Bhutan may soon become the first country in the world to administer the first doses of COVID-19 vaccine to all its eligible population.

This small country in the Eastern Himalayas bordered by China and India occupies an area of 38,394 squared kilometers, making it a bit smaller than Switzerland. It has a multiethnic population of 760,000 inhabitants. While it has had a hereditary monarchy since 1907, the country became a parliamentary democracy in 2008.

Bhutan has already vaccinated 466,811 people in the last nine days, which is 85% of the eligible population and 62% of Bhutan’s total population. The second dose of the vaccination program is already scheduled eight to 12 weeks from now – depending on the arrival of more vaccines from India over the next few months.

As a gift from India, Bhutan received in January 150,000 doses of Covishield vaccines manufactured by the Serum Institute in India – followed by a second shipment of 400,000 vaccines in March. India has also supplied Bhutan with medicines and medical supplies, including paracetamol, PPEs, N95 masks, test kits, and x-ray machines.

The second batch triggered the start of the vaccination campaign across the country last week. Bhutan’s health minister initially said the country would vaccinate its entire adult population within a week of launching the campaign. While the goal wasn’t met, it came down close.

The government ensured the vaccines reached all parts of the country, setting up 1,200 vaccination sites operated by doctors and health workers and distributing vaccines with airplanes and helicopters. Some vaccinators even walked for days through rough and mountainous terrain to reach remote villages in the country and make sure everyone.

An ‘auspicious’ vaccination

Interestingly enough, Bhutan waited for an ‘auspicious’ time to start its vaccination campaign. It didn’t start vaccination in January, when it received the first batches, instead waiting for the ‘right time’.

“Once we have the required number of doses, our plan is to vaccinate the entire population… in one week,” the prime minister’s office said in a statement in January. It was “important we roll out the nationwide vaccination on an auspicious date,” he added.

That meant that Bhutan authorities waited until the passing of an ‘inauspicious’ month to start vaccination.

“Upon consulting with Zhung Dratshang (the Commission for Monastic Affairs), we were informed of dana (inauspicious month) which falls between February 14 and March 13. We will wait until the period is over,” the statement said.

Buddhist astrologers advised the government that a woman born in the year of the monkey should be chosen as the first person to receive the vaccine. Ninda Dema, a 30-year-old Bhutanese woman, was the chosen one. She received the shot at a school-turned vaccination center in the capital Thimphu amid chanting of Buddhist prayers.

The national government imposed a strict lockdown in December after the number of infections rose sharply, and has barred foreign tourists since March. So far 873 cases of Covid-19 and one death have been reported since the start of the pandemic, according to data from Johns Hopkins University.

Sangeeta Thapliyal, professor of Inner Asian Studies at Jawaharlal Nehru University, told The Independent that the country was able to contain the spread of the virus despite limited medical infrastructure. The pandemic “brought out a national preparedness and response plan” that was quickly implemented, he argued.

While the speedy vaccination is very good news, local media outlets have reported signs of complacency and carelessness by those who received their first shot. This includes a relaxation of social distancing and the use of face masks, for example, as people stop following health protocols – vital to prevent the spread of the virus even after vaccination.

“Very few people are following the health protocols seriously, including physical distancing,” a Thimphu city resident told Kuensel newspaper. “Hand-washing taps in front of shops and public places are not in use anymore. People have forgotten the hand sanitization and hand-washing protocols.”

World’s Health Organisation’s (WHO) country representative in Bhutan, Dr Rui Paulo de Jesus, told Kuensel that people will have to continue using face masks, avoiding crowds and washing their hands regularly despite receiving the vaccine. “We still don’t know how long the immunity from the vaccine will last and also how the disease will evolve,” he added.

At the same time, Bhutan’s Health Ministry has repeatedly informed the public that an individual can be considered fully vaccinated after receiving the two doses of the vaccine and a cushion period of two weeks. This would happen towards the end of June or the start of July, considering the vaccination schedule for the second dose.

This isn’t the first time Bhutan has made headlines for an admirable campaign. Bhutan is the world’s first “carbon negative country,” absorbing more greenhouse gases than it produces. The country managed to do this despite increasing tourism, by instilling sustainability at every level of society. The country’s constitution mandates that 60% of the country must remain a pristine forest, and Bhutan only allowed TVs starting 1999. Tourists must also pay a hefty sustainability fee when visiting the country, a fee that is used towards sustainability, but also education and alleviating poverty.