STATEMENT BY HONOURABLE CARVIN MALONE
MINISTER FOR HEALTH AND SOCIAL DEVELOPMENT

DURING THE SIXTH SITTING OF THE THIRD SESSION OF THE FOURTH HOUSE OF ASSEMBLY OF THE VIRGIN ISLANDS
ON WEDNESDAY 10^TH MARCH, 2021
AT THE SAVE THE SEED ENERGY CENTRE
 

COVID-19 VACCINATION UPDATE AND ADVOCACY

Mr. Speaker, COVID-19 was declared a GLOBAL PANDEMIC on March 11, 2020.

Empowered by The Public Health Ordinance of 1977; The Infectious Diseases (Notification) Act, 2013; Quarantine Act, 2014 and the Public Health (Covid-19 Control And Suppression Measures) Orders of 2020, the Health Emergency Operations Centre (HEOC) was activated as the primary advisory body in the Territory’s defense against COVID-19.

Mr. Speaker, with the advice, decisions, and actions of the HEOC, the Cabinet of the Virgin Islands, the House of Assembly and the efficient works of public, private and voluntary institutions and individuals, as a territory we did the following:

1. Enacted nine (9) Public Health (COVID-19 Control and Suppression Measures) Orders;

2. Supported the enactment of forty-five (45) Curfew Orders;

3. Redesigned and commissioned a COVID-19 isolation ward on the 3^rd floor of the Dr. D. Orlando Smith Hospital;

4. Expanded the facilities and ensured the certification of laboratory services for on-site COVID-19 testing in the Territory and to-date have conducted 24,597 tests, of which 154 were positive. One hundred and fifty two (152) cases have recovered; One (1) untimely death has occurred and there exists presently ONE (1) active case, resulting from a returning resident who was tested while in quarantine.

5. Developed and commissioned COVID-19 permanent and mobile swabbing facilities at the Dr. D. Orlando Smith Hospital; at the T. B. Lettsome International Airport and at various interim locations throughout the Virgin Islands;

6. Approved and funded quarantine accommodations, transportation and meals, free of cost, to qualified individuals from June 1^st 2020 to February 28^th 2021; and 

7. Proactively contracted, in August of 2020, the COVAX consortium for the provision of vaccines when they become available. Notifications of the delivery of 12,000 doses have been received and receipt is being finalised.  

Mister Speaker, on February 4^th 2021 the Virgin Islands received the first 8,000 doses of AstraZeneca vaccine compliments of the United Kingdom Government.  Members of this Honourable House would be aware that five members of this House inclusive of the Minister of Health and Social Development, Governor Rankin and YOU Mr. Speaker were among 33 brave persons vaccinated on February 11, 2021. 

Further to this Mister Speaker, we began the roll out of the vaccination campaign in a phased manner, starting with healthcare and frontline workers in Phase I, followed by elderly and those with chronic disease in Phase II, during the week of the February 15^th this was accomplished.  During the week of February 21^st Mister Speaker, Phase III which included essential workers commenced.  Admittedly the planned rollout of the vaccination programme did not materialise exactly as we had envisioned, however, we continue to progress this important initiative. 

The vaccine rollout was structured using community vaccination centres at the R&R Malone Center in Pockwood Pond, Nurse Theresa Smith Blyden Clinic, Cappoon’s Bay; St. Williams Catholic Church Hall in Road Town, The East End Seventh-Day Adventist Church in Fat Hog’s Bay and the Cane Garden Bay Baptist Church on Tortola; the Nurse Iris O’Neal Clinic and the North Sound clinics on Virgin Gorda and the clinics on Jost Van Dyke and Anegada.

Mister Speaker, using this Community vaccination approach, we have been able to achieve between 500 to 600 vaccinations per day, with the exception of the days that the programme was placed on hold, due to concerns with the delay of the arrival of the second shipment of AstraZeneca from the United Kingdom, and the need to ensure that persons having done their first inoculation would be assured of the availability of the second dose.  Mister Speaker, I am pleased to inform the Honourable House, as of today March 10^th 2021, we have completed 5,031 vaccinations in these Virgin Islands.  Mister Speaker, this number accounts for -  

• 4,113 individuals on Tortola
• 770 on Virgin Gorda
• 68 on Anegada
• 80 on Jost van Dyke

Mister Speaker, for emphasis I must note for the record of this Honourable House, a decision was made to place on hold the distribution of vaccinations until we had secured delivery dates for the next two tranches of 12,000 vaccines each.  This pause afforded us the opportunity to consolidate and fine tune the process further.

