Moving the needle on hesitancy, vaccine 2.0 takes off today
As the country shifts gear on the next phase of vaccination, state health authorities have asked private hospitals to pull up their socks and be ready to take on the inoculation challenge once registration on COWIN 2.0 begins from 9 am on Monday.
From managing registrations and storing vaccines to also making timely payment to the Centre for the doses procured, the private sector is poised for a bigger and more active role in administering the life-saving jab.
In a well-laid out plan, the Centre has said that as the COWIN portal goes live for the general public in specified age groups on March 1, it is likely to be a soft launch at some reserved vaccine centres. The drive will pick up as more people in the 60-and-above and 45plus with comorbidities register on COWIN.
The proportion of slots, where on-site registration, appointment, verification, and vaccination will happen on the same day as part of the mobilisation exercise, will be decided by states. Private hospitals will be kept out of this.
Slots will be automatically reserved for those scheduled to receive their second dose — which was suspended for Saturday and Sunday.
The rest will be open slots available to the general public. A vaccination time table will be prepared by the district administrator — this will be available on the COWIN portal.
The type of vaccine will not be disclosed at the time of appointment. Currently either of the two vaccines — Covishield or Covaxin — will be available in hospitals.
The Delhi government had asked hospitals to make an immediate payment of ~150 per dose to the Centre for the stock they wish to purchase. A maximum number of 2,000 doses and a minimum of 600 will be provided by the Delhi health department to each hospital, said a senior official.
Maharashtra is working on preparing a master plan. State Health Secretary Pradeep Vyas said a meeting was held with hospitals on Saturday. “Based on their willingness and infrastructure, we will proceed,” said Vyas, adding that the private sites will need to make an upfront payment to receive the doses. The Mumbai civic body is likely to conduct inoculations mostly at government sites on Monday. Mulund-based Platinum Hospital, which is on the government panel, said it has so far not heard from the civic body. “We do not have any doses yet. There will be greater clarity in the next few days,” said a hospital official. Vyas said the drive will stabilise in the days to come.
Covishield, which comes in vials of 10 doses, and Covaxin, in vials of 20 doses, have to be stored in 2-8 degrees Celsius. Hospitals have been told to be ready for random inspections, checking on their storage and refrigeration facilities on site.
In a marked departure from the earlier strategy, where government teams were collecting unused vials and providing support to trained staff, private hospitals will now have to take over on-ground implementation. Delhi’s Max Hospital, for instance, will start the vaccination process from 12 noon onwards. Delhi’s health officials have directed the hospitals to keep the drive going six days a week, from 9 am to 5 pm.
The target number of doses in a vaccination cycle will be decided by states, based on the total number of available doses, additional doses likely to be available, and after factoring in the requirement for the second dose. One person will be able to register up to four beneficiaries; the identification card for each has to be different. “Appointments for any date for a Covid vaccination centre will be closed at 3 pm on that day for which the slots were opened,” said the health ministry.
Beneficiaries will be able to edit records of registration and appointment till vaccination. As soon as the date of appointment is booked, the COWIN portal will schedule the person for the second dose on the 29th day from the first one. In certain cases, the second dose can be rescheduled up to the 42nd day. There will be a special reserve slot beyond the 42nd day.
If a person cancels the appointment for the first dose, the second one will be automatically cancelled. However, there is no option to cancel the second-dose appointment.
The government has also advised hospitals to ensure there is no overcrowding by managing the time slots.
The Delhi government said that from March 1, no doses at private hospitals will be available for free, including those scheduled to take the second dose. Private hospitals in Gujarat like Apollo CVHF Heart Institute have said they will not be able to begin the vaccination drive from Monday.
“It is only on Sunday we were given instructions. Our own staff has its second dose scheduled on Monday. While spot registrations as well as through apps like COWIN and Aarogya Setu are being encouraged, one needs to see how many are able to do so. It will take at least two to three days to begin inoculation,” said Apollo CVHF Heart Institute’s Chief Operating Officer S R Anklesaria. A spokesperson at another leading private hospital in Ahmedabad said the ‘internal management’ at private hospitals of the vaccination drive will take time.
“Unlike government hospitals, much of the standard operating procedures are not yet in place. There is no clarity on how to go about the process. For instance, will the inoculation be done during outpatient hours needs to be ascertained. With manpower crunch, the internal management of the drive will take time. We won’t be able to begin vaccination before a week from Monday,” the spokesperson added.
Besides, the health ministry’s campaign against vaccine hesitancy is also expected to gain momentum, with focus on community engagement and social mobilisation.
A list of 20 comorbidities has been specified by the health ministry for those in the 45-59year age bracket, including diabetes for more than 10 years, Ct/mri-documented stroke and hypertension, coronary artery disease, moderate or service valvular heart disease, among others. The age will be calculated as on January 1, 2022. Covid vaccine price has been capped at ~250 per dose at private hospitals: ~150 for vaccines and ~100 as operational charges.