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Reaching the unreached with COVID-19 vaccination across the Western Pacific Region

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Countries across the Western Pacific Region are continuing efforts to reach people in vulnerable, at-risk groups with vaccines to protect them against severe illness and death from coronavirus disease (COVID-19).

In Manila, the capital of the Philippines, for example, the World Health Organization (WHO) helped transport people to a special vaccination centre. Its aim was to reach people who were vulnerable to COVID-19 but had so far missed out on life-saving vaccines because of stigma, a lack of money or residential address, difficulty accessing vaccine registration, or other barriers.

Robert, one of the city’s nearly 3 million homeless people, who at first was hesitant to be vaccinated, says “This vaccination drive is a huge relief for us, especially since the vaccines are free. We hope that everyone gets vaccinated. It’s a relief knowing that eventually, everyone will be vaccinated.”

Across the world, the most disadvantaged and marginalized people are most at risk of missing out on all kinds of health care, including vaccination.

WHO has issued guidance on many aspects of the COVID-19 pandemic response, and the WHO Strategic Advisory Group of Experts on Immunization (SAGE) has published a roadmap recommending prioritizing vaccination for older and immunocompromised people, those with underlying health conditions, at-risk groups in vulnerable settings, and hard-to-reach populations, in addition to ensuring health-care workers and other essential workers are fully vaccinated.

“We cannot think of ourselves as separate from others. One person who is not vaccinated or one person who has no access to health services represents an equity issue for our society. We can’t just talk about our own vaccination; we must ensure that others are vaccinated as well. Our own protection relies on other people’s protection,” said Dr Dulce Natividad, Associate Professor of the University of the Philippines, at a vaccination drive for homeless people and survivors of gender-based violence.

Overcoming barriers of geography and mobility

In the Pacific, small populations dispersed over vast areas make vaccination challenging. One particular challenge was vaccinating people in Tonga’s remote Ha’apai islands, which were heavily affected by a volcanic eruption and tsunami in December 2021. WHO and partners are supporting countries and areas in the Pacific to reach everyone with COVID-19 vaccines, regardless of location.

The result: high vaccination rates across many Pacific island countries and areas, including those that had not yet recorded a single COVID-19 case.

The WHO Representative to the South Pacific, Dr Mark Jacobs, said: “This is no small feat. It is the result of hundreds of hours spent by dedicated health workers travelling by boat and on foot to reach the hardest-to-reach villages and communities. Whenever the virus arrives on their shores, these high vaccination rates will help to prevent severe illness and keep death rates low.”

In Viet Nam, mobile vaccination teams made home visits for older adults and people with disabilities who were unable to get to health facilities.

Ensuring access to information and partnering to build trust

In order to increase vaccination rates among migrants, the Malaysian Ministry of Health had to first overcome their lack of access to information. The Government, with WHO support, developed tailored information materials and translated them to ensure that all communities had equal access to information about vaccines.

Malaysia’s Health Minister, Mr Khairy Jamaluddin, said, “We made vaccination information and material in more than 20 languages, because if you cannot speak to people about something as personal as putting something in their body, you are not going to succeed.”

Information is just as important for people living in remote, ethnic minority communities. Viet Nam’s solution: mobile communication officers who traverse narrow, winding and bumpy roads, broadcasting COVID-19 messages using loudspeakers mounted on their motorbikes, and who go house-to-house to share reliable health advice in local languages and answer questions.

In many countries, partnering with trusted civil society and nongovernmental organizations is key to ensuring no one is left behind. When news of the COVID-19 outbreak in Malaysia reached an indigenous Orang Asli community in Kelantan province, community members tried to isolate by retreating into the forest. A joint effort by government agencies, tribal leaders and WHO helped to disseminate information about the spread of the virus and gain the community’s trust. Community engagement included a vaccination drive in a community hall, with songs, games, and food and snacks to create a friendly, positive and inclusive environment.

Vaccination and other measures needed

Vaccination is an important tool, alongside other public health and social measures, such as mask wearing and distancing, hand and cough hygiene, ventilation, monitoring of health-care capacity and use, early detection of cases or clusters among vulnerable populations, and a risk-based approach to border measures. This package of tools forms the core of WHO’s recommended approach to the sustained management of COVID-19 in the Western Pacific.

Reaching every group with vaccination is crucial for protecting against severe disease and death, reducing the risk of transmission and mutation of the virus, protecting the health system and supporting ongoing social and economic recovery.

WHO’s work supporting countries across the Western Pacific Region to reach people with vaccines against COVID-19 is made possible by the support of donors and partners including through COVAX, which is co-led with the Coalition for Epidemic Preparedness Innovations (CEPI) and Gavi, the Vaccine Alliance, alongside the United Nations Children’s Fund (UNICEF) as key delivery partner.

Read more about COVID-19 vaccination here.