With the rollout of the first doses of the Covid-19 vaccine having begun in the United Kingdom, Mumbai too is gearing up for a large-scale immunisation drive having identified 1,300 vaccinators, 1.25 lakh health workers as shortlisted beneficiaries, and a soon-to-be set up central storage space for 1.2 crore doses in Kanjurmarg.
On Tuesday, 60 staffers working in the health post on the first floor of the five-storey BMC building in Kanjurmarg were moved out as the structure gets transformed to store the city’s entire stock of vaccine vials and syringes.
“We are converting the first floor into storage space because it has ramp access. The transport vehicle will directly come into the storage facility without exposing the vials to sunlight. We will have to break a wall to create a doorway for that,” a civic official said.
The 5,000 square feet area will have two walk-in coolers that are 40 cubic metres and can store 50-60 lakh doses each. Each cooler will have a backup facility in case of power outage. There will be one dry storage room for syringes and needles, one cold storage room to store vaccine carriers and ice packs, one workshop for maintenance of equipment, and a room to ‘condition’ ice packs.
“Each time the vaccine has to be transported, ice packs have to be first kept at room temperature to slightly melt them. If the vaccine directly comes in contact with frozen ice it may get spoilt,” a civic official explained.
A BMC team had visited Pune’s National Institute of Virology and National Cold Chain Resource Centre to prepare the layout for the storage facility. The location has been chosen keeping in mind its access to the highway and easy connection to South Mumbai. Officials said the facility will be ready this month.
While BMC is yet to hear from Bharat Biotech on vaccine packaging and usage, Serum Institute of India has informed BMC that the Oxford-Astra Zeneca vaccine will come in a 5 ml vial. Each person requires a 0.5 ml dosage, and each vial can be used to immunise 10 people.
Once the immunisation process begins, each beneficiary will receive an SMS informing them about the location and time for vaccine dosage. “The process is app based. We have fed data of all health workers on the software. An automated message will be delivered to beneficiary days before vaccination,” said a doctor from the public health department.
Mumbai has registered 1.25 lakh public and private healthcare providers for the first phase of vaccination. For now BMC intends to start vaccination drives in its four medical colleges and a few peripheral hospitals. For that it will procure 17 iced line refrigerators to store the vaccine.
A vial once removed from cold storage can be sustained for 8-10 hours, so civic officials plan to micro-manage its transport. “We will start training for logistics handling. The challenge is to arrange and administer the right vaccine when the person comes for a second dose. When two or more vaccines are approved, our officials will have to manage all that,” a public health department official said.
The BMC has experience of paediatric mass immunisation. Officials said this will be the first time mass adult immunisation is undertaken.
“We plan to follow the measles-rubella vaccine campaign,” the official said. Each vaccination centre will have three rooms, one to register the beneficiary, second to give immunisation shots and third to observe them for half an hour for adverse reaction.
Both the Covishield and Covaxin require two shots given 28 days apart. BMC plans to utilise 1,300 health workers who are already part of a regular immunisation programme to provide Covid vaccines.
With the Centre directing states to not compromise on other immunisation drives, civic officials say their manpower will be stretched to its limit.
“Each vaccination centre will have a team to address adverse reactions. If a beneficiary has an adverse reaction to a vaccine, they will first be inspected by the health workers and then referred for hospitalisation,” a health official said.
Each beneficiary will be asked to download a mobile app on which his first shot will be registered and dates and timing of the second shot will be displayed. A vaccination certificate will be provided. Civic officials are worried if a beneficiary decides to not turn up for second dosage.
That may waste resources spent in administering the first dose.x