Nestled against China's far western border, Bhutan's remote Lunana region boasts some of the world's highest peaks and remains inaccessible by road. Yet, most residents there have received their first COVID-19 vaccine dose.
In a remarkable feat, the Buddhist kingdom of Bhutan delivered first doses of the AstraZeneca vaccine to over 478,000 people—more than 60% of its population, including over 93% of eligible adults. At the time, this placed Bhutan sixth globally, surpassing rates in the UK and US. All doses were donated by India, where the serum is produced.
The bulk of these first doses were administered across roughly 1,200 vaccination centers in just one week at the end of March into early April. Bhutan strategically waited for full delivery before launching the campaign. But reaching Lunana posed a unique challenge.
This glacial, peak-dotted Himalayan area, isolated from the world, required ingenuity. Under King Jigme Khesar Namgyel Wangchuck's directive, eight dedicated volunteers—known as Peacekeepers—helicoptered in.
Health workers then trekked village to village through snow and ice, carrying vaccines, tents, and oxygen. To maximize efficiency, they vaccinated by day and hiked at night—10 to 14 hours per leg. Yaks occasionally raided their camps, adding to the hardships.
Some villagers hesitated, busy with barley harvests or wary of side effects. Yet, success prevailed. Lunana's village chief, Pema, told The New York Times, "I got vaccinated first to show my community it's safe and doesn't cause death. After that, everyone followed." Vaccinations covered all 13 settlements, with 464 of about 800 residents dosed by mid-April.
This efficient campaign was vital for one of Asia's poorest countries. Bhutan's free healthcare system relies on external support; complex cases like brain surgeries, transplants, and cancer treatments are referred to India or Thailand at government expense, notes Dr. Yot Teerawattananon, a health economist at Singapore's National University.
A weekly government committee prioritizes such referrals. Dr. Teerawattananon warns a severe COVID outbreak would overwhelm this setup, underscoring vaccination's priority.
Complementing the drive, Bhutan closed borders (with exceptions) and enforced 21-day quarantines for entrants. To date, it has recorded fewer than 1,000 cases and just one death. Second doses are slated 8-12 weeks after the first, per Oxford University's guidelines.
