New Delhi: The emergency use authorisation of a Covid-19 vaccine in India is expected any time now, but the rollout may be painstakingly slow.
Health ministry officials in the know say states may initially conduct the actual vaccination drive no more than once or twice a week. This is both to ensure that routine immunisation and other health services do not suffer during the drive as well as for logistical reasons.
Vaccines are initially expected to come only in a trickle. However, if vaccine supplies do not dry out, the process may be completed in one-two months, the Centre hopes.
The subject expert committee of the Drug Controller General of India (DCGI) will meet on 1 January and it is possible, sources say, that the Serum Institute of India could have the first clearance for its Covishield vaccine. If that happens, then the company currently has a stockpile of about four-five crore doses and has the capacity to increase monthly production to 10 crore doses per month by February.
India’s first four priority groups comprise 30 crore people and to vaccinate them, 60 crore doses of the vaccine will be required.
The Covid vaccine, unlike the ones used in the routine immunisation programme, cannot be reused once the vial has been opened. But the government is planning for the vaccination with the same 10 per cent wastage margin that it does for the Universal Immunisation Programme.
This means that for vaccinating 30 crore people, 66 crore doses of the vaccine will be required. From past experience, the health ministry estimates that the first four groups should be completed in about two months, subject to vaccine availability.
The government has also communicated to states the absolute need to avoid a situation like during the lockdown when Covid contact tracing and active case finding became the sole pursuit of healthcare workers, causing routine immunisation and health programmes such as those against tuberculosis and for maternal health to suffer greatly.
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‘Look for vaccinators other than ANMs and ASHAs’
To ensure other routine services continue, it is important for states to look for people beyond the usual vaccination pipeline to be roped in for Covid-19 vaccinations.
“We have told the states that a situation should be avoided in which routine immunisation and routine health services are affected because the entire health manpower is busy with Covid vaccination,” a senior health ministry official said on condition of anonymity.
“States will probably designate one or two days every week for Covid vaccination with a very small number of people per session being vaccinated. By the looks of it, the limiting factor will be vaccine supply. Vaccines will only trickle in initially so that is probably all that will be available,” the official said.
The official added: “We have also asked states to look for vaccinators other than ASHAs and ANMs so as not to disrupt mother and child immunisation. That means that will have to use nurses, doctors, paramedics as vaccinators. They can also rope in the private sector. But even at the meeting this morning, states were very confident.”
There is a lot of emphasis on vaccine distribution being exactly in amounts that will be required.
“Vaccine distribution should be planned in small quantities (e.g. on a weekly basis to all cold chain points) to avoid any additional risk of temperature excursions during transport on larger vaccine quantities,” say the operational guidelines for Covid vaccination drawn up by states.
Health ministry officials draw on the past experience of measles rubella vaccinations of 32 crore children in 2017 to estimate that if the vaccine supply does not run dry, it may take between one-two months for states to complete the 30 crore targeted vaccinations.
“That campaign took about one to one and a half months. So we are hoping this will be done in two months time,” the official said.
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