Time to Tackle Challenges In Covid-19 Vaccine Delivery In India

The Indian government aims to achieve vaccination for all adult population by the end of 2021. As covid19 is spreading rapidly, vaccination is the preventive measure took by many countries of the world. This will help in creating herd immunity that will break the chain of transmission from one person to another

India has to Face Many Challenges in Vaccination :-

1 Vaccine Inequity.

The distribution of vaccine is not equal among the urban and rural areas. Availability of vaccine is not there in remote areas of the country. It has been seen that age wise distribution also varied in the middle of crises. At world level also there exists vaccine inequity.

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2 Supply and Logistics

India ranked within the 51-75 percentile range among 89 countries on effective vaccine management as per a global analysis by WHO-UNICEF in 2018. Its performance was relatively poor when it came to following the required vaccine arrival procedures and using the MIS system for estimating demand of vaccine, syringe, etc.

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3 Vaccine Hesitancy

Vaccine hesitancy implies, fear among citizens of the potential after effects/side effects of the vaccination, so they don’t prefer to go for vaccination.

Previously it has been observed in case of the polio vaccination campaign that was started in 1995. Fake news on the social media is the prorogating factor for such problem. Some people also introduce communal basis to prevent population for vaccination.

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4 Vaccine Nationalism

Vaccine nationalism hampers supply of vaccines to the developing countries. Its simply means that the developed countries make a deal with companies to supply vaccine first to their countries and they pay large amount to these companies.

Other countries who cannot afford this, will get into trouble with shortage of vaccines in their country.

Also as per World Health Organization (WHO) Director-General Dr. Tedros Adhanom Ghebreyesus has warned that the mentality of vaccine nationalism — where countries push to get first access — puts the world on the brink of “catastrophic moral failure.”

6 Follow up and monitoring after vaccination

As the vaccination process continue to cover entire adult population there is need to follow up for any kind of after effects. This will provide the exact data for efficacy of medicine in the country. But no such efforts have been seen for monitoring the after effects.

7 Lack of funding

Proper research, infrastructure, trained professionals, and other facilities are required to deliver vaccination. That requires funding, but government is short of it.

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8 Federal divide

However, the vaccines for these were to be procured by State governments directly and the Central supply was to be used only for the 45+ population. This created a segmented market, with States vying to secure the maximum doses for themselves from the two vaccine manufactures in the country.

9 Digital divide

The digital device means the difference that is created by lack of access to technology like smartphones. As smartphones are required to provide book slots for vaccination, it is not accessible to everyone especially in rural areas.

Also, digital literacy still lacks in India. That may lead to decrease in number of doses administered in the country.

10.The Issue of Vaccine wastage

 According to the RTI information, India has wasted more than 44 lakhs of 10 crore doses (Till April 11). Tamil Nadu wasted over 12 percent, followed by Haryana (9.74%), Punjab (8.12%).  Ideally, a vaccination centre must have 10 recipients to make optimal use of a single 10-dose vial. If the person is not available then that vaccine vial becomes a waste.

Many efforts have been done by the Indian government to fight against crises and increase the administration of doses in the country.

  1. The International Monetary Fund (IMF) welcomed the steps taken by the Indian government to facilitate access to Covid-19 vaccinations and to increase the production of essential drugs required in combating the coronavirus disease.
  2. India’s vaccine management has improved over the years thanks to a real-time supply chain management system known as the electronic vaccine intelligence network (eVIN).
  3. A large percentage of those aged 18-44 years does not have the resources to pay for vaccines and hence will fall through the cracks. So, the states will have to take a leading role in free immunisation programme. While nearly two dozen states have already committed to vaccinate for free the target population, it remains to be seen if they use any criteria to identity the beneficiaries.
  4. The Indian government requires citizens over the age of eighteen to register themselves before they can be vaccinated. They have been provided the option of registering though the CoWIN website (a platform created to monitor vaccine delivery) or the Aarogya Setu app (a government-sponsored mobile application originally created for contact tracing that now also allows vaccine registration).

What’s need to be done?

  1. The new tendency of “vaccine shopping” — that is, choosing a particular vaccine, which is seen more among urban people — needs to be controlled through proper communication strategies.
  2. Local civil society organisations, NGOs, and eminent citizens need to be involved in this effort.
  3. As the digital divide will result in people being left out even when they want to get the jab. There’s a need to have spot registration and inoculation at all the centres in rural areas, so that people get acquainted with the process by the time supplies stabilise
  4. Further, there is a need to prioritise the high-risk groups — like vegetable vendors, shop owners and workers, transport workers, bank and other office employees, construction workers, essential service providers, and residents of congested slums — and vaccinate them first.
  5. Regular training, hand-holding and strict monitoring with clear accountability at all levels down to the Primary Health Centre (PHC) could accelerate accomplishment of the vaccination target.
  6. Effective distribution and delivery can be achieved through a robust PPP mechanism, which can be developed by each State as per its situation.
  7. Private hospital participation needs to be enhanced to increase administration of doses in such a vast population.
  8. Manufacture and procurement. The Indian government must proactively negotiate deals for bulk procurement of vaccines and raw materials.
  9. Efficient, expeditious and equitable vaccination mechanism is the solemn responsibility of the state and all stakeholders engaged in the process.

There is an opportunity for us to set right the recent distortion and get ready for vaccinating all our citizens by end of 2021, in the fairest manner for all.

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