Imbalance in COVID-19 vaccination coverage in Karachi

In an informal study of the statistics of the vaccination status of the citizens living in the province of Sindh, the disparities in the COVID-19 vaccination coverage between different districts of Karachi was quite evident.
The statistics over a period of over one month (August 1, 2021 to September 9, 2021) were reviewed and analysed and a lot can be inferred from these statistics.
Pakistan started administering COVID-19 vaccines through a phased approach starting in the middle of February.
Initially frontline health workers were vaccinated followed by the geriatric population and gradually made its way down age groups. Karachi, the largest city in Pakistan and seventh largest in the world, is divided into 6 districts namely Karachi Central, East, Korangi, Malir, South and West, with Karachi West having the highest above 18 population and Malir district having the least.
Karachi followed the same phased approach however with time, disparity in vaccine coverage became very evident. One can question whether the disparity is due to the dereliction of duty by the government in promoting vaccine equity or due to hesitancy of the citizens to get the vaccine due to the myths that have stemmed concerning to the COVID-19 or due to the low efficacy of the vaccines being administered in the city.
Since August 1, Karachi South has been at the forefront of getting its residents vaccinated (488,205), followed by Karachi East (408,510). Even though Karachi West has the biggest population in the metropolis, it could only manage to vaccinate the second least amount (271,104) within the city, just a little more than Karachi Malir (202,978) which surprisingly happens to have the smallest population in the city. It is striking to see that the largest and smallest districts of the city managed to vaccinate roughly the same number of people in a period of one month. Even though South and East have the highest vaccination coverage, the government still has higher per day targets for the next five months for these districts compared to those districts falling behind.
Since the inception of COVID-19 the timely steps taken by the local and federal governments have been lauded internationally. As mentioned, that the government has had higher targets for Karachi South and East, probably that is why the government has set up numerous drive-thru vaccination facilities in these two districts even though now others need it more.
The government has set a deadline for September 30, 2021, for citizens to get fully vaccinated or else they will not be allowed to take part in numerous essential and non-essential activities such as but not limited to travelling, using public transport, working in a professional environment, dining out etc. Hence, we believe that the government should focus relatively more on facilitating vaccinations in the districts falling behind after seeing the success in Karachi South and East of the measures taken.
Incentives and awareness can be the key driving factors for increasing vaccination rates in the metropolis. A major hindrance for people who want to get vaccinated are the extremely long queues at the main vaccination centers of the district. Incentives like drive-thru facilities and mobile vaccination vans can promote vaccine administration and also reduce the traffic at major local vaccination centers.
This will make it very convenient for people of all ages to get vaccinated without worrying about standing in long queues in the scorching heat of Karachi. Currently there are 12 mobiles vans, divided almost equally between districts, being operated in the city. The government should increase the number of these vans overall and increase the number of these vans in districts of West, Central and Korangi.
The government has arranged very successful drive-thru vaccination facilities in the districts of East and South through partnerships with many private banks. Using the same ideology and framework, the government should partner with more private companies who are able to organize and execute such an operation.
A substantial increase in the quantity of vaccination facilities will considerably help to curb the spread of the virus. Another incentive that can be offered is a reward for getting fully vaccinated, something being practiced in many countries in the world.
In the initial days of the pandemic, private mobile network operating companies assisted the government financially and also gave free or discounted top-ups to their customers during lockdown period. If a similar agreement can be made between the government and these telecommunication companies where fully vaccinated people are rewarded in the form of a free top-up in terms of calling minutes or internet MBs, it will motivate a lot of people to get vaccinated.
Spreading awareness regarding the COVID-19 vaccine will also play a vital role in convincing citizens to get vaccinated. Since the start of the pandemic, the government has very effectively spread awareness using the caller ringtones. Innovative ringtone messages about the importance of getting vaccinated will positively impacts knowledge, perceptions and behaviors towards getting vaccinated for people from all socio-economic backgrounds.
The failure to distribute vaccines equitably is taking its toll on some of the city’s poorest and most vulnerable people. With discovery of new variants, poor living conditions and blatant ignorance of SOPs in public spaces, the risk of infection is very high for people who are not yet protected by vaccination.
Living in a city where there is poor implementation and following of SOPs in public places, it is imperative that we get maximum people vaccinated and not just achieve herd immunity but go back to the days where we were not required to constantly wear a mask around people.
After great success in Karachi East and South, the government should now aim to reduce the imbalance in the vaccination coverage and facilitate citizens based on equity and not equality. As citizens we should assist the government in any way we can to promote COVID-19 vaccinations as part of our social responsibility.
This can include but not be limited to getting vaccinated ourselves, convincing others to get vaccinated or assisting the government to carry out mass vaccinations. We have made it this far, soon this will also pass.
Abdullah Ahmed is a medical student at the Aga Khan University. Mir Ibrahim Sajid is a medical student at The Aga Khan University and has worked on key barriers and limiters to the success of vaccination nationally.
References:

On 01.08.2021, a total of 211,911 citizens received #COVID19 vaccine in the province of #Sindh. The number of vaccination has sharply increased over the last few days. Thank u people of Sindh 🙏 for the support pic.twitter.com/iNdCX5gXGj

— Murtaza Wahab Siddiqui (@murtazawahab1) August 2, 2021

As of 06.09.2021, the district wise situation of #Covid19 vaccination in the province of #Sindh is provided herein below. Please vaccinate now if u havnt already. Thank u pic.twitter.com/xA7CWeIQU8

— Murtaza Wahab Siddiqui (@murtazawahab1) September 7, 2021

https://jsbl.com/js-bank-covid-19-vaccination-drive-through/
 
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