Covid Vaccination

The precarious second wave of COVID-19 infections has hit India with greater ferocity than the first.

Second wave of corona virus infections:

• India’s aggressive second wave of corona virus infections marked by over 3,50,000 cases a day and many deaths is clearly the result of lowering of guard against covid early in the new year.
• After prematurely assuming that COVID-19 was virtually over, governments made rash decisions to allow large religious gatherings and political campaigns with little regard for disease control.
• The lapse is now also threatening a nascent economic recovery.

Shortcomings in the healthcare system

• Consistent shortage of beds and ventilators has exposed the systemic issues with healthcare system.
• Temporal and spatial unavailability of oxygen across the country is proving to be fatal for the patients
• Undue pressure on the already limited and exhausted workforce of healthcare professional
• Black marketing of essentials like oxygen cylinder, medicines like remdesivir highlights lack of proper management and monitoring across the system.

Vaccination as solution 

• Vaccination drives across the country with Covishield and Covaxin jabs have been initiated since January.
• Recent data suggests the efficacy for both vaccines from preventing covid infection is over 70% and over 90% for preventing fatality due to covid.
• Vaccination coverage is set to expand in forth phase from May 1, including everyone aged 18 and older.
• In the first three phases, when healthcare workers, frontline workers, and those above the age of 45 were vaccinated, the Centre procured the entire quantity of vaccines from the manufacturers, Serum Institute of India (Covishield) and Bharat Biotech (Covaxin), and distributed it to states.
• The states distributed the stock to government vaccination centres, which administered the vaccine free of cost, and to private hospitals that charged recipients Rs 250 per dose.
• From May 1, the supply will be divided into two baskets: 50 per cent for the Centre, and 50 per cent for the open market.
• Through the second non-Government of India channel, state governments, private hospitals, and industries that have facilities to administer the vaccine, will be able to procure doses directly from manufacturers.
• The Centre will allocate its 50 per cent share to states based on the extent of infection (active cases) and performance (speed of administration)

Challenges of mass vaccination against Covid

• Vaccine Shortage: At the optimistic rate of three million doses a day, it would take at least 260 days from today for every adult to get at least a single shot.
  Given the shortage of vaccines, India cannot afford to have a single or universal policy and needs to make it more targeted.
• Under Financing: It is unclear if merely the policy move of liberalizing vaccine supply will leave States in India with the finances and negotiating power to procure enough stocks of vaccines.
• Shortage of Raw Material: The inability of getting the much-needed raw materials from the United States – bags, vials, cell culture media, single-use tubing, specialized chemicals, etc. till now has disrupted the vaccine production in India.
• Vaccine Hesitancy- propagated by fake news and unauthorized and unconfirmed sources have made common citizens vary of opting for vaccines.

Steps needed to resolve issues with accelerated rollout of the vaccine

• International collaboration- from countries like usa to ensure availability of raw materials for vaccine production as production capacity is sufficient in the country alongwith accelerated availability of international vaccines by companies like Moderna, Pfizer etc.
• Financing- alternate sources of funding the vaccination need to be sought. For e.g. A legitimate source of funding vaccine purchase is health insurance. All health insurance companies, including those providing State-sponsored Ayushman Bharat, can legitimately be asked to provide for procuring vaccines for everyone who is insured with them.
• Train more vaccinators for delivery closer to home, stepping up daily administration rates at more centres.
• The benefit of currently available vaccines is to provide protection against severe disease, not infection per se. Mass Awareness campaigns to ensure improvement of vaccination drives across the country by releasing the clinical trial data to boost confidence of citizenry in the vaccines.

Other alternatives which will supplement vaccination

1. Preventing super spreader events- a ban on large gatherings, Travel restrictions etc.
2. household surveillance of symptomatic individuals by primary health-care teamssupported by citizen volunteers
3. Symptomatic but negative persons and household contacts should be re-tested three to five days later but wear masks and observe isolation
4. Contact tracing needs to be conducted with speed and efficiency.