Health & Insurance. 56
Colombia’s Health Ministry announced May 8 a new, updated Covid-19 vaccination plan on the heels of accelerating vaccination rates – now topping 200,000 daily, likely meaning that more than 10 million Colombians will have had at least one shot by the end of May 2021.
The plan adjustments “were made based on scientific evidence, which made it possible to identify new comorbidities in people with higher risk from the virus and other populations that, due to their exposure, have an increased risk of infection,” stated Health Ministry infectious-disease prevention director Gerson Bermont.
While virtually all of Colombia’s front-line health workers have long since been vaccinated under “Stage 1” of the national plan, the “next-in-line” health workers in the now-underway “Stage 2” include “all the human health workers in the EPS [health-provider networks], control bodies and different organizations that assist, accompany and validate the entire process of care and management of Covid,” Bermont said.
As for the “Stage 3” vaccinations starting this month, people with certain comorbidities (see below) will be included along with people between 50 and 59 years old. “Before now, this group was in Stage Five and now will go to Stage Three as a priority by age, taking into account that age continues to be the highest risk factor,” according to Bermont.
“Stage 4” now includes people aged 40 to 49 and all public-relief groups. Meanwhile, “Stage 5” will including people aged 16 to 39 years without comorbidities.
Here are all the updated categories, according to the Health Ministry:
Stage 2: Population between 60 and 79 years of age.
“Includes all health professionals in compulsory social service; resident physicians and their teachers within the framework of the teaching-service agreements and internal physicians of all health service providers of any level of complexity who carry out their activities in any of the services provided by health service providers and who do not are classified in stage 1.
“Also includes human talent in health and support that attends patients in health service providers, traditional doctors, ancestral physicians, private health agents and health students in clinical practice.
“Also includes human talent that supports the response to the pandemic, the National Vaccination Plan, the Expanded Plan for Immunization and Inspection, Surveillance and Control, plus human talent in health that cares for patients or visits providers in spaces other than the IPS, as well as human talent that works in blood, organ and tissue banks.”
Stage 3: “Population between 50 and 59 years old, as well as population between 16 and 59 years old, presenting at least one of the following conditions: Hypertensive diseases; acute ischemic heart disease; heart failure; cardiac arrhythmias; cerebrovascular disease; diabetes; renal insufficiency; HIV; cancer; tuberculosis; chronic obstructive pulmonary disease; asthma; Obesity Grade 1, 2 and 3 (Body Mass Index> 30); those on the waiting list for transplantation of vital organs; post transplant of vital organs; neurological disorders; Down's Syndrome; primary immunodeficiency; schizophrenia, schizotypal disorder, and delusional disorders; autism; bipolar disorder; intellectual disability and other mental disorders due to brain injury or dysfunction or somatic disease; cystic fibrosis.
“Also includes educational agents, community mothers and fathers linked to early childhood services, identified by [child-welfare agency] ICBF; teachers, educational directors, logistical and administrative support personnel of initial education, preschool, basic primary, basic secondary, secondary education and higher education establishments; caregivers of populations of special protection; public force; indigenous guard and maroon guard; human talent from funeral homes, crematoriums and cemeteries that handle corpses; Search Unit Personnel; Colombian Migration Personnel; highest national, municipal, district and departmental Police and Health authorites; personnel of the Office of the Attorney General of the Nation.
Stage 4: “People in prisons; personnel who, due to their functions, are in direct contact with prisoners; first responders in risk management; street dwellers; human talent that works in social services for the attention of the homeless population; active international flight attendants and pilots and crew of international cargo ships; high risk aeronautical personnel; human talent of the Family Protective Service Stations in charge of the care and protection of victims of domestic violence; UNGRD emergency and disaster field care human talent staff; and people aged 40 to 49 years.
Stage 5: “People aged 16 years and over not found in the populations indicated in stages 1, 2, 3 and 4. Priority in this group includes adults between 30 and 39 years of age, then young people and adolescents.”
Colombia President Ivan Duque announced April 21 that while 4 million Colombians have already received at least one shot of Covid-19 vaccine, that number will have topped 5 million by May 4, thanks to accelerating vaccination rates.
Meanwhile, Antioquia Acting Governor Luis Fernando Suarez revealed April 21 that 600,000 people in Antioquia (including metro Medellin) – 10% of its total population – have already gotten at least one shot, as 74% of the 703,000 doses provided to Antioquia through the national government’s “MiVacuna” program have been applied into arms.
Nationally, Colombia now has more than 40,000 trained and certified Covid vaccinators, with another 20,000 undergoing final training, President Duque added.
