Vaccination and the Overseas Territories: A Great Success Story

By Craig Brewin, craig.brewin@fotbot.org

The roll-out of the COVID-19 vaccines is continuing at a remarkable pace, with over 200 million people having been given at least one dose. The fact that half the doses have been given in the USA, with the rest predominantly in Europe and China, has raised concerns about vaccine nationalism, but that was always likely to happen. While it is true that no one is safe until everyone is safe, the wealthier nations would see this as, to use an airline analogy, putting their own mask on first.

The UK announced back in October that its Overseas Territories would be given priority and supplies began arriving in January this year. These were initially for those with the storage facilities required for the Pfizer vaccines, with deliveries of the Oxford vaccine arriving in the other territories the following month. As a result, the BOTs are now the most COVID-vaccinated places on earth, with Gibraltar running way ahead of the rest of the world, helped by a minuscule 3.5% refusal rate. Commonwealth countries are currently looking elsewhere: St Kitts and Nevis is receiving Russian vaccines, Antigua and Barbuda get theirs from India, and Dominica is one of 53 countries currently getting China’s vaccine.

Take-up in the OTs is not just down to availability, and the territories all launched take-up and anti-disinformation campaigns. “A vaccine is the way out for us” announced the Cayman Premier, Alden McLaughlin, and he promised to loosen Cayman Island’s very tight entry restrictions after the vulnerable had been protected. The islands have had no community transmissions since last summer, but this has come at a cost. There are restrictions on who can visit, regular testing of the non-symptomatic, testing on arrival, electronic tagging of those in quarantine and prison sentences for those who breach it. Educational material, including a video, were produced long before the vaccines arrived on the islands.

The OTs had also developed complex ways of ensuring their economies could still function in advance of the vaccines arriving. Anguilla’s approach is very creative, with tourists able to visit the island, providing they remain in a bubble for any stay less than two weeks. But this does allow supervised excursions to designated places that ensure no contact with the local population. This process is expensive to administer, and the visitors have to pay.

McLaughlin is keeping his promise to relax entry restrictions in the Cayman Islands at the end of March, and the quarantine period for those vaccinated is to be reduced. He recently announced that over 90% of the 5,000 over 60’s living on the island had now received the vaccine. This was “a much-anticipated milestone” he said. 30% of the population has now had at least one dose, and the aim is to get to 70%-80% before they consider opening the borders. We have “a ways to go still” said McLaughlin “but we’re certainly well on the way”. Cayman’s third delivery is this month, with another due in April.

The former Premier of the Turks and Caicos islands, Sharlene Cartwright-Robinson, described their take-up campaign as “aggressive.” “The vaccine was created to save lives,” she said, “and to protect persons from this highly contagious virus. We want the people of these Islands not to consumed by the fear generated by myths and false information about the vaccine and the virus. I urge the public to follow the Ministry of Health’s advice to read credible health information and to do their research seeking guidance from reputable health organisations only. We all must do our part to ensure that our family, friends and work colleagues remain safe, healthy and COVID-19 negative. If taking a vaccine will assist in ensuring the health of our population, then that is what we must do.”

The British Virgin Islands had also set an ambitions target. The Premier, Andrew Fahie, announced that he was aiming to vaccinate the entire population, and his campaign kicked off with senior health staff taking the vaccine in public alongside government and opposition politicians. Even St Helena is up to 24 doses per 100 population, which puts them around 20th in the world rankings.

This week Gibraltar launched its plans to re-open, which it has called “Operation Freedom.” All of it's adult population has now been vaccinated, making it the first juristiction in the world to do so. The take up has been helped by the highly concentrated population and the daily migration on and off the territory. It is actually “Operation Freedom with Caution”, said Health Minister Samantha Sacramento. She said: “Being vaccinated is absolutely no carte blanche to then behave without any restrictions. But then, we also have to go back to being a little bit more human, being able to breathe fresh air.” Gibraltar is currently developing an App that will record vaccination and test data in the hope of attracting visitors back to the peninsula.

The least successful Overseas Territory is Montserrat. But even it, with 20 doses per 100 population, has one of the highest take-ups in the world. However, the number registered is still well below the 1,500 needed to use up its first delivery. The Premier and the Governor were both vaccinated publicly, but the take-up campaign has been relatively low profile compared to elsewhere.

Overall, the vaccination programmes in the OTs have been a success, with some territories even ahead of the UK. With the USA now joining COVAX, the global distribution alliance, greater attention can be given to other countries that need support. No one is safe until we are all safe.