Synopsis: Government has issued strategic guidelines for the effective rollout of COVID vaccine program. There are challenges in the way of the Vaccine program that should be tackled as soon possible.
Strategic guidelines for COVID vaccine programme
With limitations of Vaccine related to efficiency and efficacy in mind, government has framed strategic guidelines for COVID vaccine programme
- Guidelines were framed using the knowledge acquired over three decades of implementing the Universal Immunisation Programme. It aims to aims to cover 30 crore people by July 2021.
- It has specified involvement of 19 departments, donor organisations and NGOs at the national, state, district and block level in the roll out of COVID vaccine programme.
- The guidelines have also clearly mentioned the priority criteria. Citizens eligible for the first round of COVID vaccine programme includes the following,
- The caregivers and front-line workers working under the department of health, defense, municipalities, and transportation.
- Persons above the age of 50.
- And persons below the age of 50 who suffers from comorbidities such as diabetes, hypertension, cancers, and lung diseases are all included.
- The strategic guidelines have also clearly stated in detail,
- The skills, roles, and responsibilities of the required human resources.
- The quantum of logistics required for delivering vaccines at point of use.
- The requirement of physical infrastructure, monitoring systems based on digital platforms, and feedback systems for reporting adverse events.
However, it has been criticised that the guidelines are ideal and have failed to provide solutions for real-time issues of our health system.
What are the challenges involved in effective rollout of COVID vaccine programme?
There are many challenges to roll out COVID vaccine programme. They are,
- First, unequal distribution of cold storage facilities among states. For example, out of the 28,932 cold chain points, half are in the five southern states, Maharashtra and Gujarat.
- Whereas the eight states in the North and Odisha that account for over 40 per cent of the country’s population have only 28 per cent of the cold chain points.
- Second, pertaining issues in our health care sector such as poor human resources, a weak private sector, poor safety and hygiene standards, frequent power outages, poor infrastructure will reduce the capacity to implement the vaccine programme with speed, quality, and accuracy.
- Third, a massive immunization programme for 30 crore people can distort the routine health service delivery and affect other immunisation drives, and can lead to exhaustion of health care workers.
- Fourth, acquiring the data for under the 50s with comorbidities will be challenging though we have data for the above-50-year-olds in the electoral rolls.
- Fifth, there are also challenge of tackling Fudging, false certification, and siphoning off vaccines to private facilities in the event of vast price differences between private hospitals and public hospitals.
- Sixth, the non-availability of efficacy data could result in huge wastage and gives scope for errors and duplication during the procurement and supply of vaccines.
- Seventh, the trust among the people on COVID vaccines are decreasing leading to suspicions and fears due to various reasons such as
- Non-transparency of data on either of the two vaccines proposed for use in the program.
- Opacity with which the licenses were given etc. For example, have not completed the Phase 3 trials that confirm the safety and efficacy of the vaccine.
- Above all, India hasn’t signed the advance purchase agreements for vaccines that have completed Phase 3 trials from other countries.
What is the way forward?
- First, avoid the complexity of listing the priority groups throughout our country. It should be replaced by covering the complete area in one go, instead of sequencing them into different groups.
- The areas could be ranked on the basis of a vulnerability index based on disease burden, caseload of COVID infections, demographic profile, health-seeking behavior and availability of infrastructure, etc.
- Second, to create confidence in the community we need to establish an independent team of experts under the aegis of the WHO to ensure adherence to recruitment standards, consent conditions, adverse event record management, compensation standards.
- Third, to build trust about vaccination programme we need to plan for large–scale public education and information programme through State- and local-level networks where people are informed, sensitised and their feedback was taken.
- Fourth, People should be involved in decision-making. For this Local leader from public figures, religious leaders, self-help groups, the media, and even educational institutions need to participate to help citizens understand its importance and build trust
- Fifth, Science, evidence, and data analytics need to be extensively used for effective policymaking.
- Finally, vaccination is not a complete solution to end the epidemic. We need to adopt safe behavior through a communication strategy. For this, the government can use its experience of controlling the HIV/AIDS epidemic.
The need of the hour is a winning strategy against epidemic that has drained us economically, socially and psychologically. Government needs to understand that the effective way of improving uptake of the vaccine while reducing costs is by creating participatory frameworks of engaging experts and communities and building effective and reliable public information, and transparency.