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Bhutan sat on coronavirus vaccines for months, awaiting auspicious rollout date — then delivered shots to 93% of adults in two weeks

A health worker administers a dose of a coronavirus vaccine to a Buddhist monk sitting in front of a portrait of Bhutan's King Jigme Khesar Namgyel Wangchuck on March 27, the first day of the country's vaccination drive. (Upasana Dahal/AFP/Getty Images)

For months, Bhutan sat on hundreds of thousands of doses of AstraZeneca’s coronavirus vaccine, waiting for the stars to align.

Despite receiving a supply of vaccines in January, the small Himalayan kingdom didn’t begin immunizing its population until March 27, a date that was selected through astrological consultations with Buddhist monks.

But once that auspicious date arrived, Bhutan made up for lost time. In less than two weeks, the country administered first doses to more than 93 percent of eligible adults, according to its Ministry of Health.

Bhutan has delivered initial vaccine doses to a larger share of its population than any other nation besides the Seychelles, and rapidly outpaced wealthy nations including Israel and the United Kingdom that have been carrying out aggressive vaccination campaigns for months. Like many other leaders in the vaccine race, it’s benefited from its small size: With only slightly less land area than Switzerland, it has less than a tenth of the people.

Bhutan has also benefited from vaccine diplomacy: India, its neighbor to the south, has been providing free doses of the AstraZeneca vaccine, manufactured in India as Covishield, in a move that analysts say is intended to counter the growing influence of Bhutan’s other powerful neighbor, China.

The first gift of 150,000 doses arrived in January, followed by additional batches, but the office of Bhutan’s prime minister, Lotay Tshering, said in a statement that no one would be getting their shot just yet because the government deemed it “important we roll out the nationwide vaccination on an auspicious date.” Zhung Dratshang, a panel of Buddhist monks that oversees the official state religion, had warned that an inauspicious month would fall between February 14 and March 13.

“We will wait until the period is over,” the prime minister’s office concluded.

As the Economist noted, allowing astrology to dictate public health decisions had some unexpected benefits. For one thing, Bhutan didn’t have to come up with a complex system to administer the vaccine to priority groups while it waited for an additional 400,000 doses to arrive from India in March. (The fact that the country has reported a minuscule number of coronavirus cases since the pandemic began and enforces a strict 21-day quarantine period for visitors made waiting to vaccinate the entire population at once a less risky gamble.)

Additionally, the swift vaccine drive could subtly ramp up pressure on India to provide the additional doses that will be necessary in roughly 12 weeks, when virtually every adult in Bhutan will be due for their second shot.

While waiting for March 27 to arrive, Tshering, a doctor by training, helped generate enthusiasm about the vaccine and addressed frequently asked questions over Facebook Live. The country’s national volunteer service corps helped set up more than 1,200 vaccination sites across the country and managed the logistics of delivering doses — a crucial task in a country that had only 37 doctors before the pandemic, according to the Telegraph. One team clad in army boots hiked through the Himalayas to deliver vaccines to six villages in six days, while helicopters made the trip to other communities where the snow was too deep.

Critically, Bhutan already had a national immunization program in place before the pandemic, meaning that the cold-chain infrastructure needed for storage didn’t have to be built from scratch.

The first day of Bhutan’s vaccine drive looked quite a bit different than in other countries: Buddhist prayers were chanted as butter lamps were lit at the auspicious hour of 9:30 a.m. The first vaccine dose was administered to a woman born in the Year of the Monkey by a nurse who had been born the same year, “in keeping with astrological requirement,” the prime minister’s office explained.

By April 8, more than 472,000 people ranging in age from 18 to 104 had been vaccinated, according to Bhutan’s Ministry of Health. Officials are now prevailing on the few remaining holdouts to get their shots, noting that King Jigme Khesar Namgyel Wangchuck has indicated that he will not get vaccinated until everyone in the country does.

“All of us must come forward, so that we make way for His Majesty to receive the vaccine as soon as possible,” said a statement from Health Minister Dasho Dechen Wangmo. “It is an opportunity to serve the aspiration of our King.”

Read more:

When smaller is better: Microstates, island nations and overseas territories speed ahead in global vaccination race

A king, a ventilator, an 8,000-mile journey: One American’s coronavirus rescue from Bhutan

India is giving away millions of coronavirus vaccine doses as a tool of diplomacy

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