Dr NK Arora
Administering 100 crore vaccine doses in less than 10 months is a remarkable achievement for a country as vast and diverse as ours. At this pace, the country can fully vaccinate all the eligible 94 crores, adults, by the end of this year. The country has taken crucial steps to strengthen the basic science research infrastructure which helped us ramp up the facilities for the development of vaccines during the pandemic. In March 2020, India invested heavily to create a conducive ecosystem. It encouraged scientists and entrepreneurs to collaborate to develop vaccines in a short time. Today, we have four vaccines manufactured in India — Bharat biotech's Covaxin, Serum Institute's Covishield, Cadila Zydus ZycovD and Russian Sputnik V — and have a robust pipeline of made-in-India Covid vaccines, which have been developed using different technologies. The country will soon have its own sub-unit vaccines and RNA vaccine. Since the vaccines were developed in a short time and were given Emergency Use Authorisation, initially, people were concerned about their safety and efficacy. By September-October, India had set up a panel of physicians, pulmonologists, cardiologists, neurologists, hepatologists and adult specialists to manage the Adverse Events Following Immunisation (AEFI). By December, most of them were trained to identify and address common adverse events as well as possible conditions that could theoretically have occurred with any new vaccine. Any clinical event or disease that occurs within 28 days of administering a dose of the vaccine is to be reported as AEFI for further investigation. Currently, the system is able to capture events occurring in the first 3-5 days after a vaccine dose. At every vaccination centre, a waiting area was set up where people can be observed for 30 minutes post-vaccination. The objective was to manage any severe reaction such as anaphylaxis promptly and then refer them to the nearest health facility. Equally important is to highlight the role IT has played. CoWIN is considered one of the world's best IT platforms for keeping a count of the doses administered, tracking vaccine recipients and also the vaccine supply line till the last vaccination centre. For the first time, social media scanning is being done in a systematic manner so that rumours and misinformation are very closely watched, followed, analysed, and countered in a methodical manner. While all-out efforts were made to develop indigenous vaccines and also manufacture locally under international license, attempts were also made to make advance arrangements with international vaccine manufacturers towards the end of 2020.
The lesson further reinforced India's resolve to locally manufacture vaccines. The first milestone was achieved when India delivered 50 crore doses in July end of this year. The highlight of the whole campaign has been continuous mid-course corrections as we moved to achieve different milestones. This involved improvements and flexibility built into the CoWIN platform, delivery for rural areas, and near home COVID vaccine delivery to name a few. I feel that one billion doses is an important milestone but the fact is that there is still a long road to effectively control Coronavirus. A substantial number of adults and all children are yet to be reached. Last-mile could be a difficult road as we may come across pockets of hesitant people, but concerted efforts to address contextual factors will help the country to achieve full immunisation. Immunisation will go a long way in protecting our population from developing severe disease and mortality due to Covid-19. Equally important will be people's compliance to Covid-appropriate behaviour. Besides, keeping a tab on any new variants and preparing the health system for any future upsurge of cases will help the country win this battle.
(The writer is member of the National Task Force and Chairman of COVID working group of National Technical Advisory Group on Immunisation. The views expressed are personal.)
