Kids in Delhi go without vaccine as Covid crisis unfolds
Even as the national Capital resumed the immunisation programme for newborns and infants on May 6 after a hiatus due to the nationwide lockdown from March 25, several factors such as a lack of awareness, limited staff and a majority of Accredited Social Health Activists (Asha)—who are primarily responsible for mobilising parents to take their children for vaccination—engaged in Covid-19-related work continue to impact the process. A month on, several families from marginalised sections have been left out of the immunisation coverage, posing a potential risk to the children’s health.
Several women had to give birth at home because they weren’t able to access maternity services during the lockdown. Due to this, newborns missed the dose of vaccination (BCG) given at medical facilities. The dose is crucial for newborns to develop immunity against infections and preventable diseases.
Pankaj Gupta, 28, said his wife had to deliver their child at home because the nearest hospital refused to admit her, saying that they did not have beds. “The local dispensary is closed. She is our first child and has turned a month old. We do not know where to take her after birth for follow-ups. People from an NGO had come to the area and told us that we could go to other dispensaries, but there are long queues at the centres. I don’t know how soon we will be able to get her the necessary vaccines,” Gupta, a resident of Sangam Vihar, H-block, who works as a salesman, said.
According to Matri Sudha, an NGO working in the maternity and child health sector, a sample study of 50 lactating women who gave birth around the lockdown in South, Southeast and Northeast districts, showed that a majority of them were struggling to get their children vaccinated. “Several dispensaries are closed because the doctors and the ANMs (auxiliary nurse midwife) are on Covid-duty. The health centres that are open have limited staff and long queues, as people are pouring in for all kinds of ailments and medicines. Several people leave empty-handed, daunted by the long wait in the heat,” Ravi Shankar Rai, project coordinator, Matri Sudha, said.
He added that according to several ANM and Asha workers, vaccine supply has been halted at some dispensaries, therefore, they cannot do anything to ensure timely vaccination. “The Asha workers also said that they have shifted their focus from vaccination to protection from Covid-19, as the latter is a priority,” the survey said.
A survey conducted by the Centre for Holistic Development, another NGO, found that at least eight newborns at Sarai Kale Khan’s slum clusters have been completely left out of the immunisation coverage.
Among them is the two-month-old daughter of Shahjuddin, a labourer. She has not been vaccinated since birth. Before he could arrange for an ambulance to take his wife to the nearest hospital, she gave birth to the baby at their shanty. “I don’t know where to take the baby for vaccination. Also, I am scared of exposing her to infection. Before the lockdown, some women workers would come down to take stock of new mothers and infants. They haven’t come since,” he said.
The immunisation programme, which had halted due to the lockdown enforced in March to contain the spread of Covid-19, resumed at the city’s vaccination centres in May twice a week—Wednesday and Friday. The Delhi government had urged parents to reach out to these centres. However, many said that they were either not aware of the scheme resuming or facing difficulties at the vaccination centres.
Under the government’s immunisation programme, infants, children and pregnant women are vaccinated free of cost. The vaccines include BCG, rotavirus, polio, HIV, pentavalent, measles and rubella virus to be given at the ages of 2, 4, 6,9 and 18 months.
The immunisation work is primarily carried out by Asha workers and community health workers. Kavita Yadav, state coordinator for Asha workers, All India United Traders Union Centre, said that a majority of health workers are not able to carry out door-to-door follow-ups on account of their increased responsibilities toward pandemic control measures. “From door-to-door surveys and putting up home quarantine posters to keeping tabs on people in home isolation and supplying medicines at the doorsteps of patients, Asha workers are engaged in a lot of Covid-management duties. They can’t visit new mothers door-to-door and vaccinate the children. Some of them are still visiting children in their designated localities despite the risk of contracting the infection,” she said.
Sushma, an Asha worker in Dharampura, said that she is worried about the children who haven’t been vaccinated in the last three months. “We don’t have the time to visit all families so we send them text messages about the date and venue of vaccination. But some parents work as daily labourers or domestic help and don’t have the time to bring in their children. In such cases, we ideally visit the homes and vaccinate these children. It’s not happening now because we’re busy with Covid-related work,” she said.
Another worker in Geeta Colony said that their dispensary is under construction and it is difficult for people to stand in queues for hours with their children. “Nobody is allowed inside the dispensaries now and people have to stand outside to wait for their turn. Since we have only two days designated for vaccination, there is always a long queue. Many people leave without getting their children vaccinated after standing in the heat for hours,” she said, adding even as there are proper measures in place at the dispensaries, people fear for the safety of their children.
Anju Aledia, the mother of a three-month-old girl, said that she has not visited any dispensary or private clinic yet to get her daughter immunised. “I feel it’s a risk to take children to clinics amid this outbreak. There should be separate facilities designated for children at this time,” she said.
However, the Delhi government has refuted these statements.
A senior official of Delhi’s health department, on condition of anonymity, said the department has asked dispensaries to vaccinate children whenever they come in. “When the Asha and ANM workers go to the field, they are given a list of children who need vaccination. They motivate their parents to go to a nearby dispensary and get the vaccines. As of now, these services are affected only within the containment areas, as the healthcare worker cannot enter them. Initially, the dispensaries would designate two days a week for immunisation but now we have asked them to vaccinate children whenever they come, regardless of the day, so we can vaccinate as many of them as possible. Also, we have received no reports of an increase in home deliveries. In case it happens, the vaccines are available at the dispensaries; the parents can come and get them,” the official said.
Dr Rahul Nagpal, head of paediatrics, Fortis Hospital, Vasant Kunj, said that mass vaccination has been majorly impacted because of the focus on Covid-19. “Primary vaccination schedule (before 9 months of age) must not be delayed at all, as it is crucial for a child’s health. Delayed primary vaccination exposes children to the risk of preventable diseases. We have already had a few cases of measles recently due to the delay in primary doses. For those depending on public health services for vaccination, it must be ensured that children are not left out, as the effects might appear in the next few months,” he said.