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TN vaccination rate among elderly population lowest, says govt data

Tamil Nadu is lagging by a big margin in comparison with Himachal Pradesh, which tops the list in the country with 146 doses per hundred elderly people.
Tamil Nadu’s vaccination of elderly is even lower than Uttar Pradesh and Bihar, the bottom two states in the Niti Aayog’s healthcare performance survey ((HT File))
Updated on Aug 04, 2021 03:53 PM IST
ByDivya Chandrababu, Hindustan Times

Chennai: Tamil Nadu has reported the lowest vaccine coverage in the 60-plus age category even as it has the fourth-highest elderly population in the country. For every hundred elderly people, Tamil Nadu has so far administered only 44 doses, based on vaccination data provided by the Centre’s CoWIN portal and as per population projections made for March 2021 by the National Commission on Population.

Tamil Nadu is lagging by a big margin in comparison with Himachal Pradesh, which tops the list in the country with 146 doses per hundred elderly people. It is intriguing why Tamil Nadu is so far behind in the inoculation drive in this age category, when it has a better public healthcare system and administration, as indicated by the Niti Aayog’s 2020 health survey.

The state government said this is due to low supply of vaccines to Tamil Nadu. Chief minister MK Stalin raised the issue in a letter to Prime Minister Narendra Modi in July. He said the number of vaccine doses provided to Tamil Nadu is only 302 per thousand eligible population, which is very low when compared states like Gujarat, Karnataka and Rajasthan, which received 533, 493 and 446 doses, respectively.

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Tamil Nadu’s vaccination of elderly is even lower than Uttar Pradesh and Bihar, the bottom two states in the Niti Aayog’s healthcare performance survey with scores of 29.2 and 32.4 respectively, while Tamil Nadu scored 60.5.

The gap between Tamil Nadu and southern neighbours is also wide. Kerala has administered thrice the number with about 133 doses per 100 elderly population. This effectively means that a 60-plus resident of Kerala is thrice as likely to receive a vaccine shot than those living across the border in Tamil Nadu. Karnataka and Andhra Pradesh have also covered the 60-plus age category twice as much as Tamil Nadu.

Since there is no data breakup of fully and partially vaccinated population in the 60+ age group, the percentage of the population vaccinated cannot be calculated. Since two doses are administered for every person, the target for every 100 elderly people should be 200 doses. So far, Tamil Nadu has administered only around 44 doses while Himachal has already achieved 146 doses per 100 elderly people.

Experts said that Tamil Nadu’s facility-based approach for vaccination dissuades the elderly, who may not be able to move around like the younger groups. (HT Graphics)

“We have to aim to reach the target of full vaccination sooner because when we are opening up, the working people and students will bring the infection back home and it will put the elders at risk,” said Dr P Kolandaisamy, former director of Tamil Nadu’s directorate of public health and preventive medicine and a member of the state’s task force to mitigate the third wave.

Besides initial vaccine hesitancy and short supplies of vaccine provided by the Union government, experts said that Tamil Nadu’s facility-based approach for vaccination dissuades the elderly, who may not be able to move around like the younger groups.

The elderly are particularly worried if they can be vaccinated when they have comorbidities.

“There is still some resistance among the elderly and the pregnant and lactating mothers,” Kolandaisamy said, adding, “Every day I get calls from people asking if they can take the vaccine if they have a cardiac condition, hypertension and diabetes and I clarify that it is safe.”

Dr Prabhdeep Kaur, deputy director, National Institute of Epidemiology, said she gets the same queries from her known circle as well as on her Twitter handle. “Not only do the elderly have doubts but there is also a misconception among some healthcare workers. From my field visits in rural and urban places, I know of incidents where vaccination centres send people back because they have high diabetes or blood pressure,” she said.

Vaccine coverage among the elderly in Chennai is better than other districts in Tamil Nadu, Kaur added.

While the vaccination of 60-plus population in Chennai was reported to be 941,159 doses, it is still lower than other metro cities such as Bengaluru (BBMP) 1,350,798 and Mumbai 1,717,931.

A senior official of Chennai corporation said that according to their data, the city’s mid-year population is 7,853,602, of which 1,871,513 are over 60 years of age. “We have vaccinated 50% of Chennai aged above 60 with at least one dose of vaccine,” the official said, not wishing to be named.

“We need to change our strategy from a hospital facility to a community-based approach. We need to increase vaccination camps, mobile vans, to target elderly who may not come forward to hospitals either because it isn’t feasible or they’re afraid they will catch an infection from there,” Kaur added.

Kaur also suggested replicating Tamil Nadu’s own approach used in childhood immunisation programmes, where the local healthcare facility has a list of eligible beneficiaries and reaches out to them. “This requires micro-planning, and they can inform the eligible population a day in advance to come to a specific street for the vaccination,” she said.

But it is still inconvenient for people like 90-year-old woman in Chennai who took her first dose of Covishield on March 12 but has been bed ridden since. Her family did not want to be identified. “For weeks we have tried reaching the corporation, the health department and the local MLAs office to request her second dose to be administered at home.

Tamil Nadu currently administers door-to-door vaccines only for people with disabilities who are immobile. “Informally, this is done for senior citizens but it will be a good idea to have a policy or an instruction to extend door-to-door vaccination for elderly who cannot move out of their home. That will be a small number anyway,” Kolandaisamy said, adding, “We also have to plan outreach programmes specifically for the elderly, pregnant and lactating women to cover them.”

Since vaccination was rolled out in India, Tamil Nadu was a slow starter in the drive as compared to other states initially due to vaccine hesitancy. “This changed only after the second wave when people saw others dying and realised the importance of vaccines,” Kaur said.

Tamil Nadu also repeatedly fell short in vaccines and was close to halting the drive several times since June. The state government said that vaccine supply was their biggest challenge. “Once supply improves our coverage will also improve,” said Dr TS Selvavinayagam, director, directorate of public health and preventive medicine. He, however, added that the supply was improving and the state is not facing acute shortage as it did before.

Recently, the state has reported zero wastage of vaccines. On July 20, data from the Union government showed that Tamil Nadu had not wasted any doses, making it the state that best utilised vaccine resources and thereby extracted additional 588,000 doses from the given supply, followed by West Bengal and Gujarat.

With inputs from Jamie Mullick

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