The Gambia could experience its third wave of Covid-19 in January 2022, according to health experts. Despite this fear though, the people are not taking the vaccines. It has been 7 months since vaccination started in the country but only about 11.8% took their jabs.

A recent survey done by the Afrobarometer has indicated that 7 in every 10 Gambian believe that prayer is more effective than a vaccine in preventing COVID-19 infection.  And 5 in every 10 Gambian think prayer is “much more effective”.

The health ministry is currently conducting a study to understand what is influencing vaccine hesitancy. In the past two weeks, Malagen has engaged various Gambians on their reasons for not taking the jabs. In this interview with Dr Mustapha Bittaye, the director of health services, we interrogate the most widely held beliefs we came across during our vox pop.

A mass vaccination campaign has started in the Gambia since March this year but only about 11% of the population has taken the jabs. What do you think is responsible for this?

This is a big problem for the Ministry and we are looking into it. A study is currently being carried out by our research unit to try to probe the reasons behind vaccine hesitancy. Anecdotally, what we are having is that there are various reasons for various people. Some people, their brothers or sisters abroad feeding them some messages from an anti-vaccine community.

For others, it is because they lack education even though Afrobarometer shows that most Gambians know about the vaccine. Some of them, the depth of knowledge is not good. For example, you have a brother in the United States who tells you that we are not using AstraZeneca, then you think that AstraZeneca is bad.

Or they tell you they have stopped the Johnson and Johnson in the United States of give them some half-baked information. They used that to form their opinion. There are some who are just sitting on the fence. Government says it is safe and others are saying it is not safe, so they don’t what to do. But when we have the survey data, we will know why some people are not taking the vaccines.

Do you think the issue of the vaccine causing blood clot could also be part of the fear? It was in the news.

I think that also played a part. When the people hear the news of a blood clot affecting some who took the jabs, even though it was clarified that this is a very small number, but they are worried.

But do you think the issue of the blood clot has reached a point that one could justifiably stay away from the vaccine?

No. It has not. All the studies have shown that the issue of blood clot associated with the vaccines is insignificant. It is good to report incidents such as the issue of blood clot when they occur and we transparently put out all information relating to the vaccine in our situation report.

We show what adverse side effects we have and we show minor ones we have. The adverse side effects, we go ahead to investigate them to see if they are link to the vaccine or not. We are very transparent with the vaccine information.

Let’s look at the benefits in vaccination. If you vaccinate a million and you get two cases of blood clot, look at how many people you prevented from having adverse effects of the virus if they get infected. Almost 5 to 10% of people who get Covid-19 get seriously sick and may die. And you prevented all that with vaccination. And those clots when they reviewed it, they are same as those taking the contraception or other drugs we are continuously using.

How many incidents, if any, of blood clot do we have in the country?

We have two suspected cases but we did not do post-mortem to confirm them. We have two deaths; I think within a week of taking the vaccine. The person was not sick. He was on his daily business and fell down. That could be related to a blood clot. There was another similar incident. But the establishment that it is related to the vaccine is not yet confirmed.

We have spoken to people who hold the view that there is some grand world depopulation agenda behind the vaccine and that it has some contraceptives in it. Is that true?

When people do not know something, they find a way to explain it. For some people, everything has to have some conspiracy theory. They also come up with something that explains things. People tend to be scared of governments, especially in the West.

Anything coming from government, they want to double-check. The vaccine world has really been good. We have been taking vaccine. Almost all children born from 1986 in the Gambia are vaccinated one way or the other. These vaccines are check regularly and they go through a process, quality control. There is a lot of quality control processes that goes into these vaccines. For example, all countries using the vaccines have public health laboratories, if there are issues, it would have been detected.

We spoke to someone who is a nurse and the person said he will not take the vaccine. Is there a policy that every health worker should take the vaccine?

We wished we could do that. We were looking into that. Some countries have made it mandatory for all civil servants. But as at now in the Gambia, no such decision has been made yet. But everybody working in the health sector, you should have the vaccine. If you don’t take the vaccine, you get Covid-19, the government spends so much on you.

This could have been prevented. We have a disease that you are working with as a health worker and there is a preventive measure, everyone should take such an opportunity. And ones you get sick, we have to spend a lot of money. That is why some countries have made it mandatory. Some of us are seriously considering that (making vaccine mandatory for civil servants).

You are a gynecologist. How true is it that there is contraception in the vaccine?

That information is inaccurate. Contraception works per circle—like circle of a woman. And it tries to regulate the hormones so that the effect they use to have on the ovary, they will not have it. The vaccine is mainly anti-viral. It produces some forms of anti-bodies that induces the production of anti-bodies.

We spoke to someone who said there is a grand conspiracy behind the vaccine by Bill Gates who, according to this individual, has some agenda to reduce the world population. Do you hear sentiments like that?

Yeah, the Bill Gates one, we hear a lot. Bill Gates is doing a lot in science. He is supporting a lot of things that are going on. Right now, in the Gambia, most of our drugs for Malaria, TB and all that is through the global funds through Bill Gates.

They are doing a lot of researches. All these grants we are competing for, most of them are from Bill and Melinda Gates Foundation… There have lot of funds dedicated to development of science…

 

Do you think there is a case of knowledge gap? And if sure, couldn’t the ministry try to use some information campaign to sensitise the people?

It is not perfect, but we have an information campaign ongoing where we go to community leaders. We have a whole unit responsible for that. Their job is to make sure we coordinate all communication activities and engagements. They are funded very well.

We have some people who expressed concerns that the vaccine was not adequately tested and unlike other vaccines which took long time to process, the Covid-19 were processed within an unusually very short period.

The vaccines usually take a long period of time from testing in animals, then do a different phase of clinical trials before it comes out. This time the first vaccines they used, the platform that they put the antigens (the MRNA) was already developed. They are already using it for other vaccines… So, most of the phases were already done. That platform has been tested for a long time. That is why this was very fast.

Is it safe the say that the scientific world has agreed that all the vaccines currently available are safe to use?  

The World Health Organisations has said that all the vaccines are safe. But countries have their preferences… based on advices from their medical control agency…

You have earlier on talked about the cost of cure for Covid-19. For a patient experiencing the severe form of the virus, how much could the treatment cost?

If you go to an ICU (Intensive Care Unit), some people in the ICU for a day can consume US$3000. You have to use so many pipes and they are disposable ones. So, cost depends on some many things including drugs they are giving you.

Finally, we just have under 12% of the population vaccinated. The target for the population to vaccinate is 60 to 70%. Are there fears that without an adequately vaccinated population, the virus could make a comeback?

Yes, we are actually expecting that the virus (Covid-19) may pick up again in January based on the trends we have seen so far. Except people take things very seriously, and we all have our vaccine and open up to the world, things could be bad.

Dr Mustapha Bittaye is the director of health services, Ministry of Health. He is a gynecologist.