Nicoya, COVID-19

Nicoya Health Area’s challenge to vaccinate the Blue Zone against COVID-19

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In Nicoya, the vaccine’s journey begins early in the morning, when the sun is just barely coming up over the Guanacaste lowlands. The nursing team, the minds responsible for the entire operation, prepare several thermos at 2° C (35° F) with about 20 doses, which they rush to give to motorcyclists to take them to each Nicoyan health center. It’s a race against time and mistakes. No injection can be wasted.

Sully Arias is the head of nursing for the Nicoya Health Area and the person in charge of the vaccination system in the canton. She was interviewed by phone at the end of her workday since the accelerated pace of vaccination doesn’t allow her to take a break until then. “We can’t afford to ruin vaccines through human error,” she said.

Nicoya was one of the first three cantons in the Chorotega region to receive vaccines for COVID-19 in January of this year. Since La Anexión National Hospital is located there, it was given priority over other locations to begin administering doses. Since then, the team hasn’t stopped working.

According to data from the Costa Rican Social Security Fund (CCSS), the Nicoya Health Area had administered 7,535 vaccines by the week of April 26 to 30: 4,995 being given the first dose and 2,540 receiving the second dose. The canton ranks third in the Chorotega region in number of immunizations, following Santa Cruz and Liberia. These three have the highest population densities.

Although Santa Cruz is the canton that has administered the most vaccinations in the entire Chorotega Region (8,536), the director of the Santa Cruz Health Area, Luis Alonso Matarrita, affirmed that the exponential increase in cases in this part of the province is delaying the process. Nicoya hasn’t yet reported a significant impact on infection rates.

Vaccinating the Blue Zone

The colonial canton faces a particular and unique challenge compared to the rest of the country. It is a blue zone, where many community members are senior citizens over 80 years of age. Health Area records indicate that there are at least 13,824 people who are eligible to be vaccinated within the second priority group (over 58 years old).

In addition, there are Nicoyan territories in places like Samara and Nosara that are up to two hours from the CCSS branch office in Nicoya. In other words, vaccination isn’t just a race against the virus but also against time.

One of the challenges arises when trying to contact the patients who will receive the doses. Sometimes the calls don’t go through because the patients are outside of the telecommunications coverage area limits. The Health team has to hurry not only in order for the vaccines to reach the EBAIS clinics in good condition, but also so the people who need them can receive them.

Immunization work days begin so early and they already know the routine by heart: the day begins and motorized personnel arrive to transport the vaccines, which are packed and sent to their destination; once in place, the patient is called and the dose is administered. That’s how it goes every day. The goal is that all the vaccines that leave the branch office arrive on time, in good condition and can be administered. They have succeeded, said Arias.

It has involved huge logistics that would not have been done without teamwork. It’s an orderly process full of challenges. In the end, this is a historical vaccination, a vaccination during a pandemic,” Arias affirmed.

The coordinator explained that the Nicoyan population, Costa Ricans and foreigners, are very committed to the vaccination process. Although there are people who have rejected the vaccine, “the vast majority are willing to get it.”

A Plan Adapted to Guanacaste

CCSS doesn’t have a national vaccination plan for coastal areas, the CCSS press department confirmed to The Voice of Guanacaste. Instead, each health area has to make its own plan, taking into account all the necessary requirements to keep the vaccines in good condition.

In Nicoya, the vaccines have to be sent from the branch office to the EBAIS clinics daily instead of sending a weekly batch to each health center. One of the CCSS’s requirements is that the doses are monitored 24 hours a day to avoid the possibility of them being stolen. Currently the district’s EBAIS clinics don’t have reinforced security to ensure that the doses are taken care of during the night. Santa Cruz is also sending vaccines to health centers every day

The amount sent to each zone depends on the level of personnel that each health center has. Arias, the head of nursing, explains that they can’t send vaccines en masse to other centers because there aren’t enough professionals to administer them in a single day. On average, they send 3 to 4 vials (bottles containing the medication) each day and, according to the Ministry of Health, each one allows around 5 to 6 doses to be administered.

Even with all the difficulties faced, the coordinator affirmed that the work is going at a good pace and that, at the rate they are going, they’ll be able to continue with the next priority group in a few weeks.

CCSS records indicate that the Nicoya Health Area has already vaccinated people over 70 with the first dose and at this time, they are dedicated to immunizing the 65 to 69-year-old group.

Even though we’re a large canton with problems of long distances and a large population, I believe that we’ve achieved a good pace of vaccination. We’re going at a similar pace to that of other cantons nationwide,” the woman in charge emphasized.

According to Arias, the Health Area has given vaccines to at least 99% of the first response teams and nearly 50% of the second priority group.

Next week, the branch office will carry out intensive vaccination days in downtown Nicoya, where they’ll vaccinate at least 300 people per day. In addition, they’ll also follow the same dynamics in Nicoyan towns with a larger number of senior citizens to finish administering doses for these groups.

The head of nursing said that if anyone has questions about when they will be vaccinated, they can call 2685-4274.