Amongst the many challenges of making sure that the laboratory-based work on the COVID-19 vaccine translates into an effective shield against the novel coronavirus is of creating a database of the first lot of beneficiaries. In India, priority will reportedly be accorded to roughly a fourth of the country’s population — one crore health workers, two crore frontline workers, including police and armed forces personnel, and about 27 crore people with comorbidities. Data will not only have to be generated at a scale unprecedented in public health history, but the officials involved in this endeavour will also be required to work at frenetic pace. The country’s decade-long programme against non-communicable diseases (NCDs) does offer policymakers a register of sorts to track people with comorbidities. It is salutary, therefore, that the first priority lists for the vaccine will draw on information at the district-level generated while screening people against NCDs. But in the coming weeks and months, these lists may need fine-tuning to make up for the deficits of the NCD surveillance programme.
Under the National Programme for Prevention of Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), launched in 2010, state governments are required to undertake regular screenings at the district level for early detection of NCDs. But this is still a work in progress. In large parts of the country, the NPCDCS programme touches only people who visit healthcare facilities for detection of these diseases. Given the poor state of healthcare facilities in large parts of the country, it will not be unreasonable to say that a substantial number of NCD patients do not come under the radar of such registries — or records of their ailments are not maintained. As the country draws up the list of the first beneficiaries of the COVID-19 beneficiaries, it will need to bolster the mapping and monitoring mechanisms for NCDs. Can this be done without placing more burden on the country’s healthcare workers? Which are the areas that require intensive cooperation between the public and private sectors, and what would be the mechanisms for this purpose? Policymakers will have to find resolutions to such predicaments and challenges.
People administered vaccines require monitoring weeks after they receive the jab. This protocol, necessary to evaluate the efficacy and side-effects of an inoculation, has acquired added significance in case of the COVID-19 preventive because it is a first-generation vaccine. It also needs little emphasising that the post-inoculation data of the 30-crore first recipients in India will be critical to fine-tuning the COVID-19 vaccines. The government, therefore, also needs to plan on creating repositories of such information.