India’s COVID-19 vaccination drive started with after Prime Minister Narendra Modi inaugurated the vaccination program connecting 3,006 vaccination sites across the country via video-conferencing. Approximately 300 million healthcare workers will get COVID-19 vaccine doses on January 16 of the massive nationwide COVID-19 injection drive.
— Narendra Modi (@narendramodi) January 16, 2021
In his speech earlier, PM Modi mentioned that a difficult task phase is coming up, with over 300 million Indians being vaccinated in the first phase of the vaccination drive. The first phase’s primary focus will be on healthcare and frontline workers, the elderly, and those with chronic health conditions.
With India entering the final stage of its fight against COVID-19, several questions have raised concerning the vaccines.
Covishield and Covaxin for emergency use:
PM Modi on January 11 interacted with the chief ministers of all the states to debate the COVID-19 vaccination plan. During the interaction, PM Modi said the two approved indigenously made COVID-19 vaccines are less expensive than those available in other parts of the world. He also said that four others are in the process work aside from the two already approved vaccines.
PM Modi said, “Our experts have taken all precautions to supply the countrymen with effective vaccines”. Further, he indicated that coordination between Centre, states in fighting COVID-19 great example of federalism.
Public representatives aren’t a part of the three-crore corona warriors and frontline workers to be vaccinated first. In the first phase, the value of vaccination for these 3-crore people would be borne by the central government.
India’s drugs regulator has the approved Oxford vaccine Covishield which was being manufactured by the Serum Institute, and indigenously developed Covaxin manufactured by Bharat Biotech for restricted emergency use within the country. On January 2 2021, Modi had reviewed the status of COVID-19 and the vaccine preparedness across states and union territories at a high-level meeting.
Process for the vaccination drive:
• Priority Vaccination Group
India is gearing up to begin the vaccination for the population against the novel coronavirus. According to the National Expert Group on Vaccine Administration for Coronavirus, the healthcare workers, including doctors, nurses, medical officers and other support staff, including the medical students, will be vaccinated first.
Alongside them, the central and state police department, the armed forces, civil defence and prison staff, municipal workers, revenue services personnel and others engaged in COVID-19 containment activities, along with ministries of home, defence, housing and urban affairs and state governments will be given the second preference for the vaccination.
Next, senior citizens and chronic health conditions will be given priority, and the category is further divided into two for those above 60 and those between 50 and 60 years. After the priority vaccination is done, the remaining population will be vaccinated.
• Registration Process
The latest electoral roll for Lok Sabha and Assembly elections will identify the senior and priority citizens