COVID-19 Vaccination in Tajikistan: Rumours and Reality

The founder of the Tajik-Iranian healthcare centre “Ibn Sina” Abdukhalil Kholikzoda officially expressed his opinion on AstraZeneca vaccine. His message was widely discussed.

On April 1, he published a message on his Facebook page, suggesting “not to rush to receive AstraZeneca vaccine”.

“If this vaccine is found to be ineffective, we will reject it and apply to COVAX for another vaccine. There are already enough victims of this disastrous virus,” Kholikzoda wrote.

He states that 100 doses of AstraZeneca vaccine were provided to his healthcare centre and 10 employees were vaccinated on March 31. Three of them complained of high fever, which is immune system’s response, so it can produce antibodies.

“However, the reports of severe side effects from this vaccine appear in different parts of the world. In particular, in Germany, due to severe side effects and even deaths, vaccination of people under 60 with this vaccine was banned, and now, vaccination is allowed only to people over 60 years old, while the manufacturer did not recommend to vaccinate people over 60 years old at the beginning. Earlier, several European countries paused vaccination process. All this inevitably leads to the thoughts that this vaccine has not been sufficiently studied,” Kholikzoda writes.

Such reports in the European media led to the fact that many people began to doubt the effectiveness of this vaccine. The users of the Tajik segment of Facebook began discussing this topic. In this regard, the WHO Global Advisory Committee on Vaccine Safety (GACVS) has conducted a study on the biological mechanisms of the Thrombosis with Thrombocytopenia Syndrome (TTS) after vaccination with this vaccine.

The analysis revealed that a link between AstraZeneca vaccination (Vaxzevria and CoviShield) and blood clots is plausible, but such cases are very rare.

“Rare adverse events following immunizations should be assessed against the risk of deaths from COVID-19 disease and the potential of the vaccines to prevent infections and reduce deaths due to diseases”, says an official statement following a meeting of the WHO Global Advisory Committee on Vaccine Safety.

The WHO experts emphasize that the cases of blood clotting after vaccination, of course, raise concern, but are very rare: dozens of cases per 200 million vaccinated people. At the same time, experts remind that 2.6 million people have died from the COVID-19 disease.

“Based on latest available data, the risk of TTS with Vaxzevria and CoviShield vaccines appears to be very low. Data from the UK suggest the risk is approximately four cases per million adults (1 case per 250 000) who receive the vaccine, while the rate is estimated to be approximately 1 per 100 000 in the European Union (EU),” the WHO stated.

At the same time, WHO experts warn that the risk of TTS after vaccination is high for people who were at risk before vaccination. Therefore, they recommend doctors to examine patients with suspected thrombosis before vaccination – to measure platelet levels and conduct appropriate radiological imaging studies.

The WHO website notes that it carefully monitors the rollout of all COVID-19 vaccines, and that open, transparent, and evidence-based communication about the potential benefits and risks to recipients and the community is essential to maintain trust.

On April 15, one of the creators of the AstraZeneca vaccine – the University of Oxford – published information on its website about the risk of cerebral venous thrombosis after vaccination – topic the media covers very often.

“The risk of the rare blood clotting known as cerebral venous thrombosis (CVT) following COVID-19 infection is around 100 times greater than normal, several times higher than it is post-vaccination or following influenza,” the researchers claim.

The study was conducted with the participation of more than 500 thousand COVID-19 patients and 480 thousand vaccinated people. The researchers concluded that compared to the AZ-Oxford vaccine, the risk of a CVT from COVID-19 is about 8 times greater.

The researchers at the University of Oxford hope that this study will help to understand the coronavirus vaccination correctly.

This is the most popular opinion. In the Tajik segment of Facebook, there are many posts or comments saying that the Indian analogue of AstraZeneca is dubious, poorly tested and, accordingly, ineffective and even dangerous.

So far, the Ministry of Health and Social Protection of the Population of Tajikistan did not announce a single case of a post-vaccine death, although the Tajik media reported on some side effects.

According to the head of the Sanitary and Epidemiological Service of the Ministry of Health Navruz Jafarov, as of May 16, the number of vaccinated persons in Tajikistan reached 72,347, of which 269 people or 0.4% of the total number reported side effects.

“The main complaints are fever, chills, muscle weakness and muscle ache. These side effects are considered insignificant and are within the acceptable range,” he told CABAR.asia.

Jafarov noted that the next batch of AstraZeneca/COVIDSHIELD vaccines from India will be delivered to Tajikistan at the end of May.

“The vaccine is reliable and certified by the WHO. This vaccine was chosen also due to the fact that India is closer to us, therefore, the transportation is easier, since the flight takes about two hours. As for side effects, before vaccination, everyone is informed that he/she should notify the doctor about the health condition after vaccination,” he said.

Tajikistan’s choice of the Indian analogue of the vaccine may also be related to the fact that the British-Swedish AstraZeneca company has an obligation to supply the vaccine to European countries before supplying it to other countries.

Research data: Meanwhile, the COVIDSHIELD fact sheet published on the website of the vaccine manufacturer Serum Institute of India Pvt Ltd notes that although the vaccine has been clinically tested in humans, “serious and unexpected side effects may occur. COVISHIELD™ vaccine is still being studied in clinical trials”.

This message shows that this vaccine is not studied comprehensively, but during the pandemic, such situation is considered as normal.

Some doctors and secondary school teachers anonymously report being charged 10 somoni (less than $1) for vaccination.

“I was charged 10 somoni, but they did not explain why. I know that it [the vaccine] is free, but there was a queue at the medical clinic, and I had to pay so as not to take others’ time. In addition, we were told that vaccination is compulsory and we could not refuse,” said a primary school teacher in one of the Dushanbe schools.

The Ministry of Health of Tajikistan officially states that vaccination is voluntary and free of charge, since the vaccine is delivered to the country as humanitarian aid under the COVAX mechanism. However, in fact, healthcare workers, teachers and public officers say they are being forced to receive the vaccine.

“We received the vaccine a week ago. I said that I had chronic hypertension, but they did not even listen to me. I stay at home already for a week. For the first three days, I could not raise my left hand, where the vaccine was administered. Then, dizziness, fever and nausea began. I feel better now, but the first days were hard,” an employee of one of the Tajik departments told CABAR.asia.

Navruz Jafarov told CABAR.asia that 150 thousand doses of CoronaVac vaccine manufactured by the Chinese Sinovac Biotech Company will be delivered to Tajikistan this summer.

“The vaccine from China will be delivered to Tajikistan free of charge within the framework of cooperation between the two countries, as agreed by the leaders of Tajikistan and China. The delivery of the Russian Sputnik V vaccine is still discussed, we continue negotiations and hope to come to an agreement with the Russian side in the near future,” he explained.

He noted that the vaccination will also be carried out primarily for vulnerable groups of the population – doctors, teachers, government workers, citizens over 60 years old.