THIMPHU, Bhutan — The Lunana space of Bhutan is distant even by the requirements of an remoted Himalayan kingdom: It covers an space about twice the scale of New York Metropolis, borders far western China, consists of glacial lakes and a number of the world’s highest peaks, and is inaccessible by automobile.
Nonetheless, most individuals dwelling there have already acquired a coronavirus vaccine.
Vials of the Oxford-AstraZeneca vaccine arrived final month by helicopter and have been distributed by well being staff, who walked from village to village by means of snow and ice. Vaccinations proceeded within the space’s 13 settlements even after yaks broken a number of the discipline tents that volunteers had arrange for sufferers.
“I received vaccinated first to show to my fellow villagers that the vaccine doesn’t trigger dying and is secure to take,” Pema, a village chief in Lunana who’s in his 50s and goes by one identify, mentioned by phone. “After that, everybody right here took the jab.”
Lunana’s marketing campaign is a part of a quiet vaccine success story in one in every of Asia’s poorest nations. As of Saturday, Bhutan, a Buddhist kingdom that has emphasized its citizens’ well-being over national prosperity, had administered a first vaccine dose to more than 478,000 people, over 60 percent of its population. The Health Ministry said this month that more than 93 percent of eligible adults had received their first shots.
The vast majority of Bhutan’s first doses were administered at about 1,200 vaccination centers over a weeklong period in late March and early April. As of Saturday, the country’s vaccination rate of 63 doses per 100 people was the sixth highest in the world, according to a New York Times database.
That rate was ahead of those of Britain and the United States, more than seven times that of neighboring India and nearly six times the global average. Bhutan is also ahead of several other geographically isolated countries with small populations, including Iceland and the Maldives.
Dasho Dechen Wangmo, Bhutan’s health minister, attributed its success to “leadership and guidance” from the country’s king, public solidarity, a general absence of vaccine hesitancy, and a primary health care system that “enabled us to take the services even to the most remote parts of the country.”
“Being a small country with a population of just over 750,000, a two-week vaccination campaign was doable,” Ms. Dechen Wangmo said in an email. “Minor logistic issues were faced during the vaccination but were all manageable.”
All of the doses used so far were donated by the government of India, where the drug is known as Covishield and manufactured by the Serum Institute of India, the world’s largest vaccine producer. Bhutan’s government has said it plans to administer second doses about eight to 12 weeks after the first round, in line with guidelines for the AstraZeneca vaccine.
Will Parks, the representative in Bhutan for UNICEF, the United Nations agency for children, said the first round was a “success story, not only in terms of the coverage but also in the way the vaccination drive was executed collectively from the planning to the implementation.”
“It involved participation from the highest authority to local community,” he said.
The campaign has relied in part on a corps of volunteers, known as the Guardians of the Peace, who operate under the authority of Bhutan’s king, Jigme Khesar Namgyel Wangchuck.
In Lunana, eight volunteers pitched field tents and helped carry oxygen tanks from village to village, said Karma Tashi, a member of the government’s four-person vaccination team there. The tanks were a precaution in case any villagers had adverse reactions to the shots.
To save time, Mr. Tashi said, the team administered vaccines by day and walked between villages by night — often for 10 to 14 hours at a time.
The yak damage to the tents wasn’t the only hiccup. Some villagers did not initially show up to be vaccinated because they were busy harvesting barley, or because they worried about possible side effects. “But after we told them about the benefits, they agreed,” Mr. Tashi said.
As of April 12, 464 of Lunana’s 800 or so residents had gotten a first dose, according to government data. The population figure includes minors who are not eligible for vaccines.
Health care in Bhutan, a landlocked country that is slightly larger than Maryland and borders Tibet, is free. Between 1960 and 2014, life expectancy there more than doubled, to 69.5 years, according to the World Health Organization. Immunization levels in recent years have been above 95 percent.
But Bhutan’s health system is “hardly self-sustainable,” and patients who need expensive or sophisticated treatments are often sent to India or Thailand at the government’s expense, said Dr. Yot Teerawattananon, a Thai health economist at the National University of Singapore.
A government committee in Bhutan meets once a week to make decisions about which patients to send overseas for treatment, Dr. Yot said. He said the committee — which focuses on brain and heart surgery, kidney transplants and cancer treatment — was known informally as the “death panel.”
- On April 13, 2021, U.S. health agencies called for an immediate pause in the use of Johnson & Johnson’s single-dose Covid-19 vaccine after six recipients in the United States developed a rare disorder involving blood clots within one to three weeks of vaccination.
- All 50 states, Washington, D.C. and Puerto Rico briefly halted or advisable suppliers pause the usage of the vaccine. The U.S. army, federally run vaccination websites and a number of personal firms, together with CVS, Walgreens, Ceremony Support, Walmart and Publix, additionally paused the injections.
- Fewer than one in one million Johnson & Johnson vaccinations at the moment are beneath investigation. If there may be certainly a danger of blood clots from the vaccine — which has but to be decided — that danger is extraordinarily low. The danger of getting Covid-19 in the US is much increased.
- The pause may complicate the nation’s vaccination efforts at a time when many states are confronting a surge in new circumstances and searching for to handle vaccine hesitancy.
- Johnson & Johnson has additionally determined to delay the rollout of its vaccine in Europe amid issues over uncommon blood clots, dealing one other blow to Europe’s inoculation push. South Africa, devastated by a extra contagious virus variant that emerged there, suspended use of the vaccine as properly. Australia introduced it could not buy any doses.
“I don’t suppose they might deal with the surge of extreme Covid circumstances if that occurred, so it’s important for them to prioritize Covid vaccination,” he mentioned, referring to Bhutan’s well being authorities.
Bhutan has reported fewer than 1,000 coronavirus infections and just one dying. Its borders, tight by world requirements even earlier than the pandemic, have been closed for a 12 months with few exceptions, and anybody who enters the nation should quarantine for 21 days.
That features the prime minister, Lotay Tshering, who received his first vaccine dose last month while in quarantine after a visit to Bangladesh. He has been supporting the vaccination effort in recent weeks on his official Facebook page.
“My days are dotted with virtual meetings on numerous areas that need attention, as I closely follow the vaccination campaign on the ground,” Dr. Tshering, a surgeon, wrote in early April. “So far, with your prayers and blessings, everything is going well.”
The economy in Lunana depends on animal husbandry and harvests of a so-called caterpillar fungus that is prized as an aphrodisiac in China. People speak Dzongkha, the national language, and a local dialect.
Last year, the drama “Lunana: A Yak in the Classroom” became the second film ever selected to represent Bhutan at the Academy Awards. It was filmed using solar batteries, and its cast included local villagers.
Lunana’s headman, Kaka, who goes by one name, said the most important part of the vaccination campaign was not on the ground, but in the sky.
“If there hadn’t been a chopper,” he said, “getting the vaccines would have been an issue, since there’s no access road.”
Chencho Dema reported from Thimphu, and Mike Ives from Hong Kong.