As a result, Colombia is on-track to boost vaccination capacity to 200,000 people daily, hence enabling the nation to meet its target of getting 35 million of the most-vulnerable Colombians (70% of the total population) vaccinated before year-end 2021, he said.
On the supply front, Pfizer just delivered another 550,000 doses of its vaccine to Colombia, while Sinovac will have delivered another 2 million of its vaccines by early May, he said.
In total, Colombia already has bought 67 million doses of Covid-19 vaccines, including 20 million through the “Covax” multinational consortium.
By pharmaceutical provider, Pfizer is providing 10 million doses (covering 5 million Colombians); AstraZeneca is providing 10 million doses (for 5 million people); Janssen (Johnson & Johnson) will deliver 9 million doses (covering 9 million people); Sinovac is providing 7.5 million doses (for 3.7 million people) and Moderna is providing 10 million doses for 5 million people, according to Colombia’s Health Ministry.
According to the Health Ministry, as of April 20, 896,839 Colombians 80 years and older had gotten at least one Covid shot (80% of that cohort), while 75% of front-line health workers (totaling 708,350 persons) likewise had gotten a shot.
One-third of Colombians 70 to 79 years old meanwhile have gotten at least one shot, while 89,360 persons 65 to 69 years old have gotten a shot to date, according to the Ministry.
In May, the national vaccination campaign extends to persons 18 to 59 years old -- if they suffer medical co-morbidities, including those with cardiovascular and pulmonary diseases, as well as those with cancer, AIDs and other diseases, according to the Ministry.
Colombia Health Minister Fernando Ruiz revealed this morning (March 15) that more than 1 million people nationally will have received their first shot of Covid-19 vaccine this week, with 1.8 million likely by end-March.
As of March 13, 782,301 Colombians had gotten a Covid-19 shot since the vaccination campaign started 25 days ago, of which 108,456 were in Antioquia – most of those (more than 70,000), in the Medellin metro area.
“We have a vaccination rate that already shows consistent and well distributed numbers,” Minister Ruiz stated in a press release.
By the end of this March, some 85% of the “phase one” priority group – front-line health workers and those over 80 years of age – are expected to be vaccinated, he said.
With about 4,500 trained vaccinators now giving an average of 50 to 80 shots per day (depending upon region), that means Colombia is now averaging 80,000 shots per day.
“But next month [April] where we will have a much larger stock of vaccines, from 5 million to 8 million vaccines, most likely closer to the 8 million, we will be addressing the entire population of those over 60 years of age, which is more than 7 million people. We hope that this vaccination [campaign] will approach the 200,000 vaccinations per day,” Ruiz added.
While pharmaceutical companies have confirmed their plans to deliver millions of vaccines to Colombia next month, the exact days are still uncertain, he cautioned.
“We do not have much control over the issue [of exact arrival days]; hopefully we can have them in time” to meet the “phase two” goal of vaccinating another 7 million people in April, Ruiz added.
Colombia Health Minister Fernando Ruiz announced March 10 that pharmaceutical giant Pfizer just confirmed that Colombia will get another 2.2 million doses of its highly effective Covid-19-prevention vaccines next month (April 2021).
This upcoming delivery comes on top of the nearly 1.5 million Sinovac doses received here last weekend -- supplementing an earlier delivery of some 200,000 more Sinovac vaccines -- plus 317,000 doses of Pfizer doses already delivered here.
As a result, Colombia will have received at least 4.3 million doses of Covid-19 vaccines in the coming days, once including the 2.2 million doses already delivered here.
In parallel, Colombia seems on-target to achieve its initial goal of 1 million persons vaccinated by March 20, according to President Ivan Duque.
To date, Colombia already has signed agreements with several pharmaceutical companies for delivery of roughly 65 million Covid-19 doses over the coming months, mainly from Pfizer, Johnson & Johnson (Janssen), Moderna, Sinovac and AstraZeneca.
However, to reach its year-end goal of getting 37 million people vaccinated, Colombia needs to more-than-triple its current rate of about 1 million vaccinations per month, Ministry data indicate.
As of March 10, only 403,000 people had been vaccinated here since the campaign began on February 17, according to the Health Ministry.
Encouragingly, shot rates are ramping up since the first days of the vaccination campaign, now at around 62,000 persons daily. But that rate needs to hit more than 100,000 persons daily to meet the 37-million-persons target.
Data-entry delays from various health-care providers and local/departmental agencies partly might explain the relatively slow rate of reported daily vaccinations, Health Minister Ruiz stated in a March 10 bulletin.
For example: Antioquia had received 185,000 doses of Covid-19 vaccines as of March 9, but had only reported 46,000 actual vaccinations, or just 25% of its total dose receipts, according to Health Ministry data.
