Covid-19 vaccination: With 15% doses wasted, states up their game

Some want an earlier roll-out for those over 50; others say CoWIN needs to shape up

A month into the world’s largest vaccination drive, as the country prepares to enter the third phase of nationwide inoculation, which will entail giving the jab to those aged over 50, the states are trying to reduce vaccine wastage.

According to industry estimates, around 15 per cent of the vaccines have been wasted sofar — the result of low turnouts. States such as Tripura, which have seen a high turnout, have wasted fewer vaccines.

“Tripura has had a high turnout of over 75 per cent for vaccination, and thus it has been able to limit waste. It is almost down to zero wastage now,” said a state official.

In Uttar Pradesh, the turnout has not been uniform. While some districts witnessed almost 90 per cent of the targeted vaccinations, others reported levels as low as 16 per cent.

Health officials here have drafted new strategies for districts with low turnouts, said UP immunisation officer Ajay Ghai.

Each vial contains multiple doses: 10 for Covishield and 20 for Covaxin. Once opened, 10 people need to be vaccinated within four hours with a Covishield vial. If people do not turn up in this time, the remaining vaccine doses are wasted.

“The turnout in Covaxin centres has been especially low. However, it is picking up now among healthcare workers as the case count has gone up here,” said a Maharashtra official.

Meanwhile, the earlier vaccine hesitancy is waning steadily. Tamil Nadu Health Secretary J Radhakrishnan noted that the vaccination campaign began with 3,126 people on the first day. By last Saturday, the number had risen to 20,032 people in one day.

“The number of vaccination sites will now be increased from 628 to around 1,000, and we are drafting a micro-plan to cover all districts rapidly,” Radhakrishnan said.

Several states are mobilising social media and accredited social health activists (Asha) to ensure better turnouts. “We are using print, electronic and social media to spread the word, and also nudging healthcare and frontline workers to come to take the jab,” said an official in Maharashtra.

The World Health Organisation and the national expert group on vaccines has said that up to 10 per cent wastage in a session is acceptable. Radhakrishnan points out that some states have 15-20 per cent waste. “All our deputy directors, joint directors and deans are making efforts to avoid wastage,” he said. Given that most of the vaccines have a six-month shelf life, some experts believe India needs to plan more efficiently to avoid wastage as the campaign spreads to larger swathes of the population.

“In the initial days, the turnout was low and many more than 10 per cent were not showing up for the jab,” said Siddhartha Bhattacharya, secretary general, Healthcare Fede­ration of India (NATH­EALTH). “With both vaccines having a shelf life of six months, the idea should be to consume the stock.” Radha­krishnan fears that precious time is being wasted by people not turning up and this has been conveyed to the Centre.

“They can open up the vaccination drive to persons who are willing to get inoculated. With the state election around the corner, many meetings are being held and people are asking for vaccines,” he said. “Those above 50 and those below 50 with comorbidities can be immunised. If the Centre gives us permission soon, we can achieve a day’s target of 100 people per site," he added.

There is also disagreement on when to start phase 3 – vaccination of those aged over 50. Maharashtra, for example, wants to start immediately.

“We are asking the Centre to allow us to start this month. The transmission rate is high in some areas like Amravati, Akola etc,” said an official in Maharashtra. “We are now thinking of seeking the intervention of the Prime Minister’s Office (PMO) in this to at least start the vaccination for the elderly and vulnerable in the hotspots.”

Other states, including Delhi, prefer to finish vaccinating healthcare and frontline workers first. Apart from the timing of the phases, as the vaccination campaign spreads, technical glit­ches have appeared. The app for the drive, CoWIN, is turning out to be the biggest challenge in the vaccine rollout.

West Bengal health officials said problems with the app have persisted since the start, slowing the drive down, because it is unable to handle such a gigantic database. “If the entire process had been managed offline, then the performance would have doubled,” said an official. The worry is that as the campaign grows and moves into the districts, the problems with the app, such as the listed beneficiaries not getting SMS notifications, will only increase.