Safe COVID-19 vaccines for the most vulnerable

Government of Japan and UNICEF help fight COVID-19 in the most remote parts of Thailand through safe vaccine storage and transfer

Monruedee Jansuttipan
A nurse vaccinate elder who live in remote village.
UNICEF Thailand/2022/Sukhum Preechapanich
23 March 2022

To step up the fight against COVID-19 in the most remote parts of Thailand such as in Mae Hong Son Province, it takes the precisely coordinated work of healthcare workers and the temperature-controlled storage and transport of life-saving vaccines.

Medical staff administers COVID-19 vaccine
UNICEF Thailand/2022/Sukhum Preechapanich
Medical staff administers COVID-19 vaccine at the vaccination site at Khun Yuam hospital, Khun Yuam district, Mae Hong Son province.

Although more than 70 per cent of the population in Thailand has been fully vaccinated, there remain ethnic minority and vulnerable groups living in remote areas that cannot readily access COVID-19 vaccines. With restricted movement and limited access to healthcare and transport, many families with children and elders are left vulnerable to infection. By the end of 2021, less than 50 per cent of the population in Mae Hong Son had received the first dose of the COVID-19 vaccine.

“The risk of the vaccines losing their potency was the main reason that healthcare workers were most concerned about delivering vaccines beyond the hospital,” said Dr. Supat Jai-ngam, Director of Khun Yuam Hospital in Mae Hong Son Province. “At first, we mainly carried out vaccination at the hospital and, later on, were able to start working with Sub-district Health Promoting Hospitals to deliver vaccines to people.”

Vaccines must be continuously stored in a limited temperature range from the time they are manufactured to the moment of vaccination, or else they lose their ability to protect against the disease. In partnership with the Government of Japan under its Last One Mile Support initiative, UNICEF procured and delivered 1,720 cold boxes and 1,000 vaccine carriers for the Department of Disease Control of the Ministry of Public Health to ensure that families living in remote areas can access life-saving COVID-19 vaccines and children can receive timely routine vaccines.

Woman open vaccine cold box.
UNICEF Thailand/2022/Sukhum Preechapanich
Cold boxes and vaccine carriers procured with support from the Government of Japan help ensure that vaccines are safe to administer to people in remote villages.

About a two-hour drive from Khun Yuam district, the detour from the main road means navigating endless dirt roads and up and down hills to reach the villages. But that hasn’t stopped determined nurses from the Khun Yuam district making the long and difficult journey to help protect people in need from COVID-19.

One of the first nurses to make this journey was Supachai Euemanee from Mae Ki Sub-district Health Promoting Hospital. Together with 10 nurses from other hospitals in Khun Yuam district to help administer vaccines, a doctor to help ease vaccine side effects and a pharmacist to ensure safe vaccine transfer, Supachai travelled to each remote village in an ambulance provided by Khun Yuam Hospital.

Supachai said that at first, people didn’t want to get vaccinated against COVID-19 as they thought they won’t be affected, living up in the hills. But then, there were COVID-19 cases among their children who were infected while in the city, so they became fully alert to the health risks.

“When we arrived in the villages, there were so many people waiting in line to get vaccinated. There weren’t enough vaccines to meet their demand back then,” he said.

Supachai Euemanee from Mae Ki Sub-district Health Promoting Hospital.
UNICEF Thailand/2022/Preechapanich
Supachai Euemanee from Mae Ki Sub-district Health Promoting Hospital.

Through managing the vaccine supply, storage and transfer in Khun Yuam district, the pharmacist Kamonrat Thongrak plays a crucial part in ensuring the supply matches the number of people registered at hospital vaccine centres and in remote areas nearby.

“First, we need to get the schedule and requested number of vaccines from each Sub-district Health Promoting Hospital and then make a request one week in advance to get the vaccines from the main ultra-cold chain freezer at Srisangwan Hospital in Mae Hong Son city, which is 1 hour and 30 minutes away. These vaccines are then thawed and ready to transport in cold boxes for storage in regular fridges at Khun Yuam Hospital,” Kamonrat explained.

The pharmacist went on that although remote villages are only 10-30 kilometres from the main district, they take 2-3 hours to reach by car.

“Cold boxes help keep the vaccines at the right temperature, which is 2 to 8 degrees Celsius. Vaccines need to be kept in good condition when stored and transferred, avoiding any shaking, which brings the risk of creating bubbles or sediments, and therefore the loss of the vaccine potency,” said Kamonrat, who also prepares extra doses in case some vaccines lose their potency or there is more demand than expected.

“More is better, as more and more people want to get vaccinated. The more cold boxes and carriers, the more vaccines reach people.”

A nurse making her way to a remote village with a vaccine carrier.
UNICEF Thailand/2022/Sukhum Preechapanich
A nurse making her way to a remote village with a vaccine carrier.

Through these great efforts, Khun Yuam district now leads with 90 per cent of the population receiving the first dose and 50 per cent receiving the second dose.

This success also comes from the help of village health volunteers, such as Patcharin Buakham from Mae Ma Hin Luang, who works to improve vaccine literacy in the village.

“At first, there were only groups of village health volunteers and village leaders of about 7-8 people travelling to get vaccinated at the hospital. When the villagers saw that we were fine, they also wanted to get vaccinated but didn’t have cars or family members to take them to the hospital. Bringing vaccines to the area has really helped them,” said Patcharin.

The most vulnerable groups in the village requiring vaccination include pregnant mothers or families with children and elders who cannot travel.

A young mother with her baby at a village’s vaccination point.
UNICEF Thailand/2022/Sukhum Preechapanich
A young mother with her baby at a village’s vaccination point.

One of them is Panaeka Bumrungkiatsakul, a 77-year-old villager who is partially blind and has a condition that severely limits his movement. Eue-eue Chomchobdee, a 59-year-old villager, also faced hardship in getting vaccinated. She takes care of her grandchildren and her mother who has a disability.

The cold boxes, vaccine carriers and dedication of healthcare workers are helping villagers like Eue-eue receive the full vaccine dose without stepping out of the village. This has also saved Kannikar Chompoo, who was eight months pregnant, from riding a motorcycle for three hours to the main hospital for her vaccination.

Khun Yuam district aims to vaccinate people with their third booster dose before the Songkran holidays when many families get together, so hospitals will be maximizing the use of cold boxes and vaccine carriers to reach the most remote and vulnerable groups.

Since the beginning of the outbreak in 2020, the Government of Japan has supported Thailand’s COVID-19 response through several timely initiatives. These cold boxes and vaccine carriers in particular will help support vaccination efforts in over 970 local health facilities nationwide across 77 provinces.

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