Simulating COVID-19 vaccination in Trinidad and Tobago

By testing procedures, simulation exercises help prepare countries for successful vaccine roll-outs.

Rajwantee Lutchman, a registered nurse, practices the steps to administer COVID-19 vaccine during a simulation exercise at the Siparia District Health Facility on 6 March 2021. © WHO/ Kibwe Brathwaite

Trinidad and Tobago received 33 600 doses of COVID-19 vaccines through the COVAX Facility on 30 March 2021, and more vaccines are expected to arrive in the coming months.

COVAX is a global effort to accelerate equitable access to vaccines and ensure that they reach all those who need to receive them. In order to be eligible to receive vaccines via COVAX, countries must demonstrate that they are ready to use them.

During a simulation exercise on 6 March 2021, Dr Sandi Arthur answered questions from people acting as COVID-19 vaccine recipients. © WHO/ Kibwe Brathwaite

Before the arrival of COVID-19 vaccines, Trinidad and Tobago used simulation exercises to prepare and train the health workforce for the roll-out. Simulation exercises help develop, assess and test the functional capabilities of emergency systems, procedures and mechanisms to respond to public health emergencies.

COVID-19 vaccine simulations test planning assumptions and procedures in a safe and constructed environment before national vaccine roll-outs occur. These simulations help to ensure that vaccine roll-outs have the best possible chance of success.

Waheeda Abdool Solomon, the senior district health visitor (DHV), gives a visual of required storage temperature for COVID-19 vaccines. © WHO/ Kibwe Brathwaite

Modifying or building upon simulations developed by WHO and COVAX, health workers in Trinidad and Tobago were able to test and practice the planning and logistics of vaccine administration within the specific context of their country. Participants in these exercises were personnel who performed their actual responsibilities and responded as they would in a real situation. They practiced their role within the vaccine roll-out at every stage and identified where the plan and procedures were working well and where they could be improved.

Janelle Alexander plays a COVID-19 vaccine recipient as part of a simulation exercise at the Siparia District Health Facility. © WHO/ Kibwe Brathwaite

Simulations can be discussion-based or operational exercises. A discussion-based (or “table-top”) exercise is a facilitated discussion of an emergency situation, generally in an informal environment. Operational exercises include the use of drills, functional exercises, and full-scale field exercises that simulate the real event as closely as possible.

During a simulation exercise on 6 March 2021, people acting as COVID-19 vaccine recipients wait to be registered. © WHO/ Kibwe Brathwaite

A series of drills for the COVID-19 vaccine rollout in Trinidad and Tobago occurred throughout February and March 2021 at the Couva District Health Facility, Diego Martin Health Center, Siparia District Health Facility, Sangre Grande Enhanced Centre, the Chaguanas District Health Facility and Scarborough Health Centre.

They enabled the development of a standard operational procedure for the roll-out, including providing immunization cards and ensuring a 30 minute post-vaccination monitoring period for all COVID-19 vaccine recipients. The simulation exercises were built upon a long history of a successful expanded immunization program and encapsulated health system strengthening.

The exterior of the Siparia District Health Facility in Trinidad and Tobago. © WHO/ Kibwe Brathwaite

During the vaccination drill conducted at the Siparia District Health Facility in Trinidad, multiple scenarios were simulated at once to test preparedness and vaccine readiness. These included responding to a COVID-19 vaccine recipient who had decided to take the vaccine, a potential recipient who was undecided, walk in recipients with no appointments, a recipient with an allergic reaction to the vaccine, and a recipient who declined being vaccinated.

PAHO/WHO Representative Dr Erica Wheeler takes notes while observing a simulation exercise. © WHO/ Kibwe Brathwaite

The COVID-19 vaccination endeavour is one of the biggest in history. It is critical that all countries are prepared and on board. Operational simulation exercises allow countries such as Trinidad and Tobago to stay one step ahead in the global fight against COVID-19 as well as for an effective and efficient vaccine roll-out.

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The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 150 offices, to promote health, keep the world safe and serve the vulnerable.

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