The story so far: The Union Health Ministry on Saturday announced that the COVID-19 vaccination drive will begin on January 16, after the forthcoming festivals of Lohri, Makar Sankranti, Pongal and Magh Bihu. The government had earlier approved emergency use authorisation (EUA) for two vaccine candidates the Serum Institute of Indias Covishield vaccine developed jointly by Oxford University and AstraZeneca, and Bharat Biotechs indigenous Covaxin. With Saturdays announcement, the country is set to begin population-level immunisation for COVID-19 and finds itself facing one of the biggest logistical challenges in a long while.
What are the challenges?
U.S. President-elect Joe Biden, speaking to reporters on Friday, said about vaccine distribution in the U.S.: [It would be] the greatest operational challenge we will ever face as a nation.
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In India, with its vast geographical spread, the sheer volume of population, and questions of access, the vaccination drive will be fraught with challenges, and the most careful planning down to the last mile is required, not only to vaccinate and provide both the doses, but to also monitor adverse events. The Centre recently conducted dry runs of COVID-19 vaccination to check if the systems laid down for the operationalisation of vaccine delivery are in place and working well.
Who is in line for a vaccine?
Priority will be given to the healthcare and frontline workers, estimated to be around 3 crore in number, followed by those above 50 years of age and the under-50 population groups with co-morbidities, numbering around 27 crore, the Health Ministry said on Saturday. People who have an active COVID-19 infection or associated symptoms are advised not to come to vaccination camps to avoid spreading the virus. They may seek a vaccine 14 days after the symptoms abate, according to the FAQ issued by the Health Ministry earlier. Taking the COVID-19 vaccine is entirely voluntary.
What is Co-WIN?
In good measure, the dry runs were not only a step to test the operational feasibility of various States to roll out the vaccine programme effectively, but also a recce to see if the electronic vaccine intelligence network, eVIN, used during routine immunisation programmes, and remodelled as Co-WIN, was functional at the field-level.
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Co-WIN aspires to be a comprehensive digital database of every COVID-19 vaccine that will be administered in India tracking beneficiaries, intimating them about vaccine sites and dates, pre- and post-vaccination procedures, issuance of vaccination certificates, and follow up through the booster dose. On January 5, Union Health Secretary Rajesh Bhushan said the details of healthcare and frontline workers in line for a shot had already been updated on the Co-WIN system, in bulk, by State and district health authorities. Currently, self-registration is not allowed on the application.
It has been promised that at a later stage of implementation, Co-WIN will also be available as an application or as a website in multiple Indian languages so that beneficiaries can access it to keep track of their own progress and be connected organically to the system, if questions were to arise. It will also be a tool for others to register for a vaccine once the first line of targeted beneficiaries is cleared.
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Aadhaar or any accepted photo ID card may be used to verify the identity of the applicant to prevent misuse. Additionally, documents authorised by specialists to indicate co-morbidities or any other health conditions may be demanded.
Further details are also awaited on the steps that will be taken to allocate turns in the schedule after the registration and for further communication regarding the date and venue of vaccination, even to people who may not have access to devices or the Internet. As per current information, text messages will be sent out after registration, telling the registrant where and when to go to get the shot.
After the second dose, Co-WIN will generate a digital certificate of completion for individuals who have been vaccinated. Messaging, chatbots and helpline assistance are available on the app, and any adverse event after the vaccination may be communicated back to the authorities through one of these access points.
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What is the kind of field-level mobilisation required for the drive?
The existing State and district health networks are readying themselves to set in place every nut and bolt in the elaborate systems that will be required for the vaccination drive. This includes mobilising personnel, making sure transportation systems are in place to take the vaccine packs to different camps, ensuring healthcare personnel are able to reach the spot on time, making sure a cold-chain system is in place, identifying and removing hurdles that might prevent beneficiaries in the general population (at a later date) from reaching the spot, and ensuring coordination between different teams on actual vaccination days to avoid any hitches.