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Saturday, August 20, 2022

Four PHCs in rural UP, 2 causes of vaccine dip: hesitancy, wastage fear

Apart from the shortage of vaccine, these are some of the other key factors that are hamstringing the vaccination drive across Maharajganj district in rural Uttar Pradesh.

Health workers wait for beneficiaries at Kritpipra PHC. (Express photo by Praveen Khanna)

VACCINE HESITANCY fuelled by lack of communication, difficulty in registering online — and worry over vaccine wastage.

Apart from the shortage of vaccine, these are some of the other key factors that are hamstringing the vaccination drive across Maharajganj district in rural Uttar Pradesh.

Maharajganj faced a fierce second wave with an active case peak of 2,096 cases on May 14, and daily peak of 688 on May 13. In the first wave last year, the active case peak was 879 on September 3, with a daily peak of 120 on September 15. On Friday, the district had an active case load of 1,298 with a total of 113 registered deaths.

On May 22, the Cowin dashboard showed 1.74 lakh vaccine doses had been given in a district with population of 26.85 lakh.

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Initially, in step with the rest of the country, vaccinations showed an upward trajectory from March 1 when they were opened for senior citizens and those above 45 years with co-morbidities: 3,700 from March 6-12 to 24,852 from March 13-19. Since then, the numbers have dropped with the dashboard showing 4,530 vaccinations from May 15-May 21.

The Indian Express visited four Public Health Centres in the district on May 18 to find why numbers are slipping — vaccination has not started for 18-44 group.

PHC Mansoorganj
Available slots at 8 am: 100 Covishield
Doses given till 12.20 pm: 0


It is 10:30 am and ANM Priyanka Kumar tells a queue of 11 that vaccines are on the way. An hour later, a blue box of 100 Covishield doses arrives on a motorcycle from the Community Health Centre (CHC). Vaccines are available once every two-three days. But even in this hour, problems have arisen. Kumar explains to a 76-year-old man that the gap between doses has been extended to 84 days, and he won’t get his second today. Three others have left, irritated at the delay. Of the rest, two are unable to register on the app, and are assisted by the lab technician.

It’s 15 minutes past noon, and the remaining seven have registered and been tested, but vaccination has not started. Says R P Singh, the doctor in-charge: “Each set of Covishield vaccines comes in a set of 10. If you don’t have ten people, the remaining shots will have to be thrown away. We are waiting.”

Ghughuli PHC in Maharajganj district lies deserted. (Express photo by Praveen Khanna)

PHC Maulaganj
Available slots at 8 am: 99 Covishield
Vaccine doses given till 1 pm: 0


At 12.45 pm, there are two people waiting on a bench outside the hall. The doctor in charge doesn’t want to be identified. “No vaccinations have happened today,” she says. “There are two reasons. One is the change in rules for second doses of Covishield, so we are turning people away. We give them a fresh date. Secondly, only two people have turned up. So we can’t open a vial,” she says. Outside, one of the two, Narender Singh, says: “I wasn’t even going to come, my son in Delhi told me to. I have been waiting since 9:30 am, I am going to leave now.”

PHC Kritpipra
Available slots at 8 am: 100 Covishield
Doses given till 3 pm: 6

The PHC in Kritpipra has been shifted to the neighbouring village of Khempipra. The approach road is barely motorable, with villagers crossing fields for half a kilometer on foot. Inside, six staff are waiting. “This is a daily wait. People think that the rich have got good vaccines, and the poor are getting bad ones. They believe vaccines are killing people. We have ASHA workers who go house to house to say this is not true. But there needs to be more communication,” says Dr Priyanka Gupta.

For a change, this PHC has not waited for a quorum of 10. Six people have been vaccinated since the morning, and there is hope that four more will come. “They should open up vaccinations for 18-44 year olds. Then entire families will get it done together,” says Gupta.

PHC Ghughuli
Available slots at 8 am: 100 Covishield
Doses given till 3.45 pm: 22


In Ghughuli, the vaccination drive is taking place at the new Community Health Centre, which is nearly 2 km from the PHC listed on Cowin. At the CHC, 22 people have been vaccinated by 3.45 pm, and there’s still about an hour to go. But the space designated for vaccinations is empty and staff are leaving. “We start at 9.30 am and go on till 3.30 pm,” said Murari Prasad, an accountant who has been put in charge of the CHC due to “shortage of staff”.

Within minutes, a man arrives on a motorcycle, glances at his watch and asks the empty hall loudly, “Koi hai? Teeka lagwana hai (Is anyone there, I want to get a shot)”. The response is quick: “Today the vaccination is shut. Come tomorrow.”


When contacted by The Indian Express, Jayant Narlikar, Commissioner (Gorakhpur division), said: “The PHCs you visited have a predominantly rural population. Definitely, when there is a lockdown — and in April we had a so-called peak of infections — people’s movement outside their homes was restricted.”

Narlikar said that “by and large”, the vaccination drive has been “good”. “Maharajganj may be a little lesser but we are telling them. For example, the government has launched monitoring committees to do surveillance. When these workers are going house to house, they are not just trying to identify symptomatic people but they are also asking them if they have been vaccinated. In a week’s time, vaccinations will pick up again,” he said.


Narlikar admits there is a tenuous balance between vaccinations being imperative, and vaccine wastage. “I don’t want a drop from any vial to be wasted because that’s a national asset. For example, if there is one person, we can’t open a vial. We will persuade him, cajole him, convince him to come tomorrow. That is in national interest,” he said. Asked when Maharajganj would start vaccinations for the 18-44 age group, Narlikar said: “That is a government policy decision.

First published on: 26-05-2021 at 02:56:07 am
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