Zimbabwe has intensified its Covid 19 vaccination strategy with vaccination now targeting children from 12 years going upwards.

The vaccination program kicked off in Kwekwe, Midlands province at Mbizo High school last week and the team will be moving around different schools until April. The Covid 19 pandemic has adversely affected the school calendar because of Covid 19 induced lockdowns. School children have had to rely on online lessons because of the constant school closures yet most do not have access to the internet nor the resources for private lessons.

Kwekwe District Medical Officer, Dr. Nyasha Mwasunda said the targeted vaccination number of 12-17 year old children who are school going is 58 220. This number  is for the whole district, Kwekwe urban and rural. “Most children are getting the Sinopharm vaccine so that they can get their 2nd dose when schools open. We have 8 teams of vaccinators who are moving in schools and vaccinating. Clinics that are close to schools are also acting as vaccination points. Hesitancy is being reported in some areas mainly due to religion,” he said.

There have been mixed reactions from parents and students alike in Kwekwe on children getting the vaccine jabs. Some parents are welcoming the idea, hoping it will mean return to a normal school calendar, whilst others are still hesitant. “My children are way below 12 years but I wish I could get them vaccinated. So that if ever they get infected they don’t have to suffer as much as I did when I had Covid. I hope they will also get to a point where they vaccinate those under 5 as well. I had not been vaccinated until after I got Covid. After surviving, I finally understood how terrible this virus is. Not only physically but it takes a toll on your finances as well,” said Pamela Dube.

Another parent Hazel Manda said that she was against the idea of 12 year olds getting vaccinated because children do not have a compromised immune system compared to older people. “I will not let my 12 year old get vaccinated, they are just too young and are the healthiest people. They already have a good immune system, I’m really against them being vaccinated. As we are looking at statistics we see Covid did not take away a lot of young people it was going for the older generation with compromised immune systems,” she said.

Zimbabwe rolled out its initial vaccination program in February 2021 as vaccination was seen as the best public health strategy to limit the spread of Covid 19. Former Health and Child Care Minister Doctor Henry Madzorera said that it is important to keep lowering the age limit for people who can and should be vaccinated. He pointed out that herd immunity cannot be reached by vaccinating adults above 18 only because they are less than 60 percent of the population.

“This is a new virus, we don’t know the percentage population that must be vaccinated in order to reach herd immunity. For measles as an example, we know herd immunity is achieved by vaccination in the neighbourhood of 95 percent of the children. But for Covid we do not know,” he said.

The Journal on the Landscape of COVID-19 Vaccination in Zimbabwe states that the country aimed to vaccinate at least 60% of its eligible population by December 2021. There are five vaccine choices approved for use in Zimbabwe‚ including China’s Sinovac and Sinopharm approved by the World Health Organisation (WHO) for emergency use‚ Russia’s Sputnik V and India’s Covaxin. Myths, misconceptions and rumours regarding the origins of Covid 19 and the dangers of the vaccines have circulated widely thereby influencing vaccine uptake.

Some parents like Lois Cheuka have said that rumours and mystery around Covid 19 make it difficult to consent to having her children vaccinated. “It’s difficult, I wish vaccination was only for those 18 years and above so that they can decide for themselves. For the 12 year olds, we have to decide for them which is difficult because we are not aware of the effects in the long run. We are concerned about the good health of our children,” she said.

Dr. Madzorera pointed out that younger people below 18 years get mild disease but that may not always be the case. He said that new variants might arise that may devastate people under the age of 18. Therefore, it is important to keep vaccinating people and going down the age groups so that if a new more vicious variant comes up it will find the country prepared with more of the population vaccinated. Dr. Madzorera added that though a lot of outbreaks in schools are mild, they are still significant and if all school children could be vaccinated, the better.

“Hopefully one day we will keep going down to 5 years of age where children normally start schooling. It’s that gathering of children in large numbers that causes the rapid spread of the virus. Children can become a reservoir that is dangerous for the adults at home. We would like to vaccinate the children so that they don’t become a pool for infection which affect those with core morbidities,” he stressed.

A Journal on Optimising COVID-19 Vaccination Policy to Mitigate SARS-CoV-2 Transmission within Schools in Zimbabwe says the Ministry of Health and Child Care (MoHCC), said that there were occasions when more than 50% of the daily cases were attributable to outbreaks in schools. Age-disaggregated data from the WHO from 30 December 2019 to 25 October 2021 reveals that all child age groups can be infected, with under-fives representing 2% of global cases, those between 5 and 14 years 7% and older adolescents and young adults, 15–24 years representing about 15% of all global cases. It also shows that China, the supplier of the Zimbabwe’s most commonly utilised vaccines, has extended its vaccination program to children aged 3–11 years to increase its mass vaccination.

One other parent, Daniel Mususa said that he would let his child be vaccinated if there was a wider choice of vaccines. “We can’t continue to have the same Sinopham and Sinovac as the only ones we are getting from the government. The issue for me isn’t the age but about available options, older people are still to get vaccinated because of the options available in Zimbabwe,” he said.

Pardon Mlambo, a Kwekwe resident said, “our children have been vaccinated against one disease or other since they were born. As a parent I have the prerogative to consent or not to have my child take the vaccine. The problem is that we don’t know if the vaccine might cause problems later on as they grow. So sometimes consenting is good but we don’t know how it will affect them in the future.”

On how safe the vaccines are for the younger population, Dr. Madzorera it was not an easy question to answer purely because there has not been any data on trials that were done on children availed in Zimbabwe.

“But we know that we have been giving inactivated virus vaccines for a long time in children. This is an inactivated virus vaccine perhaps it will work just as well and it will be just as safe. The only thing we have not controlled against is quality of the manufacturing, those are some of things we will be checking when we do clinical trials. To see if what the manufacture said they did is actually what they did. In as much the WHO inspected these vaccines, mistakes and short cuts can still happen after an inspection.”

“But there is no need for panic because we have used inactivated virus vaccines before and the government says they did clinical trials and they are happy so let’s use the vaccines in the children and hope Government will collect data as we go. That routinely collected data is extremely important as it is what we call phase 4 trials which we use to verify the safety of a vaccine,” Dr. Madzorera said.

Former WHO Regional Adviser and Midlands State University Faculty of Medicine and Health Sciences Professor Davison Munodawafa said that the vaccines that WHO approved for use among 12 year olds and above are safe. He said that no adverse effects were detected and it was found that the vaccines boosted the immune system of young people. “This boost of the immune system has shown to increase defenses against viruses including those that cause COVID-19. On that count, the efficacy of the vaccines among 12 and above outweighs any adverse effects that may be reported in isolated cases,” he said.

Professor Munodawafa added that the virus that causes COVID-19 is known to attack those 12 years and above. However, this age bracket has fairly strong defense systems and therefore most children do not get very sick or require hospitalisation as they do self-care or go unnoticed. However, he further said that this age group is in school and highly mobile thereby they have high transmission rates within age mates or across older adults in the homes, markets or sports. “It is therefore prudent to vaccinate them in order to increase protection. The potential to weaken the virus from vaccination is very high and therefore young people will be spreading a weakened strand of the virus,” he said.

In addition Dr. Madzorera said Government should have more campaigns to consientise the public on the effectiveness of the vaccine on children instead of just telling people to get vaccinated. “People are happier when they see numbers and hear real stories coming from government. To show that government is actually active and conscious to collect information on adverse events. If it looks to people like government is hiding something then people aren’t very happy. Government should raise the bar in terms of educating the population, giving them data so that they make informed decisions,” he said.