In contrast, Bogota seemed to be doing a better job, reporting that its vaccinations were already at 46% of total doses received.
Remarkably, relatively remote territories and areas including Choco, Amazonas, Casanare, Buenaventura and Vichada all reported vaccination rates of at least 90%, best in all Colombia.
However, another key factor explaining the delay between vaccine-shipments and shots-into-arms is the several-weeks-of-waiting required between the first and second shots of the two-dose regimen for the Pfizer vaccine.
Vaccinators Expanding
Meanwhile, boosting the total number of certified Covid-19 vaccination professionals also will help accelerate the daily shot rates here, according to the Ministry.
Today, Colombia has more than 30,000-such trained-and-certified vaccination professionals, with another 21,000 due to gain their required Covid-19 certifications by the end of March 2021, according to the Ministry.
In addition, another 107,000 health workers have signed-up for Covid-19 vaccination training, which will greatly expand capacity in the coming months, the Ministry adds.
Antioquia’s Front-Line Health Workers
Meanwhile, the Antioquia departmental government reported March 9 that 76% of front-line health workers here have already gotten their Covid-19 vaccinations.
Those health workers – along with people 80 years and older – are first priority in the national Covid-19 immunization campaign.
The Antioquia government calculates that front-line health workers and adults 80-and-over total 200,000 persons here, nearly all likely to be vaccinated before the end of March.
Colombia President Ivan Duque announced this morning (February 15) that the nation will receive the first 50,000 doses of Pfizer Covid-19 vaccines today, followed by 1.6 million more doses from various providers over the next three weeks.
As a result, the first vaccinations will start here right away -- a few days in advance of an initially projected February 20 start-up date.
Front-line doctors and hospital workers are first in line for vaccinations through the “MiVacuna” national program (see: https://mivacuna.sispro.gov.co/MiVacuna), along with people 80 years and older. Next in line are those between 60 to 79 years of age.
“We have acquired through direct purchases from pharmaceutical producers as well as through the multilateral Covax program 61.5 million doses, with which we will vaccinate 35 million Colombians in 2021,” added Colombia Health Minister Fernando Ruiz.
According to Colombia’s Office of Information Technologies and Communications (OTIC) director Weimar Pazos Enciso, the “MiVacuna” national computerized database taps patient-data input from EPS health-insurance networks as well as "different sources such as the National Registry [citizen and resident cedulas], the Ministry of Education, and Migration Colombia, among others.
“From the consolidation and purification of data, today we have the information on more than 35 million [vaccination candidate] prioritized Colombians. This has been available since February 5, so that people can consult the vaccination [priority] stage according to the different criteria established in the ‘plan nacional de vacunacion’ [PNV]," he added.
The “MiVacuna” web page “has a very robust infrastructure supported by 22 servers that support the database and the concurrence of each of the different phases of PNV,” he said.
Meanwhile, Health Ministry Chief of Staff Germán Escobar added that Colombia expects to receive this month 100,000 doses from Pfizer via direct purchases; another 117,000 doses of Pfizer vaccine via the Covax program; 192,000 doses from Sinovac; and 750,000 doses from AstraZeneca via Covax.
In March, Colombia is scheduled to receive 500,000 more doses from Pfizer via direct purchase; another 2.3 million doses from Sinovac; then another 1.75 million doses from AstraZeneca via Covax.
“Based on these estimates, [vaccine distribution] planning processes have been developed with the different departments and districts to consolidate their respective requirements for the National Vaccination Plan,” according to Escobar.
Medellin Receives 1st Ultra-Cold Freezer
On a related front, Medellin’s Health Secretary Andree Uribe Montoya on February 13 confirmed the receipt here of the very first ultra-cold freezer for proper storage of the Pzifer-BioNTech vaccines.
This first of several freezers being delivered here can hold 40,000 Pfizer vaccines at a temperature of -80ºC, in addition to other freezers already existing at various locations here, she added.
As for the broader Antioquia departmental preparations, Antioquia’s Covid-19 program director Leopoldo Giraldo added that mayors, health agencies, health insurance network directors, hospitals, clinics and essential health workers throughout the department and the Medellin metro area have already undergone intense training and consultations on Covid-19 vaccination management and coordination.
Meanwhile, Julián Fernández-Niño, Colombia’s Director of Epidemiology and Demography for the Health Ministry announced that Colombia has already confirmed via the “MiVacuna” program vaccination appointments for 263,000 front-line medical personnel along with 19,000 medical support workers for Stage 1 of the program.
