Gujarat completed its third dry run for Covid-19 vaccination on Tuesday, covering nearly 30 district and seven municipal corporation areas.
Who gets the vaccine first and when?
State immunisation officer Nayan Jani, who is overseeing the vaccine delivery modalities in Gujarat, said that an estimated 4.30 lakh health workers are due to be the first-phase beneficiaries. As per the central government, both COVID19 vaccines – Bharat Biotech’s Covaxin as well as Serum Institute’s Oxford-Astrazeneca are due to be supplied, based on availability. The vaccination is expected to commence in 15 days in Gujarat. Jani added that another estimated six lakh frontline workers, which includes police and defence personnel and government functionaries, are expected to be vaccinated in the second phase. Data collection for third phase – population above 50 years of age – and fourth phase – population less than 50 years of age with serious comorbidities – are currently continuing.
How will a beneficiary know the date of vaccination?
Beneficiaries, whose details are on the Co-WIN software including name, contact and photo, will be notified at least 24 hours in advance of the date, time and address of their vaccination site. A photo ID and a phone message to confirm their identity will have to be presented at the vaccination site.
Once the vaccine is administered, the details of the same will be updated on the software and a message will be sent. From the vaccination room, they will then be taken to the observation room for 30 minutes. Details of the next dosage date will be orally conveyed. Notably, most district administrations are striving to designate schools as vaccination centres, so as to not disrupt ongoing health services at healthcare centres.
How will routine immunisation programmes work?
According to Jani, existing cold chain points (facilities where vaccines are stored for a limited time and taken to the vaccination site) which are more than 2,200, would be occupied only upto 60-70 percent. “Additionally the government of India has given us (Gujarat government) 169 in-line refrigerators specifically for storing COVID19 vaccine have been added, as have been walk-in coolers and walk-in freezer. Total ILRs including the new ones, now stand at nearly 2,500,” says Jani.
What are the logistical challenges?
A challenge several district level health officers and medical officers cited was converting primary, urban primary, urban, and community health centres (PHC, UPHC, UHC, CHC) as vaccination points, as it may result in disruption of regular health services, including routine immunisation programmes and institutional deliveries. Further, pulse polio (oral polio vaccine) drive commences on January 17, thus posing a challenge with respect to deployment of manpower, storage, vaccination sites and other logistics. As was also pointed out by district level health authorities, there has been no communication yet on whether the Covid-19 vaccine will be in dry form or liquid form, as storage logistics require to be handled accordingly. Neither is there a clarity on whether vaccines will be delivered in multiple-dosage form or single dosage form or if all vaccine demand will be delivered immediately or in a phased manner.
While most districts did not report a network issue, given that a large part of the vaccination exercise will be technology-driven over the Co-WIN software, an Ahmedabad district health official said that a meeting was expected to be held with central and state authorities to report on the feedback or challenges that were reported during dry runs and to find workarounds. For plausible network related issues, it was likely that district officials may be told to keep physical records of those eligible for vaccine, as a back-up measure.
Meanwhile, in districts such as Banaskantha that has historically seen low immunisation (45% were routinely immunised as per NFHS- 5), apart from those registered for the vaccine, a challenge anticipated is eligible beneficiaries especially those above 50 years and those below 50 years but with serious comorbidities, not turning up at the vaccination sites. To remedy the same, the local district administration is relying on not only political and religious leaders but also dairy unit leaders, given the district’s diary-focused trade.
While dry runs until now have focused on the vaccination site-related logistics and handling of the beneficiaries who arrive at such spots, fine tuning of broader logistics of the vaccine remains.
Who will bear the cost?
While those in the four priority groups are expected to be vaccinated free of cost, the Gujarat health department did not comment on cost-related queries for others.
However, addressing the media on January 2, Deputy Chief Minister Nitin Patel, who also holds the health portfolio, had said, “The Government of India has not decided on the cost of the vaccine. But I want to promise the people of Gujarat that when the state government has treated Covid-19 patients without taking a single rupee in the government hospitals or in the private hospitals designated by the municipal corporation, whatever is needed to be spent will be done by the state government and I trust that Prime Minister Narendra Modi will help the state. As far as possible, we will not burden the people of the state with the cost of the vaccine.”
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