Vaccination lagging, govt appeals against hesitancy
There are at least three states where fewer than 40% of people turned up for coronavirus vaccination, top government officials said on Tuesday, calling hesitancy among doctors and nurses “upsetting” and issuing fervent appeals for them to come forward.
The remarks were made at the government’s weekly briefing on Covid-19, which was opened by Union health secretary Rajesh Bhushan, who said three regions – Tamil Nadu, Puducherry and Punjab – vaccinated fewer than 40% of their targets. Figures released later showed till Tuesday, 631,417 people have been inoculated in 11,660 sessions – translating to a coverage rate of 54 people per session, nearly half of the 100 identified as an appropriate threshold.
Officials who asked not to be named said the situation is now so serious that in All India Institute of Medical Sciences (AIIMS), where the health minister and a bevy of top officials launched the mammoth vaccination drive on Saturday, did 55 vaccinations on Tuesday, a day after doing only 8.
Staff in other hospitals across Delhi now fear that vials of vaccine may go to waste if they don’t have 10 people to administer doses to within four hours of opening a vial.
“If doctors and nurses are declining to take vaccines, it is upsetting. The government appeals to you – please come don’t be reluctant. Because we don’t know how the pandemic will shape up in the coming days,” said VK Paul, Niti Aayog member (health).
Paul and Bhushan said that three days of vaccinations have shown that adverse reactions were lower than what has been seen globally, and the adverse effect following immunisation (AEFI) monitoring mechanism was robust enough to catch any problems. Bhushan said the number of mild AEFIs – reactions such as pain, nausea, mild fever – were reported in 0.18% of people vaccinated till Monday night. Severe AEFIs, which required hospitalisations, accounted for 0.002% of the immunisations.
“Look at the data, look at the AEFI surveillance system we have put in place. This system has been built over two-and-a-half decades. We should have faith on such a system. If something serious comes up, we will respond to it. But if there isn’t, why are we afraid? Vaccine hesitancy among health workers should end,” Paul said.
Paul added that by India’s capacity and speed, health care workers in the country can be vaccinated “in a matter of not even months, but days”, and this, he said, could allow all health care services to be opened up.
“We are very fortunate that we are able to begin vaccinations when our pandemic is under control. In this period, the most we can vaccinate, we must. We will reach vaccine-induced herd immunity soon,” he said.
His appeal was reiterated by Indian Council of Medical Research (ICMR) director Balram Bhargava. “As we approach half a million vaccinations, it’s very clear both vaccines are very safe. There are three things we must remember about Covid vaccines: they do not cause Covid-19, they prevent Covid-19 infections, and they prevent Covid-19 deaths. The time to take a vaccine is now, when we can break the chain of transmission,” he said.
Tuesday’s 54% vaccination rate was only marginally better than the 50% seen till Monday. According to preliminary figures released by the Union health ministry late in the evening, there were 3,800 sessions across the country throughout the day and roughly 180,000 vaccinations were done.
AIIMS director Randeep Guleria told HT in an interview on Monday that some of the hesitancy has been fuelled by misconceptions about vaccines in general and due to misplaced concerns about safety of the two vaccines being used in India in particular. The problem is exacerbated by the fact that one of the vaccines, Covaxin made by Bharat Biotech, is yet to draw any significant clues from Phase 3 trials.
The other factor hampering the colossal exercise has been glitches in the digital tool to identify and track recipients. The government moved to address problems with the Co-WIN mobile application after complaints from states. The app identifies 100 recipients for a particular session and triggers automatic SMS alerts. But as selected recipients failed to turn up, vaccinators discovered a flaw in the design that would not allow them to call in others instead – this problem was rectified on Tuesday.
“We have made a provision in the app to also accommodate beneficiaries scheduled to take the jab on other dates. Earlier, the software wasn’t designed to accept beneficiaries outside the day’s list,” said Dr RS Sharma, chairman, empowered group on Covid-19 vaccination.
The application is particularly crucial because India has created a matrix of recipients based on their vulnerability to the disease and their likelihood of catching the virus. First among the priority groups are health workers, who will be followed by frontline essential workers like police and cleaning staff, and ultimately people above 50 and those younger but with associated comorbid conditions.