In addition, another 200,000 medical workers are now in the MiVacuna queue for Stage 2 vaccinations, he added.
Medellin-based Healtix Home IPS and Bogota-based WTA Latam IPS jointly announced January 29 the start-up of Covid-19 testing services at Medellin’s José María Córdova (JMC) international airport in Rionegro.
“From today, our airport will have a laboratory to carry out Covid-19 detection tests,” according to a bulletin from JMC. “This service will be provided by WTA Latam IPS and Healtix Home IPS.”
All international passengers arriving to or leaving from Colombia are now required to pass a Covid-19 test within 96 hours of flights to-or-from most destinations including North America, Europe and much of Latin America.
Many nations (including Colombia) currently accept either the relatively rapid-result (but less accurate) antigen test (results in 20 to 40 minutes) or else the more-accurate but lengthier PCR test (24 to 36 hours for results). Passengers unable to get a Covid-19 test before boarding a flight to Colombia must get this test upon arrival and face quarantine as well.
The antigen test here at JMC is priced at COP$80,000 (US$22) while the PCR test costs COP$230,000 (US$64.50), according to the companies involved.
Colombia’s medical-services regulator Invima has certified both of these tests, according to JMC.
Colombia Health Minister Fernando Ruiz announced last night (January 29) that the first 337,000 doses of Covid-19 vaccine will be administered starting February 20.
Thanks to recent purchase deals, “Colombia has secured the 35 million vaccines necessary to immunize 70% of its population against Covid-19, with which we will achieve herd immunity,” according to the Ministry.
“We have managed to buy 20 million doses for 10 million Colombians through Covax, and through bilateral [purchase] mechanisms another 41.5 million doses for 25.25 million people. In this way we reached 61.5 million doses for 35.25 million people to be vaccinated,” Minister Ruiz revealed.
Total government spending for vaccine acquisition now totals COP$2 trillion (US$560 million), he aded.
The “National Vaccination Plan” (PNV in Spanish initials) now includes the following vaccines:
Pfizer: 10 million doses purchased for 5 million people (two shots per person), using the “messenger RNA” chemistry. “This vaccine differs from the traditional ones because it does not incorporate live or attenuated virus agents, or fragments of it,” explained Ruiz.
AstraZeneca: 10 million doses for 5 million people, similarly a “non-replicating viral vector vaccine that must be applied in two doses.”
Janssen (Johnson & Johnson): 9 million doses for 9 million people, as a “single-dose vaccine that is easy to take to dispersed areas” since it doesn’t require ultra-cold refrigeration.
Moderna: 10 million doses for 5 million people, “a new technology vaccine also of messenger RNA that requires deep freezing,” he said.
Sinovac: 2.5 million doses for 1.25 million people. “It is an inactivated, two-dose vaccine that can be stored in standard refrigeration at 2°C to 8°C,” according to the Ministry.
All these vaccines “have shown efficacy, all exceed the minimum standard required by the WHO [World Health Organization] for vaccination processes and allow us a diverse portfolio of maneuverability in the event of any eventuality,” Ruiz said.
Updated Vaccination Rollout Schedule
Thanks to the recent acquisitions and updated delivery schedules, the following dose schedule is now foreseen starting February 20, 2021:
February: 337,000 doses
March: 3,333,764
April: 4,663,843
May: 3,939,843
June: 7,553,450
July: 8,294,941
August: 11,258,941
September: 5,642,941
October: 6,260,116
November: 4,934,352
December: 3,166,666
As a result, “Colombia has the possibility of completing 100% of targeted vaccinations in 2021,” rather than an earlier estimate of 2022, he said. “Bear in mind that 35 million people represent almost the entire population over 16 years of age in Colombia,” he added.
“This is the opportunity for the country to unite, regardless of any divergence, towards a safe and effective vaccination process, because that is the basis for our country’s ability to turn the page on Covid-19” -- enabling both public health improvement as well as fuller economic recovery, he concluded.
Colombia Health Minister Fernando Ruiz announced last night (January 14) that another 71,473 vaccination specialists soon will join the existing 7,000 nationally qualified Covid-19 vaccinators via a new training program that starts today.
The “Management of Vaccination Against Covid-19 in Colombia” course now underway with Colombia's SENA training institute includes more than 42,000 nursing assistants, 13,000 registered nurses, 6,800 doctors, 3,500 dentists, 3,500 public health workers and 2,200 bacteriologists.
Of the 71,473 new trainees, Antioquia accounts for 8,637, according to the Ministry.
Course materials cover basic information on Covid-19 infection, technical and operational guidelines for vaccination, preserving the ultra-cold-temperature-storage chain, an “open bottle policy”on how to handle vials of vaccines, patient monitoring and data-information systems for correct registration of those receiving vaccines.
