COVID-19 Vaccines Message From Mr. Adolphus Clarke Program Manager, Expanded Programme on Immunization, MOH

April 8, 2021—As a public health response strategy, the Ministry of Health (MOH) wrote for both ethical and regulatory approvals through the National Research Ethics Board of Liberia (NREB) and the Liberia Medicines and Health Products Regulatory Authority (LMHRA) based on an official request by the Ministry of Health (MoH). They make sure that individual who agree to take the vaccine are protected from the harmful effects of the novel coronavirus disease 2019 (covid-19).  If you wish to find about more about the vaccination exercise in Liberia, please call Adolphus Trokon Clarke, Director, Expanded Programme on Immunization on +231777024582 / +231886560846

Introduction

We are vaccinators and health workers, working with the Ministry of Health.

We are inviting you to take part in this vaccination response. We had a meeting with community leaders and members and told them about this vaccination exercise. You do not have to decide today about taking part. You can talk about it first with your friends, family, elders or the vaccination team before reaching your decision.

If you are pregnant and decide to be vaccinated, please consult with your physician.  If you do not wish to take part, even if your physician agrees, we will not vaccinate you. You can agree to receive the vaccine by signing your name or providing a thumbprint on the consent/assent form. We ask for your agreement but will also ask for the agreement of your physician.

Additionally, if you are above 18 years and decided to receive the vaccine, please consult with your parent or guardian.  If you do not wish to take part, even if your parent agrees, we will not vaccinate you. You can agree to receive the vaccine by signing your name or providing a thumbprint on the consent/assent form. We ask for your agreement but will also ask for the agreement of your parent or guardian before you can take part.

To help you to decide, first we will explain what is involved. Please ask if you do not understand. If you have questions later, you can also contact us.

What is Coronavirus Disease (Covid-19)?

COVID-19 is the disease caused by a new coronavirus called SARS-CoV-2.  WHO first learned of this new virus on 31 December 2019, following a report of a cluster of cases of ‘viral pneumonia’ in Wuhan, People’s Republic of China. The COVID-19 is the cause of an outbreak of respiratory illness first detected in Wuhan, Hubei province, China. This is severe disease caused by a small organism which is not visible, called a virus. The community has likely already discussed this with you.

What are the symptoms of Coronavirus Disease (Covid-19)?

The most common symptoms of COVID-19 are

  • Fever
  • Dry cough
  • Fatigue

Other symptoms that are less common and may affect some patients include:

  • Loss of taste or smell,
  • Nasal congestion,
  • Conjunctivitis (also known as red eyes)
  • Sore throat,
  • Headache,
  • Muscle or joint pain,
  • Different types of skin rash,
  • Nausea or vomiting,
  • Diarrhea,
  • Chills or dizziness.

Symptoms of severe COVID‐19 disease include:

  • Shortness of breath,
  • Loss of appetite,
  • Confusion,
  • Persistent pain or pressure in the chest,
  • High temperature (above 38 °C).

Other less common symptoms are:

  • Irritability,
  • Confusion,
  • Reduced consciousness (sometimes associated with seizures),
  • Anxiety,
  • Depression,
  • Sleep disorders,
  • More severe and rare neurological complications such as strokes, brain inflammation, delirium and nerve damage.

People of all ages who experience fever and/or cough associated with difficulty breathing or shortness of breath, chest pain or pressure, or loss of speech or movement should seek medical care immediately. If possible, call your health care provider, hotline or health facility first, so you can be directed to the right clinic.

What is the purpose of this vaccine? Many cases of coronavirus (covid-19) have been confirmed in Liberia. You have been approached for vaccine because of the risk of contracting the disease, your residence, work, or other possible contacts with a confirmed case. This public health response uses four delivery strategies (Fixed, Temporary, Outreach and Mobile) to vaccinate segment of the population in the following categories:

  • Healthcare workers
  • Elderly (60+)
  • People with underlining health conditions
  • Others (i.e., people would cannot physically or socially distance given the work or tasks being performed

The vaccine was tested in more than 10 000 persons in several countries in Europe, Africa and the United States and was found to be safe for use. The World Health Organization (WHO) says the vaccine is safe and that its benefits outweigh the risk.

