Context- The challenges vaccine poses to qualify as a ‘public health’ intervention in India.
What is the purpose of vaccination?
- Individual prevention- – The ability to develop immunity by producing antibodies among those individuals who have taken a vaccine shot.
- It builds an adaptive immune system
- To achieve herd immunity– It is a concept used for vaccination, in which a population can be protected from a certain virus if a threshold of vaccination is reached.
- Herd immunity refers to community protection.
- The threshold coverage is estimated to be around 60% for COVID-19 vaccine to achieve population-level immunity.
- The idea of herd community is to protect the vulnerable.
What are the concerns related to vaccination?
- Safe immunization– There are three major elements of immunization safety.
- Health care providers must be concerned with the safety of vaccines themselves (their composition),
- Administration of the vaccination (handling, scheduling, and injections),
- And surveillance and evaluation of the immunization program, including documentation of vaccine efficacy and the probability of adverse events.
- Economic concern-The huge economic resources will be needed to make the vaccine available for a large population.
- Lack of infrastructure– Vaccines require cold chain infrastructure for storage. Logistical and Infrastructural issues in storage of vaccines hampering it’s penetrability in the rural hinterland.
- Cost- If open market forces determine the cost of the vaccine and affordability then, the section of society most vulnerable to the disease would get left out.
- Credibility- ears regarding safety and credibility can be almost impossible obstacles to overcome and must be addressed head-on.
What are the challenges related to population based vaccination programme?
Priority- Within the country, it is certainly not clear who should be treated first or it should be determined by need, affordability, vulnerability or some other criterion or a combination of all.
The outcome is the clear– If this process target only specific population group then its very purpose will be defeated as the pandemic can infect all groups similarly.
What is the way forward?
- It is safe to demonstrate the success of vaccination as a public health intervention in a small population, like a block or a district, before scaling it up for the national level.
- However, if herd immunity is not the focus, then the key purpose of COVID-19 vaccines will be to ensure individual immunity.
- Protect the vulnerable– Use the first limited supplies of vaccines to protect those most in need, without worrying about the more robust members of the “herd”.