By end-January, yet another batch of trainees will enter the national program. For that upcoming session, “we will be inviting other professional health workers with a whole contingent that is working with us throughout the year, and with the territorial entities, the EPS [health insurance networks] and IPS [hospitals and clinics], in vaccination programs,” Ruiz added.
Colombia Health Minister Fernando Ruiz revealed last night (January 12) that the first 850,000 people here to get Covid-19 vaccinations will get their shots in February. Assuming compliance with projected delivery and distribution schedules, the tentative vaccination plan includes:
February: 850,000 people vaccinated.
March: 3,862,900.
April: 1,800,000.
May: 7,968,900.
June: 3,360,000.
July: 8,431,567.
August: 6,382,667.
September: 3,779,567.
October: 7,212,900.
November: 3,212,900.
December: 2,097,011.
The COP$1.5 trillion (US$432 million) budgeted on vaccinations so far include Pfizer vaccines -- soon arriving here -- while Janssen and AstraZeneca vaccines are scheduled to arrive between April and May 2021, Ruiz said.
The initial plan would vaccinate the 34 million most-vulnerable Colombians, with contracts for 29 million immunizations “already guaranteed,” Ruiz said.
Under the “Covax” multinational vaccine-purchase program, Colombia already has 20 million doses guaranteed (two per person required), hence this program will cover 10 million inhabitants.
“An agreement has been established with the pharmaceutical company Pfizer for 10 million doses, which will be destined for 5 million people, as well as with the pharmaceutical company Janssen, a single dose, for 9 million people, and with AstraZeneca with 10 million doses for 5 million Colombians,” according to the Ministry.
“Distribution mechanisms are being established with Pfizer. It is projected that vaccinations will begin with the prioritized populations in February,” then more doses through the Covax program will continue in March, Ruiz said.
“Probably May, June and July will be the months where we have the greatest amount of vaccinations. Those from Janssen and AstraZeneca would be arriving in the country from April or May 2020,” he added.
Meanwhile, the national government “has established talks with other pharmaceutical companies, whose vaccine developments are expected to be approved by international authorities for emergency use in the coming weeks. Surely, these would be applied for the second half of this year,” he said.
Colombia today has about 3,000 vaccination points and 7,000 vaccinators, "but we must grow in that capacity, for that reason the training course ‘Management of Vaccination Against Covid-19 in Colombia’ was developed with [Colombia’s national training institute] SENA, with which we seek to support the territories throughout the vaccinator training process," Ruiz said.
Doctors, nurses, dentists, bacteriologists, nursing and public health assistants or technicians will be able to access the training course, he added.
Ultra-Cold Storage Capacity Grows
On a related front, Gerson Bermont, director of prevention at the Ministry of Health, revealed that Colombia now has two special large-capacity warehouses in Bogota for initial receipt of “up to 40 million vaccines at a single moment” while nationwide, "Colombia has 37 collection centers for the storage and conservation of vaccines."
“The first vaccines to arrive in Colombia require deep freezing and from this moment there are eight [ultra-cold freezer] distribution points in Bogotá, Cali, Medellín, Barranquilla, Cartagena and Pereira,” he said.
“At the national level, we have 2,975 vaccination points equipped with cold equipment certified by the World Health Organization (WHO,” Bermont added.
CDC Mandates Covid-19 Tests International Arrivals
Meanwhile, the U.S. Centers for Disease Control (CDC) announced yesterday that starting January 26, all international airline passengers must show proof of having passed a Covid-19 infection test within 96 hours of boarding a flight to the USA from Colombia (or from anywhere else). As a result, the USA joins Colombia and some100 other nations mandating Covid-19 infection tests and/or quarantines for all international passengers.
“With the U.S. already in surge status, the testing requirement for air passengers will help slow the spread of the virus as we work to vaccinate the [North] American public,” according to CDC.
“Before departure to the United States, a required test, combined with the CDC recommendations to get tested again three-to-five days after arrival and stay home for seven days post-travel, will help slow the spread of Covid-19 within U.S. communities from travel-related infections,” according to CDC.
“Air passengers are required to get a viral test [either PCR or antigen] within the three days before their flight to the U.S. departs, and provide written documentation of their laboratory test result (paper or electronic copy) to the airline or provide documentation of having recovered from Covid-19.
“Airlines must confirm the negative test result for all passengers or documentation of recovery before they board. If a passenger does not provide documentation of a negative test or recovery, or chooses not to take a test, [then] the airline must deny boarding to the passenger,” the agency added.
