The article explains the challenge in the vaccination program for the Covid-19 vaccine.

Issue of lack of data about the vaccine

• In the COVID vaccine roll out, there is no clear data for either of the two vaccines proposed for use in the programme.
• We do not know if they provide protection for life, for a year or six months, its efficacy among the elderly or the very sick or in stopping new infections.
• Getting such data requires at least three years and cannot be obtained in a few months.

Guidelines for implementing vaccine programme

• Given these limitations, the government has drawn up strategic guidelines for implementing an vaccine programme covering 30 crore people by July.
• The guidelines draw upon the knowledge of running national campaigns acquired over three decades of implementing the Universal Immunisation Programme.
• These guidelines detail the skills, roles and responsibilities of the required human resources, logistics for delivering vaccines at point of use, physical infrastructure, monitoring systems based on digital platforms and feedback systems for reporting adverse events.
• The approach involves 19 departments, donor organisations and NGOs at the national, state, district and block level.
• The guidelines also mention the priority criteria — caregivers, front line workers of the departments of health, defence, municipalities and transportation; persons above the age of 50 and those below 50 having diabetes, hypertension, cancers and lung diseases.

Issues with the guidelines

• Of the 28,932 cold chain points, half are in the five southern states, Maharashtra and Gujarat.
• Combined with poor human resources — doctors, nurses, pharmacists — a weak private sector, poor safety and hygiene standards, frequent power outages, poor infrastructure, the capacity to implement with the expected speed, quality and accuracy is daunting.
• The immunisation can disrupt routine health service delivery — antenatal care, national programmes like those pertaining to TB or other immunisation drives.
• While data for the above-50-year-olds is available in the electoral rolls, line listing of the under 50s with comorbidities can be challenging.
• Not only are urban-rural variations substantial, but urban areas have weak public health infrastructure and a multiple number of private providers due to the poor implementation of the Clinical Establishment Act, 2010.
• Patient tracking can be problematic.
• The non-availability of efficacy data could also impact the procurement and supply of vaccines, result in huge wastage, and can introduce scope for errors and duplication.

Way forward

• Central to the success of the roll out will be the confidence of the people in the vaccines.
• Coming out of this messy situation is necessary and one option — as adopted for the polio eradication programme — is to establish an independent team of experts under the aegis of the WHO to ensure the safety of the vaccine.
• This will create confidence in the community and international authorities as well.

Conclusion

it is important to understand that vaccination is an incomplete solution to ending the epidemic, since the virus is mutating. Adopting safe behaviour is.

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