COVID-19 vaccine hesitancy worries Centre, appeals beneficiaries to shun it

The Union government has appealed to India’s healthcare workers (HCWs) to shun novel coronavirus disease (COVID-19) vaccine hesitancy and come forward for taking shots that have been allocated to them.

VK Paul, chairman of National Expert Group on Vaccine Administration for COVID-19 (NEGVAC) addressed the media on this issue January 19, 2021.

“Please understand there is a big clamour for COVID-19 vaccines globally. On the other hand, here in our country, we have developed two vaccines on our own and people are shunning them. This is very sad,” he said. According to data provided by the Union Ministry of Health and Family Welfare, as many as 177,638 HCWs have been vaccinated till January 19.

This was, incidentally, the first admission on the part of the government that there is a COVID-19 vaccine hesitancy in the country. In the first phase of vaccination, 10 million HCWs and 20 million frontline workers are to be inoculated. 

Down To Earth had reported earlier that HCWs were hesitant to receive the jabs for various reasons. In Assam, like a couple of other states, some of the doctors cited the lack of interim efficacy data for Covaxin manufactured by Bharat Biotech International Ltd in collaboration with Indian Council of Medical Research (ICMR).

In Punjab and Himachal Pradesh, accredited social health activists and doctors in the government set-up feared vaccines were being just tried on them that was fraught with risks.

Similar apprehensions and doubts have been reported from Jammu and Kashmir, Kerala and Andhra Pradesh.  Incidentally, while launching the vaccination drive  January 16, Prime Minister Narendra Modi had termed the doubters as propagandists. 

Paul said if the HCWs continued rejecting the shots, not only would they be putting themselves at risk but would also fail at fulfilling their ‘societal duty’.

“We have to start all health services, including the non-COVID ones, in full swing. If you continue to remain afraid of the fact that you may contract infection while doing so and not take a vaccine to overcome that fear, how will we achieve our goal? I request (healthcare workers) on behalf of the government to please accept the vaccines,” Paul asked.

His fears were somewhat reflected in data too. According to a presentation made by Union health secretary Rajesh Bhushan, at least three states have reported less than 40 per cent coverage of what was targeted on the first two days of the drive. The lowest was in Punjab (27.9 per cent), Puducherry (34.6 per cent) and Tamil Nadu (34.9 per cent).

The highest coverage was observed in Lakshadweep (89.3 per cent), Sikkim (85.7 per cent), Odisha (82.6 per cent), Andaman and Nicobar (81.9 per cent), Telangana (81.1 per cent), Dadra and Nagar Haveli (80.8 per cent), Arunachal Pradesh (75.4 per cent), Uttar Pradesh (71.4 per cent) and Rajasthan (71.3 per cent).

Bhushan said vaccine hesitancy was common with all immunisation programmes of the world and COVID-19 was no exception to it.

The Union secretary said adverse events following immunisation (AEFI) were only 0.18 per cent of the total number of people vaccinated on January 16 and 17. Of these, a minuscule (0.002 per cent) required any hospitalisation.

Two people — one in Moradabad and one in Ballari — have died after vaccination but the health ministry has said those deaths were not linked to vaccination, quoting post-mortem reports.

Follow-up and vaccine distribution

Balram Bhargava, ICMR director-general, who was also present in the press meet, was asked about whether the follow-up of recipients of Covaxin would be different from Covishield, developed by Serum Institute of India, since the former had been approved in clinical trial mode.

“A recipient of Covaxin is given a factsheet about the product. S / he has to fill an informed consent form and is also given an AEFI sheet where s / he can record any side-effects for seven days. Over and above this, the health ministry, ICMR and Bharat Biotech are ensuring regular follow-up of Covaxin recipients,” Bhargava said replying to a DTE query.

Bhushan added that if a Covishield vaccine recipient developed an adverse event, the onus would be on him / her to report it to the hospital. This, Bhushan said, is a passive follow-up.

“But Covaxin recipients are actively followed up. A doctor rings you up on a daily basis to enquire about side effects following vaccination,” Bhushan claimed.

Incidentally, several clinical trial participants of Covaxin at Bhopal had alleged several adverse events following the first dose. One even died following vaccination though his post-mortem report claimed he died due to poisoning. The participants had alleged there was no follow-up. The government has not responded to these allegations yet. 

DTE also asked if there was any criterion on the basis of which states were being allocated a certain dose of Covaxin or Covishield.

“States get these vaccines on the basis of the proportion in which the Union government receives the supplies from companies,” Bhargava said without qualifying how exactly a decision to allocate a certain vaccine and distribute it to a particular state was taken.

“Once the Centre has supplied the vaccine, it is entirely up to the state to decide which session site will be allocated with which vaccine,” Bhushan said.

In a statement released January 19, the Union Ministry of External Affairs has said the COVID-19 vaccine would be made available to Bhutan, the Maldives, Bangladesh, Nepal, Myanmar and Seychelles beginning January 20.

It would be offered free of cost. Regulatory approvals are awaited from Sri Lanka, Mauritius and Afghanistan. 

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