Bhutan’s experience with COVID-19 vaccination in 2021

Modelling studies predict significant reduction in overall attack rates by SARS-CoV-2 through use of effective COVID-19 vaccines, with the highest relative reduction among older adults (aged 65 years and older), reduction of intensive care admissions and deaths.1 As of 18 April 2021, 14 vaccines have been approved for human use by at least one country2 and 890 million doses of COVID-19 vaccines have been administered globally.3 In the South Asia region, the Oxford-AstraZeneca (COVISHIELD) vaccine manufactured in India has been made available through the COVAX Facility.2 As of 18 April 2021, 122 million doses (7.9% of the population) have been administered in India, 6.6 million doses (3.5%) in Bangladesh, 0.9 million doses (4.3%) in Sri Lanka, 0.8 million doses in Pakistan, 0.3 million doses (54%) in Maldives and 0.1 million doses (0.3%) in Afghanistan.3 Bhutan, a country with a population of 0.72 million, has vaccinated 472 139 individuals with the first dose of COVISHIELD covering 94% of the eligible population (18 years and older) within a span of 2 week.4 Bhutan has reported a total of 957 cases of COVID-19 up till 18 April 2021 with one death.4 The country has seen two nationwide lockdowns and disruption of public services, schools and colleges.5 6 The physical distancing measures and the closure of international borders has impacted almost all sectors of socioeconomic activities in the country with the major brunt on the tourism, entertainment and export–import industries leading to an all-time high unemployment rate. Identification of vaccination centres were key in the placement of cold chain storages at central locations catering to several vaccination centres in the catchment area. In the months leading up to the vaccine roll out, multiple batches of health workers were trained on the management and monitoring of vaccine cold chain, organisation of vaccination booths, delivery of vaccine and post-vaccination monitoring. The vaccines were delivered to regional and district cold storage centres from where daily doses of vaccines were released on the days of vaccination.