Everything you need to know about COVID-19 vaccination in South Asia

Vaccinating the world against COVID-19 is one of the largest mass undertakings in human history — and efforts are well underway.  

But no one is safe until everyone is safe.  

That’s why UNICEF is working with WHO, partners and governments across the world through the COVAX facility, a global effort to ensure COVID-19 vaccines reach the most in need — whoever they are and wherever they live.  

In 2021, COVAX aims to make 2 billion safe, effective and affordable COVID-19 vaccines available to those in the world that need them the most.  

As part of COVAX, UNICEF is leading the procurement and delivery of COVID-19 vaccines, drawing on decades of experience as the largest vaccine buyer in the world. 

We spoke to UNICEF expert Srihari Dutta, working on the frontlines of the largest health and logistics operation in history, about how vaccines are being rolled out in South Asia. 

How are countries in South Asia getting COVID-19 vaccines? 

In South Asia, vaccines are being supplied to countries in two different ways: 

1. Through the COVAX facility 

The COVAX facility (UNICEF, WHO and partners) is part of a global effort to speed up the development, production and equal access to COVID-19 tests, treatments and vaccines. 

The COVAX facility aims to make sure vaccines are equitably distributed. 190 countries have joined up so far. COVAX pools the buying power of these countries to support the development and manufacture of COVID-19 vaccines across the world. It buys vaccines directly from manufacturers, so that as vaccines become available, any country, regardless of their ability to pay, has the same access to them.  

Through this collaboration, COVAX will help countries with: 

• Early access to effective vaccines. 
• Access to the world’s largest and most diverse portfolio of vaccine candidates. 
• Securing enough vaccines for 20% of their populations.  

All 8 countries in the South Asia region — Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka — are participating in the COVAX facility.   

2. Through each country’s government  

Governments are negotiating directly with different vaccine manufacturers, and other governments, to procure vaccines for their citizens. These agreements are at different stages in each country. 

Which vaccine will my country get? 

Governments have the final say on the vaccines that will be used in their countries.

There are more than 200 vaccine candidates currently in development, with many in the final stages of approval. The COVAX facility will distribute any vaccine approved by WHO. As soon as vaccines are proved to be safe, effective, and become available, COVAX will deliver them.

WHO has already approved the Pfizer-BioNTech, AstraZeneca-Oxford, Janssen (Johnson & Johnson), Moderna, Sinopharm and Sinovac vaccines.

UNICEF has developed the COVID-19 vaccine dashboard which provides an overview of all the vaccines in the pipeline globally, their development stage and supply agreements.

For more information on the national vaccination plans in your country check with your Ministry of Health.

Who will get the COVID-19 vaccine first? 

Vaccines can only be manufactured and distributed at a limited speed — and it’s important that those who need vaccines most get them first.  

Governments are responsible for determining which groups in their country will receive the vaccine first. 

WHO is supporting governments to determine their priority groups. They have advised that priority groups should include: 

• Health and social care workers on the frontlines. 
• People over the age of 65.  
• People under the age of 65 who have underlying health conditions that put them at a higher risk of dying from COVID-19.  

Who will be the next priority for vaccines? 

After priority groups have been vaccinated, and more vaccines become available, governments will identify new priority groups.  

UNICEF is calling for governments to prioritize teachers, child protection and social workers as soon as possible after healthcare workers, to help children and communities get back to normal.  

Will vaccines be free? 

All vaccines distributed through the COVAX facility will be free. 

Governments in South Asia have not announced any plans to charge their citizens for vaccines that are part of their national rollouts.

Will I get side effects? 

All vaccines, including COVID-19 vaccines, may cause minor side effects.  

Side effects are the body's response to the vaccine and a sign that your body is building immune protection. 

Common side effects observed with COVID-19 vaccines include: 

• Some pain and swelling on the arm where you receive the vaccine.  
• Chills or feeling feverish.  
• Tiredness.  
• Headache. 
• Feeling sick (nausea). 
• Joint pain or muscle ache.  

These side effects typically go away within a few days. 

After you have been vaccinated, you will have to stay at the vaccination center for 20-30 minutes for observation. This is to monitor your reaction to the vaccine and make sure help is on hand if you do experience any severe side effects. 

Severe side effects are rare. But, if they do happen they are most likely to do so within the first 30 minutes after being vaccinated. Waiting in the center during this period, means that medical workers will be able to treat you immediately if you experience any severe side-effects. 

Can my child get vaccinated against COVID-19?

Children’s immune systems are different from those of adults and can vary significantly depending on their age.

The World Health Organization (WHO) has currently recommended the use of one vaccine – Pfizer/BioNTech – in children, starting from the age of 12 years old.

According to WHO, if your child doesn’t have a specific vulnerability or health condition, COVID-19 doesn’t pose a high risk to their health. Because of this, and to help tackle COVID-19 globally while vaccines are still in urgent supply, it’s important that vaccine doses be prioritized for the most at risk everywhere in the world, such as elderly people and frontline workers, before being rolled out to children widely — and, if they are rolled out to children, this should be after careful assessment of the risks and benefits to the child.

If your child is over the age of 12 and has a vulnerability or health condition that puts them at a higher risk if infected by COVID-19, speak to your health worker about getting them vaccinated.

