India's Covid-19 vaccine: A look at the blueprint of the rollout plan starting Jan 13
As India conducts the second dry run for Covid-19 vaccine rollouts today, we look at the framework of last-mile vaccine delivery, which includes real-time, remote temperature monitoring and capturing vaccination data in an electronic database
Dr. Roderico Ofrin (2L), Regional emergencies director, World Health Organisation, at UPHC Bhangrola to review the Covid-19 vaccine dry run on January 7, 2021 in Gurugram, India. A dry run of the COVID-19 vaccine roll-out was conducted in Haryana on Thursday, a day before the exercise will be conducted across India. The exercise, which was held across all 22 districts of the state, was aimed at identifying challenges in vaccine delivery to help resolve them. WHO Regional Emergencies Director Roderico Ofrin visited two of the six session sites in Gurugram.
Image: Parveen Kumar/Hindustan Times via Getty Images
“The vaccination will commence within 10 days of the drugs regulator giving accelerated approval to the Covid-19 vaccines,” health secretary Rajesh Bhushan had announced at a press conference in Delhi on January 5.
On January 8, the government is conducting a mock drill on Covid-19 vaccinations, across some 736 districts across 33 states and Union Territories. “The objective of the mock drill is to simulate the actual vaccine administration event,” the health ministry said. “The entire planning of the vaccination drive, including beneficiary registration, microplanning and vaccination at the planned session site, will be tested under the leadership of district collector and also familiarise the state, district, block and hospital level officers on all aspects of Covid-19 rollout.”
The drill is being carried out by some 1.7 lakh vaccinators and three lakh vaccination team members who have been trained on beneficiary verification, cold chain and logistics management, bio-medical waste management and AEFI (adverse event following immunisation) management.
Giving more information about the government’s overall rollout strategy, Bhushan said the vaccines—which have to be stored at a temperature between 2 and 8 degree Celsius—will be airlifted from manufacturers and stored in four government medical store depots located in Mumbai, Karnal, Chennai and Kolkata. They will then be moved across touchpoints from state to district to primary health care centres in refrigerated/insulated vans. From the primary health care centres, they will be moved to ‘session sites’, where beneficiaries will be registered and vaccinated.
This decision to start with the vaccination of priority groups is based on the feedback received from the dry runs conducted across the country on January 2. According to Union Health Minister Harsh Vardhan, the mock drill of Covid-19 vaccine administration was held in all states and Union Territories, at 286 session sites spread across 125 districts. “Around 114,100 vaccinators were trained," said the government, adding that an important focus of the dry runs was also to manage “any possible adverse event following immunisation”.
The health ministry has targeted inoculation of approximately 30 crore people in the first phase of vaccination. This includes approximately one crore health workers and two crore frontline workers. This will be followed by a prioritised age group, which means senior citizens who are above 50 years of age as of January 1, 2021, and those below 50 years of age who have serious comorbid conditions. This segment of the population is approximately 26 crore.
The manufacturers of the vaccine candidates, Serum Institute of India and Bharat Biotech, have also said in a joint statement released on January 5, that both companies are “fully engaged” in the vaccination process and will ensure a “smooth vaccine rollout in India and to the world”.While health care workers are defined as health care providers and workers in health care settings, personnel from state and central police departments, armed forces, home guard and civil defence organisation, including disaster management volunteers and municipal workers, are categorised as frontline workers. “The state governments have already started building a database of workers in the health care space for priority vaccination,” Dr E Sreekumar, a senior scientist at the Rajiv Gandhi Centre for Biotechnology, told Forbes India in November.
The data for these essential workers are ‘pre-populated’ or captured in the Co-WIN digital platform launched by the government. This platform is now being expanded to include other beneficiaries of the Covid-19 vaccine. The health ministry has also clarified that vaccination will be voluntary and that people will have control of their data.
“India is reasonably well-equipped to undertake this vaccination drive, mostly because there is no diagnosis involved at the last-mile here, only administration,” says Ajoy Khandheria, founder of Gramin Health Care, which works to deliver last-mile health care services in the remotest corners of India. India’s capability in mass inoculation has been built on the back of its successful polio vaccination programme, which caters to almost 2.6 crore newborns and approximately three crore pregnant women every year. This Universal Immunisation Programme, one of the largest in the world, works with a network of 28,947 cold chain points for storage and distribution of vaccines, according to the health ministry.
Khandheria believes that follow-ups to ensure people receive both doses of the vaccine is crucial. For this, the government’s Co-WIN will be central to registration, session allocation and vaccine administration process. The platform, according to the health ministry, will be “integrated with Aadhaar/UHID [for authentication], DigiLocker [for document verification] and SafeVac [for reporting AEFI at the vaccinator-level].”
Once the beneficiary is vaccinated, they will receive an SMS notification with details of the dosage, followed by the date and time for the subsequent dose. They will also be provided a digital certificate with a QR code. As of January 2, around 75 lakh beneficiaries had registered on the Co-WIN platform.
The rollouts of the vaccine will follow the election model. Approximately 100 people are expected to get vaccinated in a session site at a time, with a five-member team of experts to monitor them at each stage, including checking registration status, authenticating and verifying documents, administering vaccines and managing the crowds. Additional team will be deployed, the health ministry says, if there are more than 200 people.
