The acutely inadequate vaccination cover in Karnataka leaves a huge majority of the population vulnerable to the dreaded disease, even as experts remain clueless about the efficacy of the vaccines against the emerging variants.
While the State Government is in the midst of Unlock 2.0, people are already out on the streets in large numbers, many with a questionable conviction that having taken one or both vaccine doses provides them with protection to move around freely.
The Indian Council of Medical Research (ICMR) on Friday said results of studies to establish whether the existing vaccines have adequate efficacy against the Delta-plus variant of SARS-CoV-2 will be out in another 10 days.
On the other hand, National Technical Advisory Group on Immunisation (NTAGI) chairman Dr Narendra Kumar Arora said vaccines provide immunity against Covid-19 for up to six months to a year.
The ICMR’s announcement and Dr Arora’s statements can confuse the common man who is waiting to see the last of Covid-19. With that in the background, experts in Karnataka profess the ‘be-vaccinated-and-hope-for-the-best’ approach — and yet the coverage in the state is a poor 4.98 per cent as of Saturday, 160 days after the drive was launched.
THE PROBLEMS
Health officials say issues of supply and management, and reluctance among people have to be addressed to ensure speedy and wider coverage. In April-May, supplies were affected due to production issues and private hospitals being asked to procure vaccines directly from manufacturers.
Although production and supplies have picked up, Dr Giridhara R Babu, Head of Lifecourse Epidemiology at the Public Health Foundation of India, and member of the Covid-19 Technical Advisory Committee, says supply chain issues cannot be solved overnight.By July-end, vaccine production is expected to go up and until then, microplanning needs to be done. To solve supply issues, the state needs to plan two months in advance, he says. On June 21, during the Lasika Mela, over 10 lakh people were vaccinated in a day. “If we are able to do that, we need 90 days for the adult population to get two doses,” he says. Now it is around 3 lakh a day,, Dr Babu says.
Dr B Unnikrishnan, Additional Dean and Professor, Community Medicine, Kasturba Medical College, Mangaluru, says to meet the target of vaccinating all citizens by December-end, the government must aim for 71 lakh vaccinations a day across India. “The adult population in the country is around 86.5 crore. For two doses for each person, we need 173 crore doses. For that, we need to increase production and also import vaccines. The current rate of vaccination is 25 lakh doses per day. We have only around 200 days to meet the target,” he says.
Dr Madhav Prabhu, Consultant, Corona Care Unit, KLE’s Prabhakar Kore Hospital, Belagavi, says two factors slowed vaccination coverage. “One, raw material for the vaccines needed to be imported and several countries, including the USA, imposed sanctions on exports. Second, both the government and citizens underestimated the severity of the second wave,” he says. “While the government was involved in vaccine diplomacy, the public became complacent. This led to a less aggressive vaccination drive. When demand grew, the government could not cope, and found solace in extending the gap between two doses.”
Besides, confusion persists among people, like in Mysuru, over availability of the second dose of vaccine as most of them express concerns over inability to book slots on the CoWIN portal, while public health centres refuse them when they visit for on-site registration.In Kodagu, the second dose is slow-paced due to minimum supply of vaccines and due to the extended time gap for the Covishield vaccine. Shivamogga lags behind for the same reason. Of the 13 lakh in the age group of 18-plus, the Health Department has vaccinated only five lakh so far.
RELUCTANCE
Dr Unnikrishnan says slow-paced vaccination coverage is due to shortage and wastage of vaccines in the initial days of the drive, and reluctance among people. “The reluctance is due to misinformation and information overload on social media platforms. People were scared to take the vaccine when vaccination was started for the general public. And, when they were ready, vaccines were not available (April/May).
Dr Umesh Prabhu, president of IMA, Udupi, says false propaganda about vaccines on social media initially led to reluctance among the public.
Dr Madhav Prabhu explains the poor coverage among healthcare workers despite an early start and being the smallest segment. “There is a saying in the medical fraternity that ‘Doctors are the worst patients’. Many HCWs adopted a wait-and-watch approach as the speed with which vaccines were developed raised doubts in their minds about their safety. This delayed coverage of this segment.
Secondly, a lot of HCWs refused vaccination underestimating its need. It was only after the safety data was out that HCWs were convinced about the vaccine, but by then, it was already late.” However, Health Minister Dr K Sudhakar, says, “Initially, there was some hesitancy among medicos over anxiety about vaccine schedules affecting their semester exams. Now, they are eager to get vaccinated.”
But there is reluctance among other segments too. In Kalaburagi, although Covid Suraksha Chakra is established through Kalyana Karnataka Regional development Board and people due for the second dose have been alerted via SMSes, up to 12,000 across segments have failed to turn up. In Vijayapura, nearly 40% and 62% of HCWs and FLWs, respectively, are yet to take the second dose.
In Gadag, misplaced notions and fears of fever/bodyaches are barriers to immunisation. Gram panchayats have started the traditional ‘Dangura’ system to spread awareness. Town panchayats and private doctors are creating awareness through social media with the help of Covid warriors — all of which could have been done in advance.
