Far-flung Pacific island nations have been among the most successful in the world at keeping COVID-19 at bay by swiftly closing their borders and imposing strict quarantine measures.
With poor hospital infrastructure and high rates of underlying health conditions Pacific governments weren’t going to take any chances. And for the most part it’s worked.
Island nations and territories including Kiribati, Nauru, Palau and Tonga are believed to still be completely virus-free, while others such as Vanuatu, Fiji and Samoa have recorded some cases, but none via community transmission.
But economically, these places, so heavily reliant on tourism, have been badly hit. Which is why the procurement and rollout of a COVID-19 vaccine is now top of the agenda across the Pacific, in the hopes of re-opening the borders and jumpstarting the economy.
Why the vaccine matters in the Pacific
Dr Stuart Minchin, the director-general of the Pacific Community, the largest scientific and technical international organisation in the Pacific, said vaccinating the region is “critical” to getting back on track.
“This region has felt the impact of COVID-19, perhaps not as acutely as a health crisis, but very acutely in terms of the impact on their economies,” he said.
“Anything that the population can do to facilitate the opening up of travel and opportunities to rebuild economies is going to be welcomed both by the governments and by the people themselves.”
The rollout of a vaccine is now top of the agenda across the Pacific. Source: AFP
Dr Minchin said he expects “to see very large queues for getting the vaccine," when the time comes.
But for much of the Pacific, a start date on a potential vaccine rollout is still up in the air. And they can't do it alone.
Many governments of the developing nations still waiting with bated breath for word from the World Health Organisation’s COVAX initiative, and from their more powerful neighbours, like Australia, for help procuring doses.
How many vaccines will Australia donate?
The Australian government has committed $500 million to “advance purchases” of COVID-19 vaccines to help the country’s neighbours in Southeast Asia and the Pacific.
$200 million of that will specifically be allocated to the Pacific including Fiji, Kiribati, Nauru, Papua New Guinea, Samoa, the Solomon Islands, Tonga, Tuvalu and Vanuatu - all nations not covered by US compact states agreements, New Zealand Realm States, or French territories.
On top of that, the federal government has dedicated an extra $80 million to the COVAX initiative which aims to secure rapid and fair access to vaccines for developing nations such as those in the Pacific.
The Australian government has been sending support to Pacific island nations. Source: Department of Defence
Australia’s Minister for International Development and the Pacific, Senator Zed Seselja, said the funding will not only be used to distribute millions of COVID-19 vaccine doses across the region, but to provide technical and logistical support to local health authorities too.
“We want to do more than just help with procurement of the vaccines themselves, we want to give end-to-end support.”
“To make sure that not only can they get access to safe and effective vaccines, but they can be administered to their populations.”
When will the rollout start?
As to when that would begin, Senator Seselja said he couldn’t “put an absolute firm date on it,” but said he expected doses via the COVAX initiative to arrive first, around the end of March.
Vaccine doses supplied by COVAX are supposed to immunise around 20 per cent of each population.
Procuring enough doses for the rest of each population will then fall in Australia’s hands. Senator Seselja said there are several ways it might go about organising that.
“It may well be the case that a surplus of vaccines here is able to be used in the Pacific, or it might be the case that we procure them through other means,” he said.
The government is planning to support each nation on a “country by country basis” with funding allocated proportional to population size.
Fijian health minister Dr Iferemi Waqainabete said Australia has been “very supportive” during the pandemic so far.
“We've been in constant contact with them, we understand Australia is procuring well and above their means of their population but they've indicated to us they're willing to support us in terms of accessing vaccines, financial support, or whatever mechanism they have,” he said.
He said the Fijian government continues to have meetings with Australian government officials to iron out the finer details of the rollout.
What challenges could the rollout face?
Dr Waqainabete said geography is one of the biggest challenges when it comes to the rollout. Isolated islands and rough mountainous terrain mean providing health services can be complex and difficult.
“We are a nation that's geographically challenged because we have highlands, but we also have quite a lot of islands, about 100 inhabited islands,” he said.
It means using certain vaccines, including the Pfizer-BioNTech candidate - which is required to be held at minus 70 degrees Celcius in cold-chain storage - would not be an option.
Many Pacific island communities are remote or difficult to access. Source: Getty
Dr Minchin said it will be a “huge logistical exercise”. “The Pfizer vaccine requires very deep refrigeration which is not a practical outcome for many of the countries in the region, so there are complexities,” he said.
He added that managing the rollout “is not just on the doses per se, it's on the whole logistical chain; getting it there and ensuring that the training is in place”.
US and French territories already underway
In some Pacific nations the vaccination rollout is already underway - including US Pacific territories Guam and American Samoa, and the freely associated states of Micronesia and Palau, benefitting from the US government’s Operation Warp Speed which aims to vaccinate the whole US population by the end of the year.
French colonies New Caledonia and French Polynesia have also received their first doses through procurement by the French government.
Esther Muna, who runs the Commonwealth Healthcare Corporation on the Northern Mariana Islands (known as the CNMI), a US territory, has been overseeing the rollout. She said while she’s happy with the progress, it’s been like “landing an airplane and you don't see the entire runway”.
Ms Muna said rollout began on the CNMI in December on the main island of Saipan. They’ve successfully been vaccinating around 400 people per day, and to date, they’ve immunised 10 per cent of the population.
But doses are being delivered in dribs and drabs, rather than in bulk, making it difficult to know when the next allocation will come.
Esther Muna (left) and her team in the CNMI with some of the first doses to arrive in the region. Source: Commonwealth Healthcare Corporation CNMI
“At the end of the day, it's slow, and the amount is not enough and this is the challenge we have as health officials ... we want to vaccinate people quickly,” Ms Muna said.
Even so, Ms Muna is hoping to get 80 to 90 per cent of the adult population vaccinated within the next few months.
“From the allocation amount, possibly by May/June we could achieve that. We were hoping it could be sooner but it depends on the allocation,” she said.
Lessons learned after fatal measles outbreak
But even after procurement and distribution is achieved, there’s still the challenge of convincing the population that it’s safe.
Vaccine hesitancy is a real problem facing many nations around the world and those in the Pacific are no exception.
But Professor Collin Tukuitonga, a public health expert from the University of Auckland, said Pacific Islands have a good historical record when it comes to vaccine uptake.
Education campaigns about COVID-19 have helped keep the virus at bay in many Pacific Islands. Source: Xinhua News Agency
“The Pacific Islands, as small as they are, have pretty good immunisation coverage for the vaccines on the schedule, in other words, immunisation has been accepted by the communities,” he said.
“I think overall we can be optimistic that there will be a reasonably high level of acceptance.”
Professor Tukuitonga said hard lessons around vaccination were learned after the devastating measles outbreak that hit Samoa in 2019.
More than 5,700 people contracted the disease and 83 people died, most of whom were young children. The cause of the outbreak was attributed to decreased vaccination rates in the country.
“I think the measles epidemic in Samoa had a profound impact on the way small island nations reacted to COVID-19,” he said.
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