Recently, a US-based pharma giant announced that its COVID-19 vaccine candidate was found to be effective in over 90% of phase 3 clinical trial participants. Scientists working on other leading vaccine candidates have also reported positive findings. Thanks to these assuring developments, the world now appears closer to a COVID-19 vaccine than ever before.
It is only a matter of time before a vaccine would be approved. The next big challenge will be to distribute and administer the vaccine successfully. The challenges would be particularly high for India, a country home to 135 crore people.
Vaccination in India
In India, vaccination is done under the aegis of the Universal Immunization Programme (UIP). Initially, a major objective of the UIP programme was to cover all the districts of the country in a phased manner by 1989-1990. Today, UIP is one of the largest health programmes in the world under which 2.67 crore newborns and 2.9 crore pregnant women are provided free vaccines every year. Vaccines included in the Universal Immunization Programme are:
- BCG (Bacillus Calmette-Guerin) vaccine
- OPV (Oral Polio Vaccine)
- Hepatitis B vaccine
- Pentavalent vaccine
- Rotavirus vaccine
- PCV (Pneumococcal Conjugate Vaccine)
- fIPV (Fractional Inactivated Poliomyelitis Vaccine)
- Measles/MR (Measles and Rubella) Vaccine
- JE (Japanese encephalitis) vaccine
- DPT (Diphtheria, Tetanus and Pertussis) Booster
- Tetanus and adult diphtheria (Td) vaccine
To ensure that these vaccines reach every town and village in our country, new places and locations have been added to the list of centers where the vaccines are administered. Today, government health facilities such as Anganwadi centres, primary health centres (PHCs), urban dispensaries, community health centres (CHCs), hospitals, and medical colleges are integral to all mass vaccination drives. Auxiliary Nurses and Midwives (ANMs) organize vaccination sessions to immunize children in urban areas (such as mohallas and slums), and villages.
Where other countries are planning to carry out COVID-19 vaccination
Several countries have started working on their vaccine distribution, delivery and administration models.
- In the US, under a federal government plan, several retail pharmacies have reportedly agreed to serve as COVID-19 vaccination centres. The pharmacies will be provided vaccines by the federal government free of charge to help facilitate the public’s access to vaccines.
- In the UK, COVID-19 vaccines would be administered at clinics, care homes, town halls, sports halls, and conference buildings. The National Health Service (NHS) in England has asked its 1,250 primary care networks to designate a single practice to administer vaccines. The vaccines would be administered at these clinics in 12-hour shifts, from 8 am to 8 pm, 7 days a week.
- Germany has asked the states to submit the details of 60 facilities that could serve as delivery centres for vaccine manufacturers. The country has also asked the states to identify central vaccination centres. The centres will be augmented by mobile teams who will go into care homes. Trade fair halls and airport terminals are some of the other facilities that will be potentially used as mass vaccination centres in Germany.
COVID-19 Vaccination in India
Once available, a vaccine for coronavirus disease would be distributed under a special COVID-19 immunization programme. The programme would run parallel to the existing UIP. However, the COVID-19 immunization programme is likely to draw heavily from the processes, technology and network of the existing UIP.
According to a blueprint being deliberated upon by the National Expert Group on Vaccine Administration for COVID-19, the state governments would identify buildings to be used as vaccination booths for COVID-19 immunization programme. Besides the existing healthcare facilities, buildings such as schools, anganwadi centres, panchayat offices, and other public setups are likely to be utilised as vaccination sites for the COVID-19 immunization programme.
The special immunization programme would likely be monitored by Electronic Vaccine Intelligence Network (eVIN), the Union Health Ministry's digital platform for UIP. The eVIN is a platform that monitors and provides real-time information on vaccine storage temperatures and stocks across all cold chain points in India. Currently, eVIN is being enhanced for COVID-19 vaccine distribution and delivery.
Under the first phase of the COVID-19 immunization programme, only at-risk priority groups such as healthcare professionals, frontline workers, police and armed forces, and people above 50 years and those with pre-existing medical conditions would be administered the vaccine. The process of identifying beneficiaries has already been started by the Central Government and State Governments.
India is positioned uniquely to take on the challenge of both manufacturing the vaccines, as well as rolling it out to all people across the country. The private sector, with their extensive distribution networks, is ramping up to work with the government in this arduous task. Large hospitals, clinics and pharmacies are well placed to offer high quality and excellent support.
Apollo hospitals, for instance, announced recently that it is prepared to administer 1 million COVID-19 vaccines a day. The group will leverage its robust pan India network of 19 medicine supply hubs with cold chain facilities and use its 70 hospitals, over 400 clinics, 500 corporate health centres, 4000 pharmacies alongside their omnichannel digital platform Apollo 24/7 to ensure massive administration capacity of Covid-19 vaccines. Other players are also expected to follow suit.
Once a vaccine is approved, the next big challenge will be to ensure effective vaccine distribution and delivery. While the first phase will only target the at-risk priority groups, the subsequent phase will target the remaining sections of the population. The Indian government has also called for making use of the experience of elections and disaster management, for developing the vaccine delivery and distribution system. It has also suggested involving non-governmental organisations, volunteers, and experts from all necessary domains for the effort. The special COVID-19 immunization programme will be unlike any other vaccination initiative in the history of India, and also of the world. The successful execution and outcome of such a programme will be a major feat for humanity.
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