The Zimbabwe Association of Church-Related Hospitals (ZACH) is encouraging people living with HIV to be vaccinated in order for them to live healthy lives during this era of the deadly COVID-19 pandemic.
This emerged at a virtual media briefing held today (Monday 2 August 2021) under the topic of discussion “HIV and COVID-19 Vaccines”.
Dr. Vimbai Mandizvidza, the ZACH Public Health Advisor explained the background and impact of the COVID-19 pandemic.
She said the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‑CoV‑2) is a highly transmissible respiratory pathogen (virus) that causes coronavirus disease – 2019 (COVID-19)
COVID-19 was first discovered in Wuhan, China in December 2019 and it slowly spread to other parts of the world, leading to the World Health Organization (WHO) declaring the novel coronavirus outbreak a global pandemic on March 11, 2020
Globally, as of 30 July 2021 (6:30 pm CEST), there were 196,553,009 cases and 4,200,412 deaths related to COVID 19. Within the African region (30 July 2021); 6,635,522 cases have been reported including 168,478 deaths. As of 30 July 2021, Zimbabwe has recorded 107,490 cases and 3,490 deaths.
She underscored the need to embrace all the messages on the prevention of COVID-19. These have included physical distancing; wearing a face mask (covering both the nose and mouth); washing hands with soap and water and if those are not readily available, using a hand sanitizer that contains at least 60% alcohol.
The preventive measures also include avoiding touching the eyes, nose, and mouth with unwashed hands. To reinforce physical distancing, the government has also implemented various levels of lockdown to restrict movement and curb the spread of COVID-19.
Dr. Mandizvidza said the lockdowns have been largely successful in slowing down the spread of COVID-19. However, the restrictions in the movement of people have had some effects on People living with HIV (PHLHIV)
“With the start of the outbreak, it was important to ensure that PLHIV were as healthy as they could be, taking their antiretroviral (ART) medications and achieving viral load suppression. PLHIV who are not taking ART or whose disease is not well managed may be at increased risk for contracting COVID-19 due to having a compromised immune system and may also be at increased risk for serious symptoms and death. However, with the lockdowns, there was a risk that PLHIV would experience treatment interruptions and reduced access to other HIV services due to the restrictions in movement and health facilities realigning their services to suit the current environment.”
She alluded to a number of challenges. These included the reduced access to health services by clients due to lockdown movement restrictions and transport issues. ZACH clients were failing to access care at sites of their choice. There was also the fear of forced disclosure and stigmatization by police at roadblocks. Community health workers were not able to conduct community activities (e.g. conducting treatment literacy and demand creation activities for HIV services). There were supply chain challenges in that the pandemic has affected the movement of procured medications and laboratory consumables.
As an intervention, there was the screening of all clients visiting the health facility (temperature checks, screening questions at entry). Triaging any clients who are unwell (flu-like/respiratory symptoms, fever) to be seen first and provided with a face mask immediately upon arrival, was implemented. Where possible an ill person coming to the health facility with symptoms suspicious of COVID-19 infection should call ahead to notify the in-charge, so they are aware and able to immediately separate the patient from other patients and place a face mask on them on arrival.
To reduce the client clinic visits, multi-month dispensing of ART medications was recommended. Recommendations were that clients receive a minimum of 3 months supply of ART and up to a maximum of 6 months depending on the health facility stock status. The ZACH pharmacy and laboratory coordinator continues to work with the ministry of health national, provincial, and district pharmacy departments to ensure ART stocks do not run out and strengthen the supply chain management systems for medicines and diagnostics.
ZACH strengthened the differentiated service delivery (DSD) models such as family ART refill and community ART refill groups (CARGs), that is, one person collecting ART for the family or group. CARGs are discouraged from conducting their usual support group meetings in the community until the COVID-19 crisis subsides. Psycho-social support is given through text messages, phone calls, or WhatsApp groups.
Mr. Paul Chinakidzwa, the Ministry Of Health and Child Care Deputy Director – Health Promotion said immunization fortifies an individual’s immune system against an agent (known as the immunogen).
A vaccine is a substance used to stimulate the production of antibodies and provide immunity against one or several diseases. It is prepared from the causative agent of a disease, its products, or a synthetic substitute. It is treated to act as an antigen without inducing the disease. Because vaccines contain only killed or weakened forms of germs like viruses or bacteria, they do not cause the disease or put one at risk of its complications. Most vaccines are given by injection, but some are given orally (by mouth).
“Without vaccines, we are at risk of serious illness, disability, and death from some preventable diseases. Although some diseases may have become uncommon, the germs that cause them to continue to circulate in some or all parts of the world. Infectious diseases can easily cross borders and infect anyone who is not protected. Two key reasons to get vaccinated are to protect ourselves and to protect those around us. Because not everyone can be vaccinated e.g. those who are seriously ill or have certain allergies – they depend on others being vaccinated to ensure they are also safe from vaccine-preventable diseases,” Mr. Chinakidzwa said.
He said no pharmacological interactions have been reported between COVID-19 vaccines and antiretroviral drugs.
“People living with HIV should continue to take antiretroviral therapy after vaccination which maintains health and prevents onward HIV transmission. Many people living with HIV have one or more comorbidities that may put them at increased risk for a more severe COVID-19. Literature suggests that people living with HIV appear to be at increased risk for severe outcomes and death due to COVID-19 compared with people without HIV.”
In Zimbabwe, women are disproportionally affected by HIV, particularly adolescent girls and young women. Young people(around a third of all new infections in 2018 were among young people aged 15-24 years (UNAIDS,2019). HIV is also prevalent among sex workers. Around 40% of female sex workers are living with HIV (UNAIDS,2019; MOHCC,2018 Global AIDS Response Progress Report). From the data that is available, an estimated 31% of men who have sex with men are living with HIV (UNAIDS,2019).