Many challenges in Covid vaccine process yet to be addressed: Experts
BENGALURU: Although the vaccination of people aged above 60 and those over 45 with comorbidities is set to begin in two days on March 1 several challenges are yet to be addressed. One of the biggest challenges is ensuring that all people aged 45 and above with comorbidities are covered. However, data on the comorbidities that people suffer isn’t readily available in most states, said Dr Giridhara Babu, epidemiologist and member of the state’s Covid Technical Advisory Committee.
“A lot of time has been spent on deciding which comorbidities must be factored in, but little has been done to identify people with these comorbidities,” he said. Identifying them is hard because most Indians do not know if they have comorbidities, he added. Giving an example, he said, “A study done by Prof GVS Murthy and others found that nearly 50 per cent of people who had type 2 diabetes mellitus had become blind by the time they found out that they had it.” Experts fear that many people could be left out because they are not diagnosed, don’t have access to the health system, or lack the access to register for jab.
Planning and logistics
Dr Babu added that with the inoculation for polio, measles and rubella, the approach to micro-planning was a bottom-up one through door-todoor survey which was used to plan the programme in a decentralised manner. “But with Covid, we are using a top-down approach and relying on an untested, unreliable software,” Dr Babu said. Comprehensive surveys should have guided the micro-planning for vaccination sessions for people with comorbidities.
“In the absence of detailed data, the coverage of people with comorbidities is going to be incomplete. The list of the elderly might be available from the voter list but not phone numbers. I am not sure how they are going to integrate this data with the CoWin app,” he said. Director of Jayadeva Institute of Cardiovascular Diseases, Dr Manjunath C N, however, said the Centre has data on non-communicable diseases which can be used. Dr Anant Bhan, bioethics researcher, said the Union Health Ministry must release guidelines on the list of comorbidities and who qualifies for them, the required documentation, etc.
Other challenges would include minimisation of platformrelated issues, working with a diversity of vaccine delivery points, keeping track of adverse events, he said. While some experts have called for doing away with pre-registration, Dr Bhan said, “We need a platform to collate information. Issues with the platform should have been fixed before expansion of immunisation.”
CHALLENGES
No data on people with comorbidities
People themselves unaware of comorbidities
Top-down approach replaced by bottom-up strategy
Vaccine availability