Centre in UP gives different vaccines in 1st and 2nd jabs

According to guidelines, each vaccine recipient is supposed to get two doses of the same vaccine about 4 to 16 weeks apart depending on whether it is Covaxin or Covishield.

At least 20 people were each administered two separate coronavirus vaccines -- Covishield as their first dose and Covaxin as their second, or booster, dose -- by health workers at an inoculation centre in Uttar Pradesh’s Siddharthnagar district bordering Nepal border, district officials said, terming it a case of negligence.

A health worker prepares a dose of Covid-19 vaccine at the heath center in the village of Bazrak, Uttar Pradesh, India, on Monday.(Bloomberg)

An inquiry has been ordered into the case and a team of the district health department visited the spot to record the statements of villagers and health workers. “Action will be taken against those found guilty,” Dr Sandeep Chaudhary, chief medical officer, Siddharthnagar, said on Wednesday.

According to guidelines, each vaccine recipient is supposed to get two doses of the same vaccine about 4 to 16 weeks apart depending on whether it is Covaxin or Covishield.

No adverse reactions have been reported among the 20 people, the CMO said, adding that authorities were monitoring their health.

The 20 recipients -- all residents of Audahi Kalan village who are in the 45-plus age group -- were first given a dose of Covishield on April 1 at the Barhni primary health centre in the area.However, on May 14, they were accidentally administered Covaxin as their second dose by the health care workers. “When villagers visited the health centre to take the second dose, the health workers did not check the card to find out which vaccine was administered to them earlier,” said Ram Surat, a 64-year-old resident of the village who was among the 20 recipients.

The CMO, too, said it appeared the health care workers at the centre did not check the first dose certificate of the 20 people. The certificate states the type of vaccine administered to a person.

Dr DS Negi, direct general of the Uttar Pradesh health department, said the state government has sought a report from the CMO. The inquiry has been ordered against health centre in-charge Dr SK Patel, auxillary nurse midwife (ANM) Kamlawati and accredited social health activist (ASHA) Gayatri.

Some countries such as Germany and France have allowed two vaccine types (Covishield and Pfizer/Moderna vaccines) to be administered to the same recipient in some cases, but the decision was taken after studies were carried out to check for efficacy and safety. India has not permitted the same for any vaccine so far.

“We have no idea of whether Covaxin and Covishield doses can be mixed for immunisation. There have been studies abroad with the AstraZeneca vaccine (named Covishield in India) and Pfizer or Moderna vaccine that show there is no ill effect of mixing the doses and the individuals do get a good immune response. But we do not have a comparative study for Covaxin in India. These cases where the vaccine doses have been mixed due to an error should be identified and their immunological profile should be studied. Such information will be helpful especially when there is a shortage of one vaccine,” said Dr Lalit Kant, former head of the department of epidemiology at the Indian Council of Medical Research.