Introduction:
Immunization is a health and development success story. In India, Expanded Programme on Immunization was launched in 1978. It was renamed as Universal Immunization Programme in 1985 when its reach was expanded beyond urban areas. Universal Immunization Programme is one of the largest and most cost-effective public health interventions which is largely responsible for reduction of vaccine preventable under-5 mortality rate. Two major milestones of UIP have been the elimination of polio in 2014 and maternal and neonatal tetanus elimination in 2015. Mission Indradhanush was launched in December 2014 and aims at increasing the full immunization coverage to children to 90%. Covid pandemic led to slight reduction in immunization coverage in 2020-21 as compared to 2019-20. However a number of steps were taken by the govt for strengthening Routine Immunization amidst the COVID-19 pandemic crisis. Covid Vaccination program launched in January last year has also been running successfully.
India and Other Vaccines
- At present 80-90% of the world’s whole Measles vaccine is provided by India.
- India supplies all the Rubella vaccines to South America.
- The indigenous developed meningococcal vaccine of India is supplied to the entire Sub-Saharan Africa.
- Meningococcal meningitisis caused by Neisseria meningitidis bacteria. It is a serious infection of the thin lining that surrounds the brain and spinal cord.
- The indigenous rotavirus vaccine is going to 16 countries in the world.
- Various novel vaccines have been introduced by India, such as the world’s firstsubunit rabies vaccine. It has been approved by the Drug Controller General of India.
- Subunit vaccinesare composed of protein or glycoprotein components of a pathogen that are capable of inducing a protective immune response and may be produced by conventional biochemical or recombinant DNA technologies.
Need for adult vaccination:
- Following the outbreaks of Japanese Encephalitis (JE) in 2005-06 — in the years that followed — India had conducted mass scale JE vaccinationin the endemic districts, which included the adult age group.
- Then, there had been a limited use of Swine Flu vaccines for health workers during the H1N1 (2009) pandemicin 2009-10.
- Other than that, there has been limited focus on the systematic efforts for adult vaccination in India.
- The first and only national vaccine policy of India, released in 2011, had no mention of adult vaccination.
- The National Technical Advisory Group on Immunisation (NTAGI)in India, on a few occasions, discussed adult immunisation but stayed away from any recommendation for the general population except for the vaccination of health workers as high-risk groups, for hepatitis B vaccine, etc.
Government Strategy for Smooth and Effective Drive:
- Preparatory measures:The key preparatory aspects that have been undertaken include the physical infrastructure, human resources and training of the vaccinators.
- The digital aspect:The government has launched the Co-WIN application for the registration of the citizens and to generate digital certificates of vaccination.
- Community participation:Besides preparatory aspects, the community participation has also been emphasised by the Prime Minister. He has urged all to come forward and help in eliminating vaccine hesitancy.
- Beneficiary identification:Separate templates have been developed for the healthcare workers and the frontline workers.
- People above the age of 50 who have comorbidities will be the next to be vaccinated.
- Aadharwill also be used for the beneficiary identification.
Steps need to be taken:
- Spreading awareness:Leaders, influential people and healthcare workers who will be vaccinated need to come forward and help spreading awareness about the vaccine.
- Effective collaboration:Effective and decentralised implementation with the collaboration of centre, state, communities and health care workers.
- Proper training:Ensuring proper training of vaccinators and adopting measures to maintain temperature of vaccines.
- Monitoring:Keeping watch of any side effects that may arise due to vaccines and adopting measures to be used in an emergency for such situations.
- Vaccine hesitancy: Either they are common people, or the frontline workers, vaccine hesitancy, if exists, it may obstruct the smooth implementation of the vaccination drive.
- If the healthcare workers are hesitant about getting vaccinated, it will not create a good impact among common people as they are the role model for the people who will be vaccinated next.
- There is uncertainty and suspicion about the side effects of the vaccine.
- Issues with the Co-WIN App:Issues such as loss of internet connectivity are expected to be faced in the app, which could cause problems while tracking the vaccine stocks, or in the updating of data of the beneficiaries.
- Lack of experience:The Covid-19 Vaccination drive is India’s first ever large scale immunisation programme. There is a lack of experience due to which the chances of mistakes are likely to happen.
- Vaccine wastage:Each vaccine vial contains 10 doses and must be used within 4 hours of opening. This could lead to vaccine wastage.
Way Forward:
- Eliminating vaccine hesitancy:The covid-19 vaccines are for adults, the communication is required in order to resolve the confusions and to eliminate the vaccine hesitancy.
- Engagement with the community based organisations and spreading awareness by educating people about the vaccine.
- Janbhagidari:Community partnership or janbhagidari should be emphasised.
People should take the vaccine and spread the word about the efficacy and security of the vaccine.
- Preventing vaccine wastage:organised appointment for vaccinations, ensuring once opened, the vaccine is surely utilised and not wasted.
- Continuing the flow of vaccines:Taking lessons from other countries, India should continue the flow of vaccines.
- The US got stalled because they started to store the second dose of vaccines too. India should continue the flow of vaccines to the areas where it is required.
- Vaccination Covid-appropriate behaviour:Neither Covid appropriate behaviour nor vaccination is enough alone. Both have to go hand in hand in order to completely eliminate the pandemic.
Conclusion:
India has now emerged as a global covid vaccine hub which is done not only by manufacturing or developing vaccines but also ensuring how it will be transported and how the entire vaccination drive has to be done.
For the world’s largest vaccination against covid-19, a multi-prong approach is required including educating people, following the vaccination process, keeping a check on new strains of virus, maintaining the records of essential data of the beneficiaries and refining our strategy.
Vaccine hesitancy is the main obstruction in the smooth vaccination drive, in order to defeat the pandemic, vaccine hesitancy should be eliminated first as It is not the vaccine but vaccination that prevents an infection.