What is the procedure for receiving vaccine? A qualified vaccinator/health worker will speak with you to see if you meet the conditions to be vaccinated. Before the vaccination process, a psychosocial counsellor will explain to you the important benefits associated with the vaccine and its side effects.

At the vaccination visit, a clean needle and syringe will be used to give one dose of a vaccine into the upper part of your arm. After vaccination, we will observe you for 30 minutes for any problems.

If you feel sick after the vaccination, please call the hotline number 4455 or you can call this number (0777024582) we will provide you for an on-call doctor available 24 hours.

Because we are not completely sure that the vaccine will protect you from Ebola it is very important that you try to stay away from being infected with Ebola. So, do not do the following things: touching body fluids (blood, vomit, saliva, urine and faeces), stay in direct physical contact with bodies of patients (dead or alive), touch the bedsheets, cloth, clothes, meal plates, or share bed and/or dishes of a sick person.

Can I choose not to take the vaccine? Yes. The choice is yours.  Whether you choose to say “yes” or “no” is up to you and your rights will be respected. 

Can I get COVID-19 from the vaccine? No, you cannot get COVID-19 from the vaccine.

The vaccine is against COVID-19 and cannot cause COVID-19. However, some people that get the vaccine might already have been infected with COVID-19. They might develop signs of COVID-19 after they have been given the anti-COVID-19 vaccine.  For them the vaccine did not give protection.

What happen to people who get COVID-19?

Among those who develop symptoms, most (about 80%) recover from the disease without needing hospital treatment. About 15% become seriously ill and require oxygen and 5% become critically ill and need intensive care.

Complications leading to death may include respiratory failure, acute respiratory distress syndrome (ARDS), sepsis and septic shock, thromboembolism, and/or multiorgan failure, including injury of the heart, liver or kidneys.

In rare situations, children can develop a severe inflammatory syndrome a few weeks after infection.

How many people will be given this vaccine?

We currently hoping to vaccinate in phases about 52% of our total population so that we can achieve herd immunity. We will aim to vaccinate those persons to help prevent COVID-19, and then we will also aim to vaccinate everyone in the target group, to prevent further spread of the disease in addition to the current IPC measures. Anyone 18 years and above can be considered for vaccination.

What are the possible side effects of the vaccine? Receiving the injection might hurt a little. You will feel a pinch with the needle. It can make your arm to have slight muscle aches. It might also make you feel pain at the injection site, give you a little fever (mild high temperature of about 37.8⁰C), swelling, or bruising at the injection site. This should not last too long. You may have redness or bruising where you got the shot for a few days, and there is a very small chance of infection at that spot. You might not feel any of these things. Since this is still an investigational vaccine it may cause other changes that may hurt or bother you that we do not know about.

People can have allergic reactions to vaccines, including hives, trouble breathing, or other allergic responses. This is very rare, but is also a possible effect of these vaccines. There may be other side effects that may be severe or life threatening.

If you have a fever, doctors can test to see if you have COVID-19 or something else, and give you treatment if needed. If you get a fever after receiving vaccine, you should immediately contact the contact tracing and/or the telephone numbers provided.

Information on Polio in Liberia

  • Liberia and Africa were officially certified as free from Wild Polio Virus (WPV) in August 2020 by WHO, an incredible milestone in global polio eradication campaign
  • In 2021 another type of polio virus called cVDPV (Circulating Vaccine-Derived Polio Virus) is causing polio outbreaks in 18 countries of Africa
  • As of January 2021, all three countries bordering Liberia – Cote d’Ivoire, Sierra Leone and Guinea – have reported polio outbreaks and over 100 children being paralyzed for life
  • Laboratory tests of environmental samples have already confirmed the presence of cVDPV type of polio virus circulating in Monrovia in December 2020
  • Liberia is at an immediate risk of a cVDPV polio outbreak and Liberian children are at an urgent risk of contracting this incurable disease

