It is often said that the day you plant the seed is not the day you eat the fruit. Former public health specialist and head of hospital services in Jamaica Dr Deanna Ashley says her work in the Jamaica public health system over many decades taught her that behaviour-change does not occur overnight.

It took Jamaica a solid three years of work towards compulsory immunisation for children. However, 40 years ago it was easier to effect change within our populace in an era when there were only two radio stations, one television station, and one newspaper to access information. Furthermore, at that time, there was a concerted effort to bring public health care to the people through community health care.

Community health-care workers and midwives used to live amongst the people; therefore, it was easier to do follow-up primary care visits, have first responder care in the case of emergencies, create ongoing sensitisation about immunisation, and answer all questions or queries from the people within the community.

This kind of networking, in tandem with the wide range of public health services offered by over 300 community health clinics and hundreds of volunteers from across the island, was the engine which allowed Jamaica to aggressively roll out a massive immunisation campaign using an oral polio vaccine targeting all individuals under 30 years of age, with special priority for children up to 14 years on June 3, 1982. So effective was our public health synchronicity that by June 30, 1982, 65 per cent of the total population received one dose; another 641 000 doses were given six weeks later to children aged up to 14 years, a coverage of approximately 70 per cent in this age group.

These efforts not only continued, but increased, and by the 1990s we were able to eradicate polio and measles (Ashley & Bernal 1985).

Unlike the polio epidemic in the 1980s, COVID-19 and the new Delta variant have hampered our ability for real person-to-person interface. This is particularly problematic in a country in which everyone comes with different perspectives, concerns, fears, and access to a deluge of social media information. What we need is a brave commitment to arm our people with correct data so that they may be encouraged through their own choice to take a COVID-19 vaccine. This will not be easy and will take deliberate effort in time for schools to reopen and for our economy to return to full normal. We must patiently engage our people like we have never engaged them before in their communities, in their spaces, and in their language.

We must work together

Jamaica moved into limited no-movement protocol on August 22, 2021 and declared mandatory COVID-19 vaccination for children returning to face-to-face classes. Further south, Prime Minister Mia Mottley announced to the Bajan people that her Government would not be mandating COVID-19 vaccines the day before.

“We are philosophically opposed to the mandating of vaccines. That’s not who we are as a people… Before we start talking about legal opinion and the legislative framework…our first thing next week is for me to go to understand those who may still be ambivalent. We have never allowed these things to divide us as a people, and whether we support vaccinations or we don’t support vaccinations, [it] must not be allowed to divide us… To that extent, my friends, we now have to work together,” Prime Minister Mottley resolutely declared.

It is perhaps easy for Barbados to make such statements, since so far 197,038, or 68.57 per cent, of its population has been vaccinated with at least one dose of a COVID-19 shot, versus Jamaica with just over 500,000, or just under 18 per cent of our population.

The Opposition spokesperson on health Dr Morais Guy has been championing the efforts for more community interventions to help our people with their ambivalence towards the vaccine. He proposed the use of established State resources, such as the Social Development Commission (SDC), Office of Disaster Preparedness and Emergency Management (ODPEM), and others which have useful human resources for community interpersonal communication. Their engagement, in conjunction with other experts from the Ministry of Health and the mobile vaccine unit going into the communities, he believes, would help to eliminate transportation costs for citizens, especially in the rural areas, while giving them reassurance as “everyone feels more comfortable in their own community setting”.

Furthermore, I wholeheartedly support Dr. Guy’s position that private medical doctors —many of whom are prepared to give their services free — should be included as a part of the national vaccine roll-out as this would help to boost patient confidence and absorb some of the stresses off the public health sector while giving relief to public health workers.

Now with the availability of adequate supplies of AstraZeneca, Pfizer, and Johnson &Johnson vaccines in the marketplace, Jamaicans are likely to go vaccine shopping. Immunisation, however, must work together with increased public testing sites and the turnaround time for test results. The cost of testing is a small fraction compared to the costs associated with hospitalisation for COVID-19. Moreover, people who are infected and asymptomatic are unaware and, therefore, actively spreading the virus in the midst of the vaccine roll-out.

Even the strident anti-vaxxers don’t want to take the virus home to their loved ones. We must provide the same resources across the country for our people to know their COVID-19 health status. This must be a corollary campaign running side by side to the national vaccine thrust, as a part of our commitment to sensitization and awareness.

As at August 23, 2021 the coronavirus positivity rate for Jamaica was 48.7 per cent, with increased daily deaths. With the continued curfews and no-movement days it could be likely that Jamaica will get ‘red-listed’ by some of our tourism partners. This would be a catastrophic blow to our tourism sector and requires urgent intervention. The Tourism Enhancement Fund (TEF) must use its resources to assist with the establishment of public testing sites across the island, but especially within the tourism corridors.

It’s time to win the battle against COVID-19 in Jamaica. I believe in boosting your immune system, eating healthy, and exercise. These are daily practices I engage in. I am also an unapologetic vaccine advocate because I understand how vaccines have and continue to save lives locally and globally. But I am not oblivious to the fact that many of our people have concerns and fears which we must take the time to address in the same way we did with other vaccines in the past.

As we continue to grapple with the ravages of the pandemic, I urge those sitting on the fence of whether to get vaccinated or not, to consider this: Smallpox, measles, mumps and rubella are not killing our people anymore, and it is because of medical science and vaccines.

We are on a mission, Jamaica, we must all work together to improve the lives of each other.

Lisa Hanna is Member of Parliament for St Ann South Eastern, People’s National Party spokesperson on foreign affairs and foreign trade, and a former Cabinet member.