Fatma El Zahra, a 68-year-old housewife, patiently awaits her turn to get the coronavirus vaccine at Al Khabeery clinic in Maadi, one of nearly 140 vaccination centers set up nationwide in recent weeks by the Ministry of Health and Population. The Egyptian government has stepped up its vaccination campaign of late, expanding its vaccine rollout to include the elderly and people with chronic diseases after several weeks of vaccinating health practitioners on the frontlines of the battle against the COVID-19 pandemic, as the Egyptian cabinet announced in early March.
"I registered on the Health Ministry vaccination website yesterday and almost immediately received a message on my cellphone scheduling my appointment for the following day," Zahra told Al-Monitor. "My brother, his wife and my nephew have all been vaccinated so I thought why not me?"
Unlike many in Egypt, Zahra is not too concerned about the vaccine's possible side effects.
"The vaccine will protect me," she said. "Even if I get infected with the coronavirus the symptoms will be milder."
Like many of the other vaccination centers in Egypt that have been overcrowded in recent days, Al Khabeery clinic is teeming with visitors — the majority of them elderly citizens. A nurse told Zahra she is No. 77 on the list and has to wait nearly two hours for her turn to get her AstraZeneca shot.
Ilham Ismail, director-general of the Maadi Health Department, attributes the high turnout for vaccines at Al Khabeery clinic to the fact that it is located in Maadi, one of Cairo's more affluent neighborhoods. "The majority of the residents here are well educated and more aware of the dangers of the coronavirus," she explained.
"Yesterday we vaccinated more than 260 people," Ismail said. "The highest number we have had so far is 300 vaccine-takers in a single day; we have had to extend our opening hours to 10 p.m. daily during Ramadan to accommodate everyone."
Ismail added that the British-Swedish AstraZeneca vaccine was being administered to all except those with chronic illnesses. "The latter receive Sinopharm shots," she said. Up until 10 days ago, there had been a shortage of people, including doctors, willing to take the shot. Several weeks after the launch of the Health Ministry vaccination website in late February, a mere 600,000 people, out of a population of more than 100 million, had signed up to get vaccinated by the first week of April. But that appears to be changing due to a recent surge in coronavirus cases in the country.
On April 20 Egypt recorded 855 new cases and 42 COVID-19 related deaths, raising the total number of infected cases to 215,484 and the number of fatalities to nearly 13,000. Health officials, however, believe the numbers are likely far higher due to low coronavirus testing rates and the exclusion of private hospitals' test results.
By April 13, a total of 355,104 vaccine doses had been administered, according to the World Health Organization (WHO) website. The figure is a drop in the ocean for the Arab world's most populous country where low transparency and lack of trust in the country's health-care system have hampered efforts to contain the spread of the coronavirus.
Many Egyptians had initially been reluctant to get the vaccine, choosing instead to adopt a wait-and-see approach.
Some Egyptians cited "lack of information" as a reason for their vaccination apathy.
"We know nothing about the vaccine or where to apply to get it," complained Hassan Mahmoud, who works as a porter in a residential building in Maadi.
Others cited safety concerns, fearing the vaccine may harm rather than protect them.
"We are still unsure about the safety of the vaccines as they were developed far more quickly than other vaccines in the past," Amina Yehia, a marketing consultant told Al-Monitor. "It is best to wait, especially as the vaccines we have here do not prevent infection altogether."
Her concerns, shared by many Egyptians, are not entirely unjustified. While clinical trial data for the vaccines authorized by Egypt suggest they are safe and effective, new reports have surfaced in recent days indicating the Anglo-Swedish AstraZeneca — one of the two vaccine brands administered in Egypt — was possibly linked to a rare blood clotting disorder.
Meanwhile, the head of the Chinese Center for Disease Control and Prevention has conceded that the effectiveness of the Chinese Sinopharm, the alternative vaccine on offer to the Egyptian public, is "not high" and "may require improvements," according to The Washington Post.
Russia's Sputnik V vaccine, also approved by the Egyptian Drug Authority, remains off-limits to the public despite media reports late last year that Russia had agreed to supply Egypt with 25 million doses of the Russian-manufactured vaccine.
