COVID-19 has affected countries across the world and India is not an exception. To deal with COVID, India is relying on the vaccination along with other measures like social distancing. More than a third of all vaccinations done in the world each day are done in India. However, many experts feel that these steps are baby steps and more effective vaccination measures are needed to deal with the second wave of COVID in the country.
WHAT CONCERNS THE VACCINATION PROGRAM?
So far, India has vaccinated only 3.2% of the adult population. Although the country covered 2.6 million doses per day on March 15, the seven day rolling average hovers only around 0.11 per 100 people. This slow pace does not constitute an appropriate response when compared to India’s true potential in scaling up vaccination.
STEPS NEEDED TO SCALE UP VACCINATION PROGRAM
- India has identified a target of 300 million vulnerable populations. To vaccinate its population over two three months it must vaccinate around 10 million people per day. This requires speeding up the pace by five times. India has 300,000 trained vaccinators who are trained in vaccinating millions of children routinely. They can be effectively utilized to meet this enhanced target.
- There is also a need to expand participation with private health facilities to cover more than seven to 10 million doses per day. Regulated sales in the private market should be used as a careful option to accelerate the vaccination campaign.
- India will also need to have a reasonable stockpile and production line of vaccines. Several other vaccines are available internationally with established efficacy and safety, and can be approved under emergency use authorization (EUA).
- The government may proactively seek supplies of alternative vaccines from other manufacturers while rapid studies can assess safety and immunogenicity in the Indian context. The ongoing arrangement with Russia for the local production of Sputnik while the vaccine is already undergoing clinical trials in India is an excellent template of using Indian companies to roll out other vaccines.
- India needs to balance compassion to supply vaccines to other countries with the compulsion to save the lives of millions of Indians, who are at risk of death as serial waves hitting different parts of the country.
- Process of getting vaccinated needs to be simplified. Any person who is 18 years should be permitted to get any vaccine approved by India, at any designated place, and at a fixed price regulated by the government.
- Inequities in the health system, which systematically neglect the poor and the marginalized, should also be taken into consideration. This social responsibility can be fulfilled by the government acting as the sole provider of free vaccines and care for all Indians below the poverty line or who cannot afford to buy Covid vaccines.
- Public health programmes should be as simple as possible to ensure scalability. Simple age based criteria should be used to expand vaccination without restrictive criteria such as insisting on a medical certification of comorbidities. Simple, offline, walking vaccination should be done with the help of CoWIN (Covid Vaccine Intelligence Work) portal.
- This opportunity can also be used to identify people with comorbidities through screening using simple digital measuring devices for blood pressure and blood glucose.
- India needs to focus on the ‘3M’ road map. First step is Micro planning. Microplanning is a process that is followed in India’s vaccination programmes, that captures the population details by identifying and mapping them. The central government can work with the States in strengthening micro plans so that the vaccination pace picks up and is sustained.
- Second step is mobilization. Mobilizing identified persons can be done by the accredited social health activists (ASHAs) in rural areas and other volunteers in urban areas for effective mobilization. The strategy for mobilization in urban areas can include innovative technological solutions.
- Monitoring and mentoring of each step is also required. The activities that need structured support include preparing micro plans, ensuring that all the necessary inter sectoral coordination is done, and that the necessary logistical and transport supplies are provided.