Subsequently, Mister Speaker, we received from Governor John J. Rankin, excerpts of which I now read as follows:

“I write to confirm that the United Kingdom now has in its possession adequate quantities of the AstraZeneca vaccine required for the BVI and that the charter flight is being booked for the planned second consignment of vaccines (i.e.12,000 doses) for delivery to the BVI on 17th March which, if the second doses are to be administered from 25th March, allows sufficient time for a further 4,000 people to have their first dose.

Again, please be minded that we have secured enough doses for the entire adult population of the BVI and will continue to work closely with the Chief Medical Officer to ensure BVI has the supply when it needs – with the caveat that this will need to be planned in advance.

Provisionally, we have a further 12,000 doses pencilled in for 31st March. Providing we continue a steady planned approach, I hope you will agree that there is no need to further pause the vaccination programme and we should continue together to encourage people to come forward for that all important first dose. I look forward to our continued close working on this very important and time critical programme.”

In actuality Mister Speaker, this delay was only for a period of 4 working days – March 3^rd through 8^th, 2021.  The vaccination rollout re-commenced on Tuesday March 9^th and is progressing quite smoothly.  Additionally, Mister Speaker, plans are being finalised with COVAX for the delivery of 12,000 units of AstraZeneca based on prior mentioned contractual arrangements. 

Mister Speaker, when we receive the new batches of vaccination, which was originally due on 3rd March but now has been confirmed to arrive on 17th March (next week), we will bring the private sector on board through a Memorandum of Understanding.  The MOU will be executed with qualified private healthcare providers and require them to provide vaccines at no administrative or product costs to persons or the National Health Insurance programme.

In recent developments Mister Speaker, I have been advised by the Ag. Chief Medical officer that on the 6^th of March 2021 an article was published in the Lancet with data from pooled double blind randomised controlled studies in which 17,178 participants receiving the AstraZeneca vaccine, were modelled.  The study determined that vaccine efficacy was 81.3% after two standard doses were given 12 weeks apart versus 55.1% when given after two standard doses 6 weeks apart, and that the difference was statistically significant.  

These studies were supported by additional studies done in participants under 55 years of age, which showed more than double the level of antibody response in persons who had the dose in intervals of 12 weeks versus those who had an interval of less than 6 weeks.  The differences were statistically significant, Mister Speaker.

Given that the 12 week interval is clearly superior Mister Speaker, this is the preferred dosing interval advisable by the medical experts and the Chief Medical Officer in the Ministry of Health and Social Development.  This guidance takes into account the very clear and published two fold improvement in the antibody response and 26.2% greater efficacy with the 12 week dose interval over the 6 week regime.  

On this premise Mister Speaker, persons who would have been scheduled for their second vaccination in the previous six weeks interval, will now be rescheduled for administration of the second dose in a twelve week interval.  So Mister Speaker, to make this even clearer, I will use myself for example.  My vaccination as well as yours took place on February 11, 2021.  Mister Speaker, our second dose in the 12 week regime now falls on May 5, 2021 as opposed to my March 25 date scheduled previously.  Persons affected can expect to be contacted by the Health Services Authority with a new appointment date.

From a legal and ethical standpoint Mister Speaker, it is our hope that persons will follow this new regime, and if they are being advised otherwise or choosing a smaller dosing interval, should do so with full information of the disadvantages.  It’s not that it cannot be done but it’s not the most efficient.

Mister Speaker, with respect to delivery of vaccines as many persons as possible should receive their first dose and as quickly as possible.  The first dose of vaccine affords very high efficacy against COVID of the order of 76% in the short term against symptomatic COVID and 63.9% when including both asymptomatic and symptomatic COVID.  We are also aware that the first dose of AstraZeneca vaccine reduces infectiousness by as much as 67% and has also led to dramatic reductions of hospitalisation in the UK of over 80% and as high with just under 20 million persons out of an approximately 60 million population having been vaccinated.

