After enduring 40 kph winds and freezing sea spray, jostled healthcare providers arrived wet and cold on two Maine islands in the North Atlantic late last month to administer COVID-19 vaccinations.
As they came ashore on Little Cranberry Island, with a population of 65, residents danced with excitement.
“It’s a historic day for the island,” said Kaitlyn Miller, who joined a friend in singing the song I’m Not Giving Away My Shot from the Broadway show Hamilton when the crew arrived.
Around the world, it is taking extra effort and ingenuity to ensure that vaccines get to remote locations. That means shipping it by boat to islands, by snowmobile to Alaskan villages and via complex waterways through the Amazon in Brazil.
Before the COVID-19 pandemic is over, drones, motorcycles, elephants, horses and camels will have been used to deliver vaccines to the world’s far corners, UNICEF immunization chief Robin Nandy said.
“This is unprecedented in that we’re trying to deliver a new vaccine to every country in the world in the same calendar year,” he said.
Although the vaccination rollout has been choppy in much of the world and some places are still waiting for their first doses, there is an urgent push to inoculate people in hard-to-reach places that might not have had COVID-19 outbreaks, but might also not be well-equipped to deal with them if they do.
“It’s a race against the clock,” said Sharon Daley, medical director of the Maine Seacoast Mission, which is providing shots on seven of the state’s islands.
Although COVID-19 vaccinations can present unique challenges, including adequate refrigeration, healthcare providers are fortunate to have an infrastructure in place through the systems they use to conduct childhood vaccinations for measles and other diseases, Nandy said.
In the rough and roadless terrain of southwestern Alaska, the Yukon-Kuskokwim Health Corp chartered planes and used snowmobiles to deliver vaccines to nearly four dozen villages spread out over an area the size of Oregon.
The vaccination effort there began in December last year, when temperatures still hovered around minus-20oC to minus-30oC and workers had to ensure that the vaccine did not freeze in the syringes’ needles.
Despite the challenges, the company delivered thousands of doses to 47 villages within a month.
In one village, residents were anguished after COVID-19 killed one person and sickened two others, including the local health worker.
“People were just really desperate to get vaccinated there, and it was pretty emotional to just kind of be able to bring something to them, to protect them,” said Ellen Hodges, an official at the company.
In India, workers trekked to Bahakajari, a village along the mighty Brahmaputra River in the northeastern state of Assam, to start vaccinating its nearly 9,000 residents.
The vaccines were first sent to the nearest town, Morigaon, before they were transported the final leg by vehicle.
People from a nearby island were brought to the village health center by boat. By the end of the day, 67 had received a vaccine, with officials planning to vaccinate 800 more within the next three days.
In Brazil, remote Amazon communities presented a challenge that meant traveling for hours on small planes and boats. Like many remote locales, getting the vaccine to the villages was important because most local communities have only basic medical facilities that are not equipped to treat severe COVID-19 cases.
Just like in other parts of the world, including the US, healthcare workers had to overcome the challenge of persuading some people that it was safe and important to get vaccinated.
“Vaccine hesitancy is a complex issue, and it’s extremely important that high-quality information is provided to all groups within society,” said a spokesperson for the public-private partnership GAVI, the Vaccine Alliance, which is focused on improving vaccinations in poor countries.
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