To do a billion vaccinations

As India has successfully started its vaccination drive, with more than two million inoculated, there lies a promise of a better year ahead. However, the fight against Covid-19 is far from over, and for the vaccination drive to be successful on a large scale, it is essential to do a long-term risk analysis of the various challenges that can arise in the course of vaccine delivery.

Umpteen number of things could go wrong during the process and, as such, it is essential that a detailed vaccination programme is ideated upon before implementation.

Over the years, India has put in considerable effort to make itself the vaccine manufacturer hub of the world and, as such, vaccine manufacturing will not be an issue in the long run to meet domestic demand. The main problems with the Covid-19 vaccine in the near term will however remain, namely, dealing with infrastructure woes, trained manpower, efficacy, vaccine disinformation, and cost of the vaccines.

Trained manpower : A large number of trained manpower will also be needed in the vaccination process, especially for the elderly. As most of these are two-dose vaccines, it needs to ensure that every person gets two doses of the same vaccine. This will happen only with trained manpower is at hand. Right now, the vaccination is being done in controlled settings, to healthcare workers. Real problems could start when mass vaccinations commence to the public at large.

Data, testing and tracing : Data is another sore point in the current testing and tracing scenario. If the government is not forthcoming with accurate data, it will create obstacles during the vaccination process. Antigen tests need to be reported accurately so that an informed decision can be taken during vaccination. If accurate data is not reported on who has been previously infected or not, it will create problems during the vaccination process, as the science is not yet precise on whether infected people can be vaccinated.

There should be an equally efficacious regime for the collection of data relating to adverse effects of the vaccines administered in different age groups where India’s track record has not been very inspiring.

Storage and transport : Two of the most efficacious vaccines from Pfizer and Moderna require ultra-high cold storage facilities, and India has very little of those. Moreover, according to the Comptroller and Auditor General (CAG) report from 2017, many States lack not just ultra-high cold storage facilities for vaccines but also have no deep freezers, ice-lined refrigerators (ILR), and vaccine carriers to maintain the vaccines at the prescribed range of temperature.

The government needs to quickly ramp up the procurement of cold-chain storage systems; else, it will not be able to meet the considerable demand for vaccination in the country.

A key driver during previous vaccination programmes has been the high level of trust entrusted into the process by the public. However, if the current process continues to be opaque, it will not be easy in the long run to get people vaccinated. With the rise of social media apps, it will not take long to spread fake news about the vaccine and the vaccination process.

Bust myths, misinformation

The rise of anti-vaxxers has been a perplexing dilemma in modern societies, and it is crucial that the government takes the lead in busting myths and misinformation around vaccines and increase awareness on the adoption of vaccines and their benefits. We are already seeing hesitancy among healthcare workers in receiving the vaccines due to unclear data and concerns over safety and efficacy of the vaccines.

Hence, it is imperative that the government puts the data of all vaccine candidates on trial in India in public domain to be independently verified by domain experts. Moreover, political leaders should vaccinate themselves on live television to inspire confidence among the citizens and remove any doubts about the vaccine’s efficacy.

The government had the foresight to establish a Vaccination Task Force even in August, which deals with all issues including vaccine production, tracking and storage. State governments have also established special task forces to figure out the logistical challenges in delivering the vaccines to the last mile.

As different vaccine candidates are under consideration in India, the government would be well-advised to choose those which are more effective in producing an immune response and not those that are most cost-effective or cheaper. Moreover, the government should also try not to differentiate between geographies by introducing different vaccines at different places. Citizens should have multiple options to choose from, and the government should not decide it for them.

If the vaccination is well-planned and done collaboratively, it could be a remarkable case study for the future.

The writer is BJD MP (Rajya Sabha) and a former Civil Servant

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