Jabs hit hesitancy hurdle
Average turnout less than 50% at vaccine sessions as recipients get cold feet; glitches in app hamper drive
NEW DELHI: In the three days since coronavirus vaccinations began in India, roughly 50 people have been given doses per session –half of the 100 on average expected by the government, data released by the Union health ministry showed on Monday, as reports poured in of people being reluctant to come forward to take the jab.
The government said that between Saturday morning and 5pm on Monday, 381,305 people were given doses in 7,704 sessions. Some health workers across the country, who are first in line to get doses, either did not turn up for their appointments, or outages in the digital platform to manage their records meant they were not informed.
The Union government has advised states to call and administer doses to 100 people on average during each session. According to figures collated by HT from across India, the total number of vaccinations by the end of Monday was 429,409.
The turnout dipped from 4,319 on Saturday to 3,593 on Monday (there were no immunisations on Sunday) in the national capital. At the All India Institute of Medical Sciences (AIIMS) in Delhi, only eight people were vaccinated on Monday, an official said, while asking not to be named.
Officials said concerns over the vaccines’ safety appear to have deterred many people. “Initially, health care workers were very keen to get the vaccine. But then because of the infodemic, because of things doing the rounds on social media, because of side effects being highlighted more than what they were, it created a lot of anxiety not only among healthcare workers but also in public at large,” said Dr Randeep Guleria, the director of AIIMS, in an interview to HT on Monday.
Hesitancy was reported among some beneficiaries in the run-up to the January 16 launch of the vaccination drive. Groups of doctors said they were apprehensive or would not prefer to get doses of Covaxin, the vaccine made by Hyderabad-based Bharat Biotech. This dose has not yet been tested entirely in Phase 3 trials, and the manufacturers don’t know how effective it is in preventing Covid-19. The other vaccine, Covishield, developed by Oxford-AstraZeneca and manufactured by Serum Institute of India, has proved its efficacy in human trials.
Two interns at Delhi’s RML Hospital, who asked not to be identified, said they were aware they could walk in and get the shots on Monday, but expressed concerns over lack of long-term data.
In UP, the state government issued a notice to a government hospital in Kanpur where only 40 people were given doses on Saturday. The state is carrying out immunisations only two days a week, Thursday and Friday from this week onwards.
The problem, as suggested by Guleria, appears to have been made worse by reports of some adverse reactions. Manohar Aghnani, additional secretary in the Union health ministry, said 580 cases of adverse effect following immunisation (AEFI) were reported in the three days.
The Union health ministry has said that most AEFIs have been mild, with symptoms such as pain at injection site, nausea and mild fever. Of the 580 – who represent just 0.15% of those vaccinated – seven required hospitalisations. For of these people were still under admission.
Experts said that these numbers were much below the thresholds for anything that should be worrying and that the risks outweigh the benefits of immunisation. “Acceptable level of AEFI would ideally be zero, but that is not the case. I think it is around 0.2% and yet we are focussing on that and not the 99.8% benefit,” said Dr Shahid Jameel, former CEO of Wellcome Trust/DBT India Alliance.
NEW DELHI: India reported 580 adverse events following immunisation (AEFI) out of 381,305 people vaccinated for Covid-19 till Monday, said data from the Union health ministry, translating to just 0.15% — a rate experts said was key to dispelling hesitancy among recipients that was dogging the inoculation programme. In Delhi, 26 AEFI were recorded on Monday out of 3,593 shots administered, a rate of 0.72%.
Overall, 133 adverse reactions, which can be caused by allergies or underlying medical conditions and are not necessarily causally linked to vaccines, were reported among 148,266 jabs given on Monday, which marked the third day of the nationwide immunization drive.
“So far, cumulative 580 AEFI have been reported, of which seven needed hospitalisation,” said Manohar Agnani, additional secretary, Union health ministry.
Two people died since Saturday,
Agnani added. One of them, a hospital employee from Uttar Pradesh’s Moradabad town, suffered a cardiac arrest and his death wasn’t related to the vaccine, the authorities declared. A post-mortem examination would be conducted late on Monday to ascertain the reason for the other death, of a 43-yearold man from Ballari in Karnataka. Of the seven people hospitalised, three were from Delhi, said Agnani.
One was admitted in the intensive care unit (ICU) of the All India Institute of Medical Sciences (AIIMS), Delhi, after complaining of uneasiness, and developed rashes within 15 minutes of getting the shot. The second was admitted for uneasiness to the Northern Railways Hospital. Both were discharged on Sunday. A third person, who fainted, is under observation at a private hospital in east Delhi, said Agnani.
Adverse events are observed with most vaccines and can range from pain, mild swelling at injection site and body ache to breathlessness and hospitalisation. Experts said AEFIs needed to be evaluated in the context of risk-and-benefits associated with immunization.
“Acceptable level of AEFI would ideally be zero, but that is not the case. I think it is around 0.2% and yet we are focusing on that and not the 99.8% benefit,” said Dr Shahid Jameel, former CEO of Wellcome Trust/DBT India Alliance.
In the case of coronavirus vaccines, the government has said that there can be mild AEFIs, such as pain and swelling at the site of injection, mild fever, nausea, giddiness and mild rashes. Serious AEFIs can be a severe allergic reaction, such as an anaphylactic shock, which could potentially require hospitalisation.
India is administering two vaccines as part of the first phase of Covid-19 immunisation covering roughly 30 million health care and other frontline workers. The lead candidate is the Oxford-AstraZeneca vaccine, manufactured by Serum Institute of India and locally known as Covishield, and the second is Bharat Biotech-made Covaxin, which has spurred some controversy because its efficacy data isn’t publicly known.
Uttarakhand reported one case of AEFI, and the health care worker is stable and under observation at AIIMS, Rishikesh. He was admitted to the hospital on Saturday. Chhattisgarh reported one case of AEFI, and the recipient is admitted in Government Medical College, Rajnandgaon, and is under observation. Karnataka reported two AEFI cases. One is under observation at district hospital, Chitradurga and the other at the general hospital in the same town.
Agnani said any vaccine link was ruled out in the case of the death of the Moradabad man who got the vaccine shot on Saturday and died on Sunday. “Postmortem by a board of three doctors revealed death due to cardiopulmonary disease (pockets of pus in lungs, enlarged heart), not related to vaccination,” Agnani added.
The Ballari man was vaccinated on Saturday and died on Monday. “Cause of death anterior wall infarction with cardiopulmonary failure. Post mortem planned today (Monday) at Vijaynagar Institute of Medical Sciences, Bellary, Karnataka,” Agnani said.