A decade after defeating polio, India is set to begin its battle against Covid-19
Sanchita Sharma
This is a week of beginnings and ends. January 16 marks the beginning of India’s vaccination drive to end coronavirus disease (Covid-19), and January 13 marks one decade of the country being free of polio, which paralysed around 200,000 children in the country each year till the mid1980s.
Multiple nationwide vaccination drives to inoculate every child under the age of five years against polio led to cases declining within a year from 741 in the end of 2009, to one on January 13, 2011, which was the last recorded case in India.
The World Health Organization (WHO) certified India poliofree in 2014 after extensive testing for the wild polio virus through lab analysis of all acute flaccid paralysis cases reported from any cause, and environmental sewage sampling found no new case for three consecutive years.
In the final years leading to polio eradication, around 2.3 million vaccinators under the direction of 155,000 supervisors visited 209 million houses to give polio drops to 172 million children on each national immunization day.
With two approved vaccines – Serum Institute of India’s Covishield, and Bharat Biotech’s Covaxin -- India is kickstarting the world’s biggest Covid-19 vaccination drive with an aim to inoculate 300 million people at most risk of infection and death by August. To do so, it has strengthened and expanded its polio and routine immunization delivery and surveillance network to both vaccinate and track potential side effects.
“We began preparations for the Covid-19 vaccine drive in early August last year when the National Expert Group on Vaccine Administration for Covid-19 (NEG-VAC) was set up to identify financing resources for its procurement and to strengthen delivery platforms, cold chain and associated infrastructure for safe, equitable and transparent delivery of the vaccine,” said
Union health and science minister Dr Harsh Vardhan.
NEG-VAC first met on August 12 to iron out the creases in the storage, distribution, tracking, administration and monitoring for side-effects of vaccine doses. The first shipments of Covishield have begun, with vaccines ready for distribution from vaccine storage depots across states. Of the 300 million on priority list, around 10 million are health workers in the private and government sectors, including integrated child development services workers. Another 20 million are frontline workers.
The ground has been meticulously prepared to scale up delivery, said public health experts. “India has identified priority groups by both occupation and age, which will make it easy to assemble and administer the vaccine. It’s efficient election commission machinery for assembling and verifying people has also been deployed successfully,” said Dr K Srinath Reddy, president, Public Health Foundation of India.
“What also works in favour of India is its strong network of central services, especially the Indian administrative service, which can coordinate well between centre and states and between vaccination centres,” said Dr Reddy.
Add to that an extensive primary health care network that is already delivering the Universal Immunisation Programme (UIP), which reaches around 26.7 million newborns and 29 million pregnant women each year.
“Mass vaccination led to polio and smallpox eradication in India. We already have a robust UIP programme with district hospitals, community health centres, primary health centres and sub-centres are equipped to deliver 12 vaccines, of which nine are given nationally and three sub-nationally. Our healthworkers are experienced in vaccine management and delivery. It’s time-tested, it works. Plus, the gaps identified by NEG-VAC since August have been addressed, and now we have increased the number of vaccine storage depots from 41 to 60, added refrigerated vans, trained vaccinators, and conducted dry runs in every district,” said Dr Harsh Vardhan.
As with polio, the last-mile access challenges remain, especially in difficult geographies. Then there is the obviously challenge of the massive scale of the operation, which will need a committed health force to administer two doses by intramuscular injection for several months till enough people are vaccinated to achieve herd immunity.
Concerns about vaccine safety and effectiveness will need to be addressed on priority to prevent vaccine hesitancy among the general population with limited access to correct information. “Inadequate vaccine literacy because of limited communication can affect reach, so community networks must be engaged on priority to ensure Covid-19 vaccine uptake remains high,” said Dr Reddy.
As I said before, this is a week of beginnings and ends. My column Healthwise, which has appeared every week in Hindustan Times without a break since the summer of 2007, ends today.
That’s all folks! Stay safe.
JASHPUR: Three persons have been killed in separate incidents of attack by elephants in Chhattisgarh’s Jashpur district, a forest official said on Monday.
The incidents took place late Sunday evening in Pathalgaon forest range of the district, he said.
As per the official, a 50-yearold native of Saraitola village, identified as one Dilsai Ram Chauhan, was returning after work from nearby Dumarbahar village when he was attacked by an elephant. The official added that two more persons, identified as Jagat Ram (62) and Karu (65), were trampled to death by wild elephants at separate places in the district’s Jhimki village.
The kin of each of the deceased were given an immediate aid of ₹25,000. The remaining compensation of ₹5.75 lakh each will be given after the completion of formalities, he said.