Egyptians do not have the luxury of choosing which vaccine to take. A shipment of more than 850,000 doses of the AstraZeneca vaccine arrived in Egypt in late March — the first of several planned shipments that will ultimately make 40 million vaccine doses available in the country via COVAX, a global initiative led by UNICEF, the WHO and other partners, and which aims at a more equitable distribution of COVID-19 vaccines worldwide.
The March 31 shipment came on the heels of earlier shipments of 650,000 doses of the Sinopharm vaccine, donated by the Chinese government.
On April 21, a health ministry source told Masrawy news that an agreement would be signed later that same day with the Chinese pharmaceutical company Sinovac for Egypt to locally manufacture the Chinese vaccine at the state-owned Vacsera Holding company, producing 20 million doses annually. The move will allow Egypt to meet local demand for the vaccine and also enable the country to export the vaccine to African countries, according to Al Arabiya.
The government recently announced plans to locally manufacture the Chinese vaccine, saying it had allocated two factories owned by the state-owned company Vacsera for the production of the vaccine. Escalating its vaccination push in recent weeks, the Ministry of Health increased the number of vaccination centers nationwide in late March, from the original 40 to a total of 138, in the hope of encouraging more citizens to register. The government has also announced it would expand its vaccine rollout to include those working in such vital, labor-intensive sectors as tourism and construction.
In another move to accelerate the country's vaccination drive, the government has responded to protests by some members of parliament who had earlier called for the suspension of parliamentary sessions until all deputies are vaccinated.
On April 12, parliament Speaker Hanafy El Gebali announced that the Ministry of Health would dispatch a medical team to the House of Representatives to vaccinate lawmakers. Responding to criticism from some social media users that the move was "discriminatory," Gebali argued, "the deputies represent the people and are as entitled as everyone else to seek protection."
But some skeptics like Mona Mina, former member of the Medical Syndicate, dismissed the recent measures as too little, too late.
Mina attributed the country's low vaccination rates to "the vaccine's inaccessibility."
"Many of those who wish to get vaccinated — including doctors — have no access to the vaccines; they have registered and are still waiting for their turn," she said. "We need greater accessibility. We also need to ensure that vulnerable groups are vaccinated before others as this is not always the case," she told Al-Monitor, citing cases of healthy, young people who have been vaccinated while doctors are still waiting for their turn.
She noted, "We also need awareness campaigns with respected figures that can convince the public of the need to get vaccinated so that everyone can be protected."
Mina lamented the high rates of infection and fatalities especially among doctors whom she reminded "have repeatedly complained about lack of protective gear and equipment at hospitals."
She added, "Some of their calls to be tested have also gone unanswered."
In the past week alone, three doctors died of coronavirus-related complications, raising the number of COVID-19-related deaths among health practitioners to 450.
Stressing the importance of making the vaccine accessible to health workers, UNICEF representative in Egypt Jeremy Hopkins warned in early April, "It is a race against time to end the pandemic and vaccinate people. In this race, it is critical that as many safe and effective vaccines as possible are available to health workers."
Mina also blamed the high infection rate on the easing of restrictions on the part of the government and citizens' apathy vis-a-vis the pandemic. In attempts to contain the spread of the virus, Egypt briefly enforced a partial lockdown for three months in the spring of last year that included a nighttime curfew and the closure of schools, restaurants, and places of worship. But the restrictions were lifted in late June and the country has since returned to a state of "normalcy," save for the face masks that remain obligatory in public spaces and social distancing rules, which are rarely observed.
Mina warned that with Egyptians observing Ramadan, the situation could get worse. Traditionally, the Muslim fasting month is characterized by family gatherings for the iftar meal and evening communal prayers. While the government has banned the annual banquets (charity meals for the poor) and public gatherings during the fasting month, mosques remain open for communal evening prayers.
Health officials warn that if the current state of public apathy vis-a-vis the pandemic continues, the consequences could be "dire" for the entire country. Ironically, the government has yet to announce plans of a second lockdown or at least tighter restrictions to curb the spread of the virus.