Opinion: Government’s vaccine strategy must remain under scrutiny

In Thai, there is an oft-used phrase: tok ma tai, “to die after falling off a horse.” It is an idiom that describes how someone can do something well almost to completion, only to make a mess of things just before reaching the finish line. 

For many, this is an idiom that increasingly looks fitting for the Thai government’s pandemic response. The first wave of infections was quickly vanquished, and declining numbers show that the second wave has come under control. 

Thailand’s vaccine strategy, on the other hand, continues to spark bafflement and criticism. The government has decided to purchase a small number of Sinovac vaccines, due to arrive today, while depending largely on locally-manufactured AstraZeneca vaccines, with the goal of vaccinating around 60% of the adult population by 2021.

The weaknesses here are obvious: procurement and projected delivery is undeniably slow, lagging behind many neighbors, and the vaccine supply is barely diversified. Private hospitals have yet to be given permission to independently conduct vaccinations. And it is unclear whether the government has secured enough doses to generate herd immunity.

I wrote in January that there are legitimate reasons for the government to move more slowly and cautiously over its inoculation drive, but that the government should explain its intentions clearly. Since then, in an open letter, Deputy Prime Minister and Health Minister Anutin Charnvirakul detailed both regulatory obstacles that impeded Thailand’s ability to secure vaccines last year along with a public health rationale for a slower rollout, saying that because Thailand’s situation is not so serious, it did not need to rush into a vaccination campaign without knowing more about side effects.

Reasonable explanations, to be sure, but the government has not done enough since then to increase confidence in its vaccine strategy. When he came under fire during last week’s no-confidence debate, a visibly angry Anutin launched a diatribe against Move Forward Party MP Wiroj Laikhanaadisorn while providing a vague defense of his policies, but viewers at home came out none the wiser over vaccines.

It was left to National Vaccine Institute Director Nakhon Premsri to answer questions such as why Thailand is the only ASEAN country outside of the vaccine-sharing COVAX program.

But a list of thirty questions posted by the Move Forward Party remains largely unanswered, and while they contain a little too much personal invective, several questions in there deserve answers. When will the 35 million doses that Thailand has reserved, but not paid for, arrive? Why has the government not purchased Sinopharm’s vaccines in addition to Sinovac’s? And what is the government’s plan B in case the current strategy fails? 

I would also add another question: how do the new coronavirus variants factor into the government’s vaccination strategy? For one, they do seem to change the calculus on the speed of vaccination.  Evidence seems to show that the UK variant can spread even more quickly, and cases spiked in Britain as the new strain dominated.

Discoveries of the variant has been limited to travelers in the state quarantine program so far, but as Thailand’s second wave of coronavirus infections showed, no country can truly seal itself off from the outside world. Vaccinations may be the only way to ensure that Thailand is no longer vulnerable when, inevitably, border controls fail again. 

It also appears that Thailand’s big bet on AstraZeneca’s vaccines may look rather risky in the face of these variants. Earlier this month, scientists found that the AstraZeneca vaccine may not be sufficiently effective against the South African variant of the coronavirus. The company has said that it plans a new version of the vaccine, updated to fight against these variants, for later this year. Yet Thailand does not need to wait — instead, it should consider diversifying its vaccine sources to other providers whose offerings are clinically proven to be effective against the new strains. 

Variants aside, there are a myriad of other considerations that show strategy changes make sense now. The government’s economic priorities, for instance, demand a faster vaccination strategy. Prayut is said to be mulling waiving quarantine for vaccinated tourists, provided that there is sufficient evidence that vaccinations prevent virus transmission. A speedier vaccination schedule would negate that requirement. 

Also worth considering is Pfizer’s vaccines, which was previously required to be stored at very low temperatures. This was a stumbling block for Thailand in the past, but new evidence shows that Pfizer’s vaccines can actually be stored higher temperatures for up to two weeks, which means that it should be an option of the government considers diversification moving forward. 

Changing circumstances demand that strategies shift. It’s okay to believe you had a reasonable strategy before, but change course when events call for it.

Of course, while the government’s problems with its vaccination program goes beyond simply a matter of public relations, a more effective communications would also help immensely, if at least to help Thai people understand where the government is. One example of how to do this comes from Japan, when Prime Minister Suga Yoshihide appointed one of its most popular politicians, Kono Taro, as minister in charge of vaccinations. 

It may simply be Suga punishing a potential rival with a difficult portfolio, but Kono’s appointment has certainly helped provide a steadier footing to what was also a shaky campaign. Videos by Kono on Twitter explaining how the coronavirus vaccines work have been widely watched. Finding a similarly gifted public communicator who can serve as a vaccines ambassador for the government could similarly help Prayut.

Above all, however, the government’s vaccine strategy must remain under scrutiny. The Prayut administration seems to be riding high at the moment — vaccinations are finally starting, it has recently survived a bruising no-confidence debate due to a comfortable majority in parliament, and protests have been largely unable to regain momentum. But just because the government seems secure does not mean it can afford to flunk this vaccine test.

We all want the best for Thailand. This government’s success in completing this vaccination campaign will be a success that bear fruit for all Thais. No one wants to see Thailand fall off the horse, figuratively speaking, as we see the light at the end of the pandemic’s tunnel. 

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