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To control the Covid-19 pandemic, India needs an equity-focused vaccination plan and a road map to provide equity and justice in vaccination.
According to WHO’s strategic advisory group of experts on immunisation, prioritizing socio-demographic groups is essential for universal vaccination. So, an equity-focused vaccination plan is essential for controlling the pandemic.
What is an equity-focused vaccination plan?
Instead of focussing on vaccinating the public, the plan facilitates vaccinating vulnerable sections of society. This plan should include the following sectors of people to prevent disease and death among them. Such as, prioritizing the poor, religious minorities, socially disadvantaged castes, Adivasi communities, those living in remote areas, urban slums, and women.
- For example, the Chhattisgarh government prioritised ration cardholders in vaccination.
- Under this, the Chhattisgarh government vaccinated high-risk persons such as the poor, people who live in multi-generation for the same house, larger household.
- Further, these are the people who lack access to mobile phones and the Internet (Crucial for registering vaccines).
Challenges in providing equity-focused vaccination plan
- Lack of data on various parameters: India’s Covid-19 impact data does not provide the impact of virus infection among gender, caste, religious, and indigenous identities. Though crowd-sourced data is available, they too lack geographic and other meta-data for tests conducted in India.
- Vaccination through digital registration: Digital technologies can create a digital divide among age, gender, economic dimensions, rural-urban differences. The government’s CoWIN data also shows inequitable vaccination between tribal and non-tribal areas.
- Role of developed countries: The developed countries do not always help other countries in vaccination drives. For example, During the 2009 H1N1 flu pandemic, wealthy countries secured more doses than they need to vaccinate every member of their population. Similar such behavior is also observed in the Covid-19 pandemic also. Poor countries in the world depend on the mercy of the European Union and the United States for vaccinating their population.
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How to improve the equity-focused vaccination plan?
- Trying out vaccination camps or door-to-door campaigns: Vulnerable sections of people often have poor access and low levels of trust in the healthcare system. So, the camps and campaigns can provide the following advantages. Such as,
- Older adults can get the vaccine from their homes.
- Essential workers will not face any interruption in their service delivery.
- Similarly, the poor and vulnerable people will not face any loss in daily wages
- The government can try women-only vaccine days to ensure that women are getting equal importance in vaccination. Women are often neglected in vaccine drive for reasons such as, they are not the breadwinner of the family, historically marginalized stature of women, etc. But this might lead to gender inequities in vaccine uptake. This will only lead to more Covid-19 infection among women
- For example, During the 1918 influenza pandemic in India, the mortality rate of women is higher than men.
- The government has to ensure vaccinating older people completely before opening vaccination to younger adults.
- In Indian villages, Accredited Social Health Activists (ASHAs) and Auxiliary Nurse-Midwives (ANMs) have enough experience and expertise with pulse polio vaccination and newborn vaccination. So, the government has to utilize its expertise to vaccinate Indian villages.
- Local governments and municipalities should prioritise vaccines for historically marginalised persons in the locality. Such as,
- Adivasi’s communities often live in remote and forested areas. The government should prioritize these regions.
- Religious minority areas such as Muslim-dominated tier-3 cities and villages should also get priority on vaccination drive.
- At the global level: WHO is consistently highlighted vaccine equity at global level. The COVAX facility can play a greater role in the equity distribution of vaccines around the world. The world leaders also need to follow the lead of WHO in vaccination and ensure global solidarity in this pandemic.
The central procurement of vaccines and providing free vaccines are not alone enough to vaccinate the entire population. So, refocused rejuvenated local, national, and global vaccination campaigns alone can provide equity-focused vaccination in the world.
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Source: The Hindu