Doses wasted in more states over hesitancy

NEW DELHI/PATNA/CHENNAI/ ROHTAK: Authorities in at least six states on Wednesday said that doses of coronavirus vaccines are going to waste because people are not turning up, underscoring a persistent vaccine hesitancy problem in the country that may now impact inventories stockpiled in the millions.

India’s start to the Covid-19 vaccination programme has been one of the strongest in the world, reaching more people on its first day than any other country. By 6pm on Wednesday, 786,842 people were inoculated in the 14,119 sessions held since the launch on January 16, Union health ministry data showed.

But this still translates to a cumulative coverage rate of 55% — every day, 100 people are selected and invited for shots for each session, and on average roughly 45 of them are not turning up.

Experts have called for opening up access to more people that just health care workers — perhaps even to the general public — if targets are not being met.

To address the problem thrown up by vaccine hesitancy, the government on Tuesday tweaked the digital platform to allow willing health workers

(who have been selected as initial beneficiaries) to take doses even if they were not scheduled to, and on Wednesday, it decided to hand out provisional firstdose certificates.

But, as on Wednesday, the numbers were yet to pick up in any significant manner. According to preliminary government

figures, the turnout for the day was approximately 65%.

This, officials in Maharashtra, Tamil Nadu, Haryana, Bihar and Assam said, was leading to doses being wasted since vials need to be used up within four hours once opened, and each vial contains 10 (in the case of Covishield) or 20 (for Covaxin) doses.

“On the first day of the vaccination, as we had recorded 100% turnout, we didn’t lose any unit. All the registered 100 health care workers opted for vaccination. All five vials that we had opened were successfully utilised. However, the next day when only 38 HCWS came forward, we lost two doses from the second vial,” said Dr Dilip Ranmale, district health officer, Amravati.

HT reported on Wednesday that officials in Delhi estimated that at least 1,000 doses were wasted across the Capital when opened vials were discarded for want of enough recipients.

The issue also led to a political fight, with former Union finance minister P Chidambaram calling on the government on Twitter to open the vaccination drive up to more volunteers.

To this, Union health minister Harsh Vardhan replied: “... (health ministry) has already taken steps to address the issue. We are ensuring that no vial or session is wasted and in case of absenteeism, vaccines are being allotted to another beneficiary.”

While officials in the six states argued that the overall wastage was less than the 10% margin that they have assumed, the loss was not uniform and more doses of Covaxin had to be thrown away at some locations since they were in vials of 20.

“In case of Covaxin, it is difficult to mobilise 20 health care workers at a time, given that hospital functioning should not be interrupted,” said Dr Binod

Kumar Singh, superintendent of the Nalanda Medical College Hospital (NMCH) in Patna, where 25% of doses were thrown away.

“Each vial has 10 doses, and if only five people are coming, either we have to deny vaccination for these five people or waste five doses,” said Tamil Nadu’s director of public health and preventive medicine Dr TS Selvavinayagam.

Tamil Nadu’s health secretary said some of this problem is inevitable. “Unused doses are inevitable as some session sites will have less beneficiaries while other sites will have more than the prescribed 100 beneficiaries in a day,” said J Radhakrishnan, while adding: “This is going to be a long process which may take up more than 1.5 years.”

But authorities in some other states continued to be concerned at the low turnouts. “We felt that the frontline workers should be contacted first to know their willingness to get the jab and availability, then selected for the next day. It is a matter of concern for us that fewer numbers of health workers are turning up to receive the dose,” said Dr Ramesh Verma, co-investigator of the clinical trials at the PGIMS, Rohtak.

Several state governments such as Punjab, Uttarakhand, Jharkhand and Uttar Pradesh reported negligible wastage of doses. Dr Kuldeep Singh Martoliya, immunisation officer in Uttarakhand, said facilities in the state “open vials only after around ten candidates are lined up for vaccination. Along with this, there is strict supervision over vaccinators to ensure that doses are not wasted”.

In Assam, the wastage was due to a logistical error when authorities had to discard 100 vials of Covishield after they were found frozen.