Polio in the World

  • COVID-19 pandemic has disrupted immunization around the world, including Liberia. From March to July 2020, 60 polio vaccination campaigns in 28 countries were suspended
  • Polio campaigns were suspended to protect communities and staff from COVID-19 impacting polio eradication efforts and increasing transmission of the disease
  • Rumors and misconceptions surrounding all vaccines, including Covid, have spread vaccine hesitancy globally including in Liberia with refusals noted among some communities
  • Africa is most seriously affected, but cVDPV outbreaks are also ongoing in the Middle East and Southeast Asia
  • In 2020 globally, over 900 polio cases were reported which is a substantial increase from 249 cases reported in 2019.
  • Polio is one of the only three diseases classified as a public health emergency of international concern along with Ebola and COVID-19 pandemic. Detection of polio is a Public Health Emergency in any country, including Liberia.

Action in Liberia

  • Based on laboratory results confirming the circulation of cVDPV polio virus in Liberia, the Government of Liberia has declared a Public Health Emergency for cVDPV polio outbreak
  • With support from the Global Polio Eradication Initiative (GPEI), which includes WHO, UNICEF, GAVI, CDC and Rotary, the Ministry of Health plans to conduct two rounds of house-to-house polio nationwide campaign with an aim of vaccinating at least 95% children aged 0-5 years while observing COVID19 protocols to ensure vaccinators, health workers and communities adhere to COVID19 precautions and are protected from COVID19.
  • With support from partners, the Ministry of Health will conduct trainings for vaccinators and other health workers on polio immunization and COVID19 precautions such as wearing of masks, keeping a safe distance and frequent handwashing with soap and clean water. In addition, personal protective equipment such as masks will be provided to all health workers participating in the polio campaign
  • To better address ongoing outbreaks of type 2 cVDPV, as recommended by WHO, the Ministry of Health plans to deploy an additional outbreak response tool, the novel oral polio vaccine (nOPV2), which is clinically proven to reduce the risk of cVDPV and is specifically designed to protect children from the only type of poliovirus that remains in Liberia

About Polio, cVDPV and nOPV2

  • Polio virus, both WPV and cVDPV, cause lifelong paralysis in children under 5 years of age
  • There is no cure for polio, but it can be prevented with two drops of the polio vaccine
  • The best protection against polio is ensuring all children are vaccinated during routine and supplementary immunization campaigns, and maintaining strong disease surveillance
  • Millions of doses of polio drops have been administered throughout the world and have saved millions of children from paralysis
  • All vaccines for children are safe even if a child is suffering from fever, cough, or diarrhea. Polio vaccine is also safe for newborns, even if they have been born a few hours ago. 
  • Polio vaccine has little to no side effects and can be given multiple times to boost immunity against the polio virus
  • If a population is optimally immunized with polio vaccines, it will be protected from all types of polio including WPV and cVDPV
  • cVDPV occurs when weakened strain of the poliovirus contained in the oral polio vaccine (OPV) circulates among under-immunized population for a long time
  • cVDPV outbreaks are stopped using same tactics that enabled progress against WPV polio, ensuring every child is given oral polio vaccine in high-quality immunization campaigns
  • nOPV2 is a safe and effective polio vaccine that has been in development for over 10 years and has been thoroughly tested in adults, children and infants across multiple countries
  • nOPV2 has been approved by the Ministry of Health and is recommended by WHO for use in controlling polio outbreaks

