Manohar Agrani

One year, 156 crore vaccinations! That means approximately more than 42 lakh vaccinations daily. This has been an extraordinary achievement of “Team Health India”, marking a year of the Covid vaccination programme that began on January 16, 2021.

We are all aware, how several subject experts and intellectuals had expressed many doubts and misgivings.

The doubters

-- Will we be able to make vaccines available as per the needs of the country; even if they are made available, does our country possess adequate storage capacities for such huge numbers;

-- It will take too much time to develop such huge capacities;

---Even if storage is taken care of, do we have the necessary transport arrangements and trained manpower?

-- Does anyone have an idea as to how much time it will take to ready the trained manpower for the vaccination of such a large population?

-- Up until now, the country has not undertaken the vaccination of adult population. So far, under the National Immunisation Programme, vaccination had been carried out only for children and expectant mothers who constitute a very small percentage of the country’s population.

-- How will we address the apprehensions of the people regarding Covid vaccination? How will we address vaccine hesitancy?

-- How will the vaccine be reached safely and on time to far flung regions? Who will vaccinate them?

Well laid out strategy

Amidst this environment of scepticism, “Team Health India” set out to work on a well laid out strategy. We already had on our side:

-- Years of experience of running our National Immunisation Programme.

-- Experience of more than 25 years of administering polio drops to almost about 10 crore infants within a short span of time during Pulse Polio Campaigns.

-- The capacity to vaccinate more than 35 crore children up to the age of 15 years against measles and rubella.

-- The experience of storing our vaccines in more than 29,000 cold chain points and reaching them to far flung areas with consistency.

-- Successful implementation of monitoring the storage and distribution of vaccines as per prescribed standards through e-Vin (Electronic Vaccine Intelligence Network).

Team work

The Ministry of Health & Family Welfare, the Health departments of the States and UTs, the NGOs working in the health sector, international organisations etc., all of them participated in endless marathon meetings, not only ideating and consulting on every aspect of the vaccination drive, but also taking these to logical conclusions in the form of various strategies and guidelines.

It was exactly a year ago from today, before the launch of the world’s largest vaccination drive by the Prime Minister, that we set the stage having finalised the basic guidelines and having completed the necessary trainings.

We were ready with all the necessary preparations much before January 16, 2021, and foremost among these were:

--The operational guidelines for COVID vaccination.

-- Identification of necessary manpower for carrying out the vaccination and their training.

-- Building systems for reaching the vaccines safely to the vaccination centres and for extra storage capacities.

-- Formulating a communication strategy which focused on addressing vaccine hesitancy, eagerness, Covid appropriate behaviour and other similar subjects.

-- Setting up of the CoWIN platform to collect necessary details in connection with the vaccination in a digitised system etc.

Anxious moments

A ‘dry run’ had been carried out in all States/UTs to ensure readiness. There was some technical issue to resolve for which everybody had to be on vigil. It was extremely cold that night. I remember, the entire night, there was nail biting anxiety, almost akin to what scientists sitting in a command centre may experience on the launch of a space shuttle. Words fail me in describing those moments of anxious anticipation or the deep sense of satisfaction on resolving the glitch. CoWIN was successfully kick started on time.

This was just the beginning. In the first phase, vaccine availability was limited and expectations were many. Rationalised distribution of the limited number of vaccines would pose a big challenge not only for the Centre, but even at the level of States and districts. In such circumstances, criticism was inevitable. “Team Health India” however, went on to implement this successfully.

However, it wasn’t easy. To achieve this, there were virtual meetings for hours on end every day with vaccine manufacturers, vaccine transport agencies, storage centres, cold chain points and Covid Vaccination Centres. And the aim was one and only one- use of every drop of the available vaccines optimally as much as possible.

The logistics

Next, imagine how the vaccines would have reached to the far flung and remotest areas of the country. Where there was no road, cycles were used; in the desert regions, camels came to the rescue; and boats helped cross rivers; in the hills, the vaccine carriers were carried on backs. Vaccines were not only reached, they were also administered.

People were invited for vaccination with offerings of turmeric rice. For those hesitant to take the vaccination, ‘Har Ghar Dastak’ or Door to Door calling was done. In all of this, we did not follow any western model. This was a purely an Indian model. The process bore the unique stamp of India’s ingenuity.

What makes the story of one year of vaccination unparalleled is that the preparations required were enormous and time too little. We kept learning from the experiences gathered from the field, the positive feedback and suggestions and we kept working on the programme, improving it.

“Team Health India” almost forgot their own personal time, their own needs, their families, their dreams and many in fact, even lost their dear ones to Covid. But despite that, there was great pride and realisation of the good fortune, “Team Health India” had had in serving the nation in a moment of crisis.

The writer is Additional Secretary in the Health Ministry. Views expressed are personal

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