The Government of Vanuatu has committed additional funds to the health sector for essential work on COVID-19 preparedness and to ensure citizens and residents can access necessary health services for COVID-19 and beyond.
These efforts will contribute towards achieving readiness for the opening of borders to international travellers. This is currently targeted for late March 2022, though is contingent on sufficient capacity and readiness as determined by border protection measures, clinical preparedness to manage cases, and national vaccination coverage rates.
Improved COVID-19 containment measures at the border and overtime for frontline health workers
Vanuatu has been successful at containing COVID-19 at the border. Since March 2020, there have been five active COVID-19 cases detected in quarantine but no cases in the community. This has been achieved through strict measures applied before travel from overseas (testing, vaccination), during travel and at the airport (masks, physical distancing) and during 14-days of quarantine. However, the delta variant of COVID-19 poses an additional threat as it is more infectious than other COVID-19 variants and has proven difficult to contain in other countries.
In September 2021, the Government of Vanuatu paused all inbound travel to take stock of protocols and processes, and to strengthen measures where needed. Protocols were reviewed and tested, new requirements were introduced, training was conducted, and improvements were undertaken. At the airport, 94 million vatu was provided to upgrade the ventilation system to reduce the risk of transmission of COVID-19 and other contagious diseases. This was also used to construct an exterior building to ensure correct and safe management of arriving passengers from higher risk areas. These upgrades will ensure better preparedness for COVID-19 and other epidemic contagious diseases, such as measles and influenza.
Public Service Commission also approved payment of overtime in arrears for those health staff who have worked intensively for the past 20 months to support repatriation and quarantine operations.
Enhanced clinical preparedness at Vila Central Hospital and health facilities
The Council of Ministers endorsed 4 billion vatu injection of funds to the health sector to be prioritized to infrastructural improvement of health facilities nationwide, a critical area to ensure improved health services for the population. A comprehensive plan to ensure impactful use of these funds is under development.
A further 1.4 billion was endorsed to be allocated for urgent upgrades to Vila Central Hospital and recruitment of specialized health staff to ensure readiness for community-wide spread of COVID-19 in Alert Levels 2 and 3.
Finances to assist overseas treatment for serious adverse events linked to a COVID-19 vaccine product administered in Vanuatu
While efforts are ongoing to enhance prevention and preparedness for COVID-19, scale up in COVID-19 vaccination continues. The Council of Ministers this week committed 120 million vatu for transfer overseas for those requiring medical treatment due to a serious Adverse Event Following Immunisation (AEFI). This financing can be accessed if the necessary treatment is not available in Vanuatu and the event is confirmed to be linked to a COVID-19 vaccine product. This allocation will allow for immediate transfer for a presumed or confirmed serious AEFI requiring overseas treatment.
Over 7.5 billion COVID-19 vaccine doses have now been given worldwide. Some people experience mild to moderate symptoms such as fever, fatigue, headache, muscle pain, chills, diarrhoea, and pain at the injection site. These usually go away within a few days. More serious AEFI such as blood clots are rare but do occur. For Vanuatu, it is expected that 2 to 4 people per 100,000 will develop a serious AEFI linked to a COVID-19 vaccine product. From the 129,568 vaccine doses already given in Vanuatu, there have been two such cases. One patient was transferred overseas for treatment and the second patient was treated successfully at Vila Central Hospital and has recovered well.
Vila Central Hospital stocks medication to treat blood clots along with other medical intravenous immunoglobulin, but further treatment may be required. Vila Central Hospital has the capability to carry out initial testing but for some AEFI additional testing using highly specialized equipment, supplies or expertise is needed. Efforts are ongoing to build this capacity in Vanuatu though overseas testing is currently still required. Financial support for overseas medical treatment and testing is therefore important for cases that cannot be fully managed in Vanuatu.
The decision to transfer a patient overseas is based on a recommendation of the Vanuatu National Overseas Referral Committee (VNORC) and endorsed by the Ministry of Health Executive. Causality of a serious AEFI is assessed by the National Vaccine Expert Advisory Group (NVEAG) to confirm if it is linked to a COVID-19 vaccine product. If so, the finances available may be used to cover the medical evacuation flight if needed, hospital bills and daily allowances, accommodation and quarantine for the patient with one accompanying relative.
The COVAX Facility also provides a compensation program for individuals who have suffered a serious AEFI resulting in permanent impairment or death associated with a COVID-19 vaccine procured or distributed through the COVAX Facility, or the administration of such a vaccine. This can take time to process, with forms to be completed and uploaded to an online COVAX platform for assessment. For vaccines provided through bi-lateral agreements with other countries, insurance schemes are also available. The Ministry of Health can provide assistance in this process as needed.
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