Public and Media Support

  • Share accurate information with the public based on this page to ensure parents are aware of the risk from polio and seek vaccination for their children
  • Counter rumors and misinformation whenever identified, without repeating the rumors, through facts and correct information on this page
  • Report rumors and misinformation to Ministry of Health at (vaccines@moh.gov.lr) so that it can be immediately responded to and stop the spread of harmful behaviors
  • Refrain from exacerbating or repeating rumors and misinformation which can result in violence against health workers
  • Maintain ethical reporting standards by protecting identities of persons infected with the disease to prevent stigmatization of patients and their families
  • Inform your families and communities about protecting themselves from contracting polio by getting vaccinated
  • Inform people to seek medical help if their child or a child in their community is suffering from sudden paralysis of one or multiple limbs
  • Post on Facebook, write stories, run radio messages and hold TV or radio talk shows to create awareness on the disease and encourage parents to immunize their children against polio
  • Use your organization’s or employer’s social media to distribute accurate information with the public based on this document so that parents in Liberia are aware of the risk from polio virus
  • Counsel and encourage parents who refuse the polio vaccine and convince them to vaccinate their children, so that their own child and other children in the community can remain safe
  • Encourage vaccinators and parents to observe all COVID preventive measures; always wash your hands with soap and clean water, wear face masks and continue social distancing
  • Encourage parents and caregivers to always take their children to the nearest Health Facility so their children can be vaccinated against all vaccine-preventable diseases
  • Reach out to Ministry of Health (vaccines@moh.gov.lr) for accurate information, clarifications interviews and support for stories

Key Messages to Use

(Approved for use by anyone and on all mediums)

  • All children in Liberia under aged 0-5 years are at an immediate risk of contracting another type of polio virus
  • Tests have confirmed that this type of polio virus is already circulating in Monrovia
  • Polio cases have already been reported in Cote d’Ivoire, Sierra Leone and Guinea
  • There is an urgent need to ensure all children aged 0-5 years are protected against polio by giving them two drops of the polio vaccine
  • Polio is a dangerous disease that has no cure and can only be prevented through multiple doses of polio vaccine
  • Polio vaccine requires multiple doses to achieve complete immunity and ensure the child’s full protection from polio; multiple dozes of the polio vaccine pose no harm to children
  • The best protection against polio is ensuring all children are vaccinated during routine and supplementary immunization campaigns
  • The Ministry of Health will conduct two-rounds of house-to-house national polio immunization campaign, dates will be announced shortly
  • All children aged 0-5 years must be vaccinated against polio with two drops of polio vaccine during the two rounds of national house-to-house polio immunization campaigns
  • The polio vaccine is free, safe and effective to protect children in Liberia from the remaining type of polio
  • Polio vaccine is given in the mouth of the child and only protects children from polio, children need other vaccines to be protected from other diseases
  • Polio drops have successfully protected millions of children around the world from polio for decades, and continuous protection is needed
  • Polio drops have safely eradicated the wild poliovirus in Liberia and other countries such as United States, United Kingdom and France.
  • Polio vaccine is recommended for use in Liberia by the World Health Organization and the Ministry of Health because it can provide continuous, urgently needed protection against the remaining type of poliovirus
  • Polio vaccine been clinically shown to be a safe option for vaccination against the remaining type of polio

Polio Frequently Asked Questions

1. What is Polio?

Poliomyelitis (polio) is a highly infectious disease caused by poliovirus, a virus which affects mostly children under the ages of 5. It has no cure, causes lifelong paralysis in children, and in some cases, it can cause death. The only way to protect children is to give them two drops of the oral polio vaccine.

2. Liberia and Africa in general was recently declared polio free, can you explain why we have an outbreak in the country despite the polio free certification?

There are two types of polio, the wild polio virus (WPV) and vaccine-derived polio (cVDPV). Africa and Liberia eradicated WPV type of polio, WPV remains only in Afghanistan and Pakistan. Liberia currently has an active outbreak with cVDPV virus confirmed in Monrovia, and over 100 cases confirmed in neighboring countries such as Guinea, Sierra Leone and Côte d’Ivoire.

cVDPV polio outbreaks occur when the weakened strain of the polio virus contained in the Oral Polio Vaccine (OPV) circulates in under-immunized communities for a long time. While Liberia has been declared free from WPV, a lot of children remain at risk of cVDPV type of polio due to the low immunization rates in Liberia and the neighboring countries.

3. Why are we reporting cases of the vaccine-derived polio in Liberia?

Vaccine-derived polio (cVDPV) continues to circulate due to the low routine and polio immunization vaccination rates in Liberia and other countries. The COVID-19 pandemic has worsened the already low routine and supplementary polio immunizations rates in the country as most activities were put on hold.