In South Asia, some countries have started vaccinating children over the age of 12 who are at high risk of getting the virus or getting ill from it, and some have commenced reaching children more widely.

Most of these countries have already vaccinated a high proportion of the adults at the highest risk from COVID-19.

Check with your local health authority for more information.

All vaccines other than Pfizer/BioNTech are yet to be approved by WHO for use in children under 18 years old. This is because children were not included in the initial trials for COVID-19 vaccines, so there is currently limited or no data on the safety or efficacy of these vaccines in children.

Vaccine trials in children are ongoing and we will update the recommendations as more information becomes available.

It is important, however, to make sure that your child is continuing to receive routine childhood vaccinations. Read about how to do so safely here.

Do children need to be vaccinated for schools to reopen?

No. Safely reopening schools is not dependent on every child being vaccinated against COVID-19.

The direct health benefits of vaccination are limited for children, especially younger ones, as they have a low risk of becoming severely ill from COVID-19.

The evidence continues to show that schools are not a main driver of community transmission, and children are more likely to get the virus outside of school settings. With risk mitigation measures in place, schools can be safe environments for children.

School closures in South Asia have had a devastating impact on children’s learning and wellbeing – and children need to return to face to face learning as soon as possible.

All schools should reopen safely, without barriers, such as compulsory vaccination, which could delay or prevent the most disadvantaged children from returning.

Schools can reopen safely with sensible safety precautions in place, like access to soap and clean water, protective equipment, regular handwashing physical distancing, and the sanitization of surfaces. It’s also important that schools consider the level of COVID-19 transmission in the local area in their operational decisions. Nationwide school closures must be avoided whenever possible. 

This way we can prevent transmission and every child can get back to learning as soon as possible.  

Can pregnant women get vaccinated? 

Yes. Pregnant women can be vaccinated against COVID-19, in consultation with their healthcare provider.

Evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy, although limited, has been growing.

Based on the current evidence, experts believe that approved COVID-19 vaccines are safe, effective and unlikely to pose a risk to pregnant women or their unborn babies.

Given the current evidence — and the increased dangers of COVID-19 for pregnant women — experts say that if you are pregnant and:

Live, work or travel in places where COVID-19 transmission is high,

OR

Have other health conditions that increase your risk of getting severely ill from the virus,

      then the benefits of getting vaccinated against COVID-19 outweigh the risks.

Pregnant women at a high risk from COVID-19 include:

• Those with a high chance of being exposed to COVID-19. For example, health workers.
• Those with health conditions that add to their risk of severe COVID-19, such as diabetes and heart conditions, including high blood pressure.
• Those aged 35 years old and over.
• Those with a high body mass index.

Full information on staying safe and getting vaccinated against COVID-19 when pregnant can be found here.

Do I need to wear a mask once I’ve had the vaccine? 

Yes. After being vaccinated for COVID-19 you should continue to wear a mask, wash your hands and keep physical distance from others.  

This is because no vaccine is 100% effective. In addition, while COVID-19 vaccines have proven effective at stopping people developing the virus, we don't yet know whether they prevent people from passing infection onto others.  

This means that, until we know more, it’s vital that everyone who gets the vaccine continues to take precautions such as physical distancing, consistent use of face masks, regular handwashing with soap and clean water, and avoiding crowded places.

I’ve had COVID-19. Do I still need a vaccine? 

Yes. WHO recommends that people who have had suspected or confirmed COVID-19 still get vaccinated.  

This is because we still do not know how strong the protection that people develop after recovering from COVID-19 is  — or how long it lasts.  

This means that if you've had COVID-19 in the past, you should still get vaccinated. 

If I have COVID-19 symptoms when I am due to get vaccinated, should I go? 

No. If you have COVID-19, or symptoms that suggest you may have COVID-19, do not go to your vaccination appointment.  

This is because you could spread the virus to others at the vaccination site.  

You can get vaccinated when it has been 14 days since you last showed COVID-19 symptoms.  

How quickly could COVID-19 vaccines stop the pandemic? 

Vaccines are a gamechanger in the fight against COVID-19. But, they are not a silver bullet and won’t stop the pandemic immediately.  

Vaccination works as a protective shield — shielding the vaccinated person, and those around, them from the virus. People who are vaccinated protect those who are not. 

As more people get vaccinated, the protection within a community builds —  and the circulation of a disease is stopped or slowed. This is called ‘herd immunity’.    

But, the massive global demand for COVID-19 vaccines means that it will take months — or even years — to vaccinate enough people to build herd immunity globally.  

There is light at the end of the tunnel. Vaccines are the fastest and most effective way to get the lives of children and families back to normal again. But we must do what we can to help the process and continue protecting our families, and one another, by: 

• Washing your hands with soap and water for at least 20 seconds, or using hand sanitizer — as often as you can. 
• Keeping at least 1 metre distance between yourself and others.
• Meeting people in well ventilated, or outdoor spaces. 
• Wearing a mask when you can’t keep your distance from others, or are inside a public space. (Guidance on children and mask use can be found here.) 

This article was originally published on 17 February 2021. It was last updated on 25 October 2021. This article will continue to be updated to reflect the latest information.