Mister Speaker, it is therefore exceedingly important for as many persons as possible to be vaccinated as quickly as possible so that the Territory can move and reap the benefits of vaccination.  We are aware of the concept of herd immunity where if we have sufficient persons vaccinated, we will interrupt the ability of COVID to be transmitted through our population.  Widespread vaccination within the Territory will also allow us to seriously review our current protocols and look at less onerous entry measures.  This even more that we begin to look to advance the process of the re-opening of our ocean borders on 15^th April.  The U.S. CDC has already recommended that persons who are vaccinated do not need to quarantine after potential exposure to the Coronavirus and also that vaccinated persons can gather in small settings without masks and other measures.

While we will continue to be cautious it is imperative that as many persons as possible get vaccinated and see this as an important tool for us as a Territory to return to some degree of normality and productivity.  As such we are encouraging persons from all sectors and all walks of life to protect themselves, protect those around them, and protect the Territory and get vaccinated.  Vaccination has been proven to be safe and efficacious.  Vaccination provides clear benefits to individuals, your connections, your community, and the Territory.  Mister Speaker, the scientific evidence is mounting, and it shows categorically that vaccination works at both the individual and population level!

Vaccination Mr. Speaker, is our most effective weapon against COVID and the most important means of returning our Territory to normality and reclaiming our lives and livelihood from COVID. 

Mister Speaker, we are aware that there are many misconceptions and malicious rumors around vaccination.  These are malicious and unfounded Mister Speaker.  We urge persons to seek reputable information based on evidence and from reputable sources and not to be swayed by malicious misinformation.  The Ministry of Health and Social Development continues to be advised by the foremost sources of evidence and experts from the United Kingdom, Public Health England, Pan American Health Organization, and the Caribbean Public Health Agency and the latest and best available evidence.

While vaccination is safe and effective, we must be aware that allergic reactions can occur within the first 15 minutes after vaccination.  As such all vaccination sites have provisions to safely and effectively treat any types of allergic reactions and also to observe persons for the first 15 minute period after vaccination when most if not all immediate allergic reactions may occur.

Mister Speaker, I will like at this time to reiterate the importance of vaccination to the Territory and the reopening of our Territory and economy.  While we look at what is going on in the world it is imperative that the Virgin Islands also does its part and takes responsibility to protect itself and the world from COVID.  The BVI Health Services Authority and private providers will be offering the COVID Vaccine to the public.  At this point in time the Ministry has recommended that the first hour of operation of vaccine administration locations shall be reserved for the following groups of persons following which all other persons are eligible to be vaccinated. 

The centres normally open at 10:00 a.m.  We will like to have between 10:00 a.m. – 11:00 a.m. on a daily basis the healthcare and frontline workers, the elderly and those with chronic disease, essential workers and any disabled person to be able to take advantage of that first hour, because we must accommodate those registered as well as walk-ins.

Persons can register to be vaccinated on a particular day or walk-in to a vaccination site.  However, all persons must fill out registration information and show identification and pre-registered persons must be given preference.

We now have the database and all the registries in place but we must ensure Mr. Speaker that those persons who are registered be given an opportunity to have preference over persons walking in, save for and except Members of the House of Assembly and other frontline persons, given the first hour.  Mister Speaker, we must be mindful of new strains of Coronavirus that continue to emerge principally because of the large numbers of infections and the increased chance for mutations.  This is another reason why vaccination is important and why all persons must get on board with vaccination.  Through vaccination Mr. Speaker, the world has eliminated or severely reduced the impact of many once terrible diseases.  These include smallpox, measles, polio, congenital rubella syndrome, tetanus, and a whole slew of childhood and other diseases.  Let us work together through vaccination to add COVID to the list of diseases that were eradicated.

Mister Speaker, we must be aware that partial vaccination programmes and partial rollouts of vaccine across the world leave persons vulnerable to infection but also increase the probability of the development of new strains which can also lead to new vaccinations having to be developed. We do not want this.  I therefore urge all of us to get vaccinated.

This is the eighth time, so that we can look forward to a brighter and better Virgin Islands and to put COVID behind us.  And at this juncture Mister Speaker, I will like to again make the 12^th appeal to all citizens, all persons residing in the Territory to REGISTER, REGISTER, REGISTER, REGISTER.
You can visit the Government’s page that will become available to you or the main page at www.bvi.gov.vg and get information on registration.

Mister Speaker, I will like to thank you for this opportunity to make this a statement but very important that we do this.  Those persons who have been registered for a 6 week period have to now reschedule to make it a 12 week period from the date of their original vaccination.

Thank you Mister Speaker!