Many parents and caregivers did not immunize their children for fear of leaving their houses due to COVID-19. Rumors and misconceptions around vaccines especially Covid Vaccine created fear in communities hence people did not immunize their children.

The outbreak can also be attributed to importation from neighboring countries and poor hygiene and sanitation in the country. Liberia is amongst 18 African countries that have reported cVDPV polio outbreaks in 2021.

4. How is cVDPV polio transmitted?

cVDPV is transmitted through the oral-fecal route from one person to another. The weakened virus is excreted through feces after a child is vaccinated and could easily spread in places with poor hygiene, sanitation, open defecation and overcrowding. This weakened virus can also transmit when water, food or fingers get contaminated by stool containing the weakened virus.

5. Who is at risk of contracting polio?

Due to the low immunization rates in the country, all children aged below 5 years are at high risk especially unvaccinated children or children with low immunity. The best protection against polio is ensuring all children are vaccinated during routine and supplementary immunization campaigns. If a child is optimally immunized with polio vaccines, he/she will be protected from both all types of polio.

6. Why is it important to immunize children again and again with the polio vaccine?

Oral Polio Vaccine (OPV) requires multiple doses to achieve complete immunity in the child and ensure the child’s full protection from polio. Receiving multiple dozes of the polio vaccine poses no harm to your child and is completely safe for children.

7. Will the Ministry of Health use the same vaccine that is causing the polio outbreak to stop the outbreak?

With recommendation from WHO, the Ministry of Health plans to use nOPV2 polio vaccine to stop the polio outbreak. This vaccine is clinically proven to be safe and more effective at reducing the risk of cVDPV.

8. How do we know the vaccine against polio is safe?

Polio vaccine is the safest way to protect children from the remaining type of polio. Polio vaccine in Liberia is pre-qualified by the World Health Organization (WHO) to ensure safety and effectiveness. The vaccines are supplied through UNICEF nationwide for both routine immunization and during immunization campaigns.

Polio vaccine is safe even if the child is suffering from fever, cough, or diarrhea, and is also safe for newborns as young as a few hours old. Polio vaccine has little to no side effects and can be safely given to children multiple times. Countries like the United States, United Kingdom and France used polio vaccine to eradicate polio and protected millions of children from paralysis.

9. How does the Ministry of Health plan to vaccinate all eligible children in the country?

Through two rounds of house-to-house polio campaigns throughout the country, the MoH plans to vaccinate 95% children aged 0-5 years while strictly observing COVID19 protocols to ensure children, vaccinators, health workers and communities are protected.

11. How will the ministry ensure safety of community, health workers and children from COVID19 during the house-to-house polio campaign?

All vaccinators and health workers who will be engaged in the polio vaccination campaign will strictly adhere to the COVID19 protocols by wearing masks, keeping a safe distance while in the communities and frequently washing hands with soap and water.

Ministry of Health also urges the public to adhere to all COVID-19 protective measures and support health workers by presenting all children under the ages of 5 for vaccination whenever a polio team arrives.

12. What impact do COVID-19, rumors, misconceptions and disinformation have on the polio campaigns?

COVID-19 rumors and misconceptions have affected routine immunization services as well as polio campaigns all over the world, including in Liberia. Restrictions of movements due to COVID-19 and dissemination of false information regarding vaccines are some of the reasons that we currently have an outbreak in Liberia.

The Ministry of Health would like to reiterate that the polio vaccine is safe and has been used to avert paralysis in millions of children globally. The Ministry would also like to urge to the public to desist from spreading false information and encourages health workers, community influencers, the media and health experts to counter rumors by providing accurate information to the public.

12. What is nOPV2 and why is it being used?

nOPV2 is a type of polio vaccine that has been in development for over 10 years and has been thoroughly tested in adults, children and infants across multiple countries. It has been declared safe and effective by the Ministry of Health and is recommended for use in polio outbreaks by WHO around the world. It is the most recommended vaccine to control the remaining type of polio virus that is still circulating in Liberia. It is given as 2 drops in a child’s mouth and protects children from polio virus. It can be safely given multiple times to all children under the ages of 5, including newborns or children who have fever, diarrhea, or cough.