesitant to get the jab due to suspicions, misinformation and disinformation about both the vaccine and the pandemic.

“I almost avoided the jab, but then changed my mind after participating in a number of sensitisation sessions as a member of the Kibera day care centre for the elderly,” she adds.

Thankfully, she says, she did not experience any side effects from the vaccine, a fact that got her to join in efforts to sensitise and encourage other elderly people to get vaccinated.

Being elderly, she didn’t have a hard time accessing the vaccine. “I expected long queues, considering that this service was being offered in government health centres. But that was not the case as I, together with the people within my age bracket, were given seats while we waited to be vaccinated,” she explains.

Horror stories

For Macfidensio Mureithi, 69, a business man in Kibera, the horror stories about the disease locally and internationally were enough for him to do whatever it took to get vaccinated.

“Tales of health complications and deaths resulting from the pandemic, especially in the initial stages, got me scared. So when the government announced the beginning of the vaccination process, I didn’t hesitate,” he says.

Mureithi’s efforts to get his second dose, however, hit a hitch:“I was supposed to get the second dose in June but then I received an SMS from the Ministry of Health stating that the vaccines were not available. But in July, it was announced that the vaccines were available and so I went to get my second and final dose without wasting any time,” he says.

According to the Ministry of Health, as of September 1, a total of 2,807,945 Covid-19 vaccine doses had been administered countrywide. The total first doses administered stood at 2,000,285, while second doses given were 807,660.

A total of 424, 919 people above 58 years old had received their first dose, which translates to just over 21 per cent of the total first dose vaccinations. On the other hand, people within this age bracket who had received the second dose were 240, 293, about 30 per cent of the total.

Low number

However, only 9.3 per cent of people aged 58 years and above have been fully vaccinated. Why this low number?

Experts argue that there are a number of factors that have contributed to the low turnout for Covid-19 vaccination among people within this age bracket.

According to Mr Jude Otogo, the country representative for HelpAge International, which champions the rights of poor and disadvantaged older people in Kenya, one of them is poverty.

Dr Stephanie Hauck, a consultant with the World Health Organization, the elderly have been the most vulnerable during the pandemic, considering that they are dependent on other people.

“Especially in the African context where they have to depend on their children and grandchildren for survival, things get even worse when they have to be isolated,” she adds.

Slum dwellers

Those who live in the slums, Mr Otogo says, have been hit hard. The first hurdle is getting to health facilities due to distance lack of money for transport

“Also, the economically challenged elderly persons don’t have time to queue for the vaccine at health centres because they spend most of their time looking for an income,” he adds.

This has been the case for Edward Nyundo, a 75-year-old security guard from Kibera 42 who is yet to get the first dose of the vaccine.

“I work at night as a security guard, meaning that during the day I am sleeping. I do not have the luxury to go sit somewhere for hours waiting to be vaccinated. What am I going to eat at the end of the day?” he poses.

National Taskforce on Vaccine Deployment chairperson, Dr Willis Akhwale, notes: “The main problem is that the elderly don’t want to come to the hospitals because they fear contracting the disease. Remember this is a group of people with a high chance of having underlying conditions like diabetes, which could cause sensations after the administration. This is made worse by the fact that many of them have misconceptions that vaccination could make their conditions worse,” he adds.

It is a challenge that Yasmin Abdulrahman Aboyo, an assistant manager at the Kibera day care centre for the elderly, says has made their Covid-19 and vaccination campaigns, a tough task.

Fearmongering

“We have had cases of fearmongering among some elderly people who have been partly or fully vaccinated and perhaps experienced some reactions, discouraging others from getting the jab,” she explains.

The challenge with the elderly, Dr Akhwale notes, will be best handled through education.

“People should understand that in most cases vaccines have side effects, which could either be mild or harsh. But does is this reason enough to avoid being vaccinated? Definitely not,” he says.

There is still hope though, as records show an increase in the number of people above 58 years going for the first dose.

“In May, we stopped people from getting the first dose until those who had already received the initial jab, got their second. But after getting enough vaccines, the operation commenced and this is a contributor to this increase. Also, initially, we had few vaccination centres as compared to now,” explains Dr Akhwale. He also attributes this to an increase in sensitisation campaigns that have made it easier for people to access information not just about the Covid-19 vaccination, but the pandemic as well.

“We didn’t start the campaigns earlier because the vaccines were not enough, so doing that at that time would have been a waste,” he says.

No structured mobilisation

Mr Otogo says lack of structured mobilisation activities and campaigns targeting older persons have hampered vaccine uptake in that demographic.

“Health activities and campaigns supporting other groups like pregnant women are in place, but when it comes to the elderly, there’s nothing tangible. This is despite the fact that they make up a very significant percentage of the population,” he says.

To reach more people within this age bracket, Dr Akhwale says his taskforce has recommended “the use of community health workers. Also, targeted outreach should be conducted to reach this group of people through listed community workers. In addition, they should be vaccinated when going for their regular check-ups.”


This story was supported by Code for Africa’s WanaData programme as part of the Data4COVID19 Africa Challenge hosted by AFD, Expertise France and The GovLab