Vaccination programme – A huge challenge for India

Vaccination programme – A huge challenge for India. A podcast.

Covid-19 vaccines seem to be around the corner and most of the countries, including India, are preparing for massive vaccination programmes to be launched with a view to protecting their populations from the coronavirus pandemic. In many countries the vaccination programme is likely to be launched in December itself for the priority categories.

In this podcast, we take a look at the massive efforts being made world over to develop and administer vaccines to the coronavirus pandemic to billions of people in hundreds of countries. We also take a look at the problems are issues that are likely to be encountered during the vaccination programmes and also whether vaccination remains the last and best resort for protection from coronavirus or not.

Most of the countries, including Russia, US, UK and India are preparing for vaccination programmes on a massive scale. A scale that is unprecedented and has never been attempted since after the small pox vaccination programme.

Vaccines are expected to be available in first batches soon. And this has aroused hopes as well as deep anxieties as the public health systems and vaccination capabilities of different countries are likely to come under severe duress.

Even while the world awaits the first batch of coronavirus vaccines to be administered to the patients, the pandemic itself has continues to rage in different parts of the world.

Reports from UK as well as USA and other parts of Europe indicate that the pandemic is still not under control. In England, 315 persons have died of coronavirus raising the total death toll in the country due to corona to 42,194.

In India too, 512 more deaths were reported in 24 hours and the total deaths have crossed 1 lakh 40 thousand.

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World wide the virus has killed 1.52 millions, and this should be repeated, 1.52 millions meaning 15 lakh 20 thousand people till date.

The pandemic has taken a heavy toll on humanity and this is why the entire world is anxious for the vaccination programs to be successful in eradicating the pandemic.

More than 200 vaccines are under different stages of development in different parts of the world. But, out of these more than 200 candidates, three are under the maximum focus – one by Moderna, the second by Pfizer and the third being developed by AstraZeneca. The fourth vaccine developed by Russia- Sputnik – too is under focus, but many feel that not much data has been revealed about the efficacy of Russian vaccine and more data would be required before any judgment is made on its efficacy.

Out of the first three vaccines, one by Pfizer has been given approval by British authorities. USA too is likely to use emergency powers to issue a temporary go-ahead to these vaccines as the current president Donald Trump is keen on expediting the vaccination process.

Even while these front-running vaccine candidates are being discussed with hope, there are many experts who are advising that a cautious approach be adopted about their safety and overall consequences. Adverse effects of all the three vaccines are still not known and they are making many experts anxious.

Even if the different countries decide to go ahead with the vaccination programme, the massive scale of any such programme in itself would be a huge challenge for most of the governments and countries.

Some experts feel that the efficacy of the vaccination programme for covid-19 is yet to be examined in detail.

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Many experts point out that the vaccination programmes have failed in preventing the transmission of certain diseases in the past. They point out that for covid-19, stopping the transmission would be more important than boosting immunity of persons temporarily. They point out that it is still not clear how many doses would be required for developing immunity.

AstraZeneca vaccine requires two does for 90 per cent efficacy, while the single dose of the vaccine provides only 70 per cent immunity. It is still not clear as to how long the immunity cover will last after two-dose vaccination of a person and whether that would vary from person to person.

Apart from the efficacy of the vaccination, the scale of the vaccination required to tackle the pandemic too is making experts anxious.

Many vaccines would require a cold chain logistics throughout the country to make the vaccination programme successful.

Vaccinating all the 130 crores of Indians would be a huge challenge for the country. It is pointed out that even for the universal immunisation programme, the country could not go beyond 65% of coverage even after 40 years. It would be very difficult to ensure that everyone in the country gets immunised.

The government too recognises the challenge and this is why now we have started hearing that vaccinating everyone may not be the first goal, but using the vaccination program strategically to counter the disease spread in the best manner may be the priority of the government now.

It seems that the government would give priority to the vulnerable populations like health care workers and above 65 years of age during vaccination programme.

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This is because preventing deaths among vulnerable sections should be given the first priority. Even covering the vulnerable sections would require a massive effort from the government and healthcare machinery. Identifying and then administering vaccines to such groups of people would be a huge task. Distribution and storage as well as ensuring safe administration of the vaccination would test the capability of the governments.

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For many countries, it would be a strategic and conscious decision to choose between vaccinating the elderly and people with co-morbidities first and vaccinating the health care workers, who have been at the front of the fight against coronavirus pandemic. The first will prevent deaths, while the second would help in breaking the chain of infection.

Experts believe that there will not be enough vaccine for everyone until 2024.

India has placed huge orders for vaccines keeping its huge population in mind. Inspite of this, some prioritisation would have to be done.

As far as vaccination program is concerned, India has already taken a decision to vaccinate the frontline healthcare workers first and then to other vulnerable groups.

By administering the vaccines first to the healthcare workers, India wants to give priority to the need to break the infections chain.

It is expected that the persons with age and co-morbidities would come next in the vaccination priority list.

The country has already started preparing for a massive vaccination programme. During this massive effort, it would need to use caution, pragmatism as well as skill and participation of the masses.

It will be a huge challenge. But the country must meet this challenge to contain this deadly virus.

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