The Significance of COVID-19 Vaccination Prioritisation to the Safe Re-Opening and Management of Schools in Uganda

The government of Uganda has kept schools closed since March 2020 as a measure to manage COVID-19 health risks to learners and teachers. Accordingly, schools will remain closed until teachers and learners aged 18 and above are vaccinated. However, by September 21 2021, Uganda had only managed to acquire a very limited supply of 2,152,840 doses of COVID-19 vaccine. Of the targeted priority group of 550,000 teachers, only 17.6% had been fully vaccinated. Only 4.7% of the targeted 3,348,500 elderly aged 50 years and above had been fully vaccinated in the same priority group. Moreover, only 2.1% of the 500,000 targeted people with co-morbidities had been vaccinated.1

The Ministry of Health is guided by a values framework for prioritising use of COVID-19 vaccines in a scenario of very limited vaccines supply, to maximise benefit and minimise risks associated with COVID-19 related challenges affecting the population health, economy, social and educational functioning.

The UNITAG: COVAX working group assessed the Ministry of Health's COVID-19 vaccines prioritisation values framework to establish its significance to schools' safe re-opening and management. The initiative also involved examining other related reports from the World Health Organization2, the European Union3, as well as several research papers on the subject of burden to learners during COVID-19 related schools’ closure. The working group drew the following conclusions:
a. The guidelines provided by the Ministry of Health in COVID-19 vaccines prioritisation values framework are broad enough to direct interventions for safe re-opening and management of schools.
b. The low risk of severe COVID-19 cases among children under age 18 makes them a low priority group for COVID-19 vaccination, save for those with co-morbidities.
c. As more vaccines become available, enough to cover 10% to 20% of the eligible population, consideration should be made to vaccinate learners 18 years and above if evidence indicates that they are susceptible to COVID-19 severe disease. In the absence of this evidence, learners above 18 years should be vaccinated based on the precautionary principle.
d. Teachers and support staff should be vaccinated before re-opening schools to minimise COVID-19 related health burdens.
e. To guard against amplification of severe illness due to COVID-19 in communities, including parents, the targeted priority group of the elderly aged 50 years and above should be vaccinated.
f. Vaccination and adherence to protective and risk mitigation measures are complementary.