The coronavirus disease (Covid-19) vaccination drive will be similar to the election process in the country, Union health ministry stated in its operational guidelines for Covid-19 vaccines sent out to states. It said that the latest electoral roll for Lok Sabha and Legislative Assembly election should be used to identify population aged 50 years and above who would be given the vaccine on priority along with health care and frontline workers.
The remaining population will be offered the vaccine based on the disease epidemiology (pattern) and the vaccine’s availability.
“While most of the healthcare and frontline workers would be vaccinated at fixed session sites, vaccination of other high-risk populations may require outreach session sites, and mobile sites/teams. State/UT can identify specific days for vaccination,” the government guidelines said.
Only pre-registered beneficiaries will be vaccinated following the prioritization, with 100 registered beneficiaries vaccinated per session. There will be no on-the-spot vaccination of beneficiaries at the vaccination site.
Covid-19 vaccine will be introduced once all trainings are completed at the district, block, and planning units.
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“As demonstrated during recent experiences with pneumococcal conjugate vaccine (PCV) introduction and polio rounds conducted during the Covid-19 pandemic, national and state training of trainers may be successfully conducted on virtual platforms and cascaded to district and sub-district levels using a mix of virtual and face-to-face trainings.”
The constitution of a National Expert Group on Vaccine Administration for Covid-19 (NEGVAC) has been the key in guiding all aspects of Covid-19 vaccine introduction in India. Twenty-three ministries and departments, and numerous developmental partners are involved in planning for Covid-19 vaccine introduction in the country.
“The Covid-19 vaccine will be offered first to healthcare workers, frontline workers and to people above 50 years of age, followed by those younger than 50 years of age with associated comorbidities based on evolving pandemic situation, and finally to the remaining population based on the disease epidemiology and vaccine availability,” the guidelines mentioned.
“The priority group of above 50 years may be further subdivided into those above 60 years of age and those between 50 to 60 years of age for purposes of phasing of vaccine’s rollout based on the pandemic situation and vaccine availability. The latest electoral roll for Lok Sabha and Legislative Assembly election will be used to identify population aged 50 years or more,” the guiding document stated.
The vaccination team will consist of five members. There will be a vaccinator officer, who could be a doctor (MBBS/BDS), staff nurse, pharmacist, auxiliary nurse midwife (ANM), lady health visitor (LHV). Anyone legally authorized to give injection will be considered as a potential vaccinator. Then there will be vaccination officer 1 with at least one person from the police, home guard, civil defence, National Cadet Corps, National Service Scheme or Nehru Yuva Kendra Sangathan who will check the registration status of beneficiary at the entry point and ensure guarded entry to the vaccination session.
The vaccination officer 2 will be the verifier who will authenticate or verify the identification documents while the vaccination officer 3 and 4 will be the two-support staff responsible for crowd management, information education and communication, and support the vaccinator.
The Covid-19 vaccine Intelligence Network (Co-WIN) system, a digitalized platform, will be used to track the enlisted beneficiaries for vaccination and Covid-19 vaccines on a real-time basis.
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The existing adverse event following immunization (AEFI) surveillance system will be utilized to monitor adverse events and inform the understanding of the safety profile of the vaccines. The reporting of AEFI through SAFEVAC is being integrated with Co-WIN software and every AEFI to be reported at the district level and further the referral mechanisms in case of any AEFI needs to be put in place.
SAFEVAC is an app-based capture of adverse effects after influenza vaccinations. Experts say it is a good idea to make use of the existing platform used for universal immunisation in India to conduct Covid-19 vaccination drive.
“To be able to effectively reach the target population for the Covid-19 vaccination, India will need to utilize its existing national immunization network, including the infrastructure (production, storage, transport, delivery facilities) as well as the human resources (vaccinators, supervisors, etc). However, given the scale of the vaccination effort required for Covid-19, the effort will need to take the existing network and build on it. This needs to be planned for, budgeted, and efforts made to put this in place ahead of a vaccine being available for widespread immunisation,” said researcher Anant Bhan, who specializes in bioethics and public health.
There are 9 Covid-19 vaccine candidates in different phases of development in India, of these 3 are in the pre-clinical phase whereas 6 are under clinical trials.
According to the statements made by the Union health minister Harsh Vardhan, India aims to vaccinate 250-300 million people against Covid-19 in the first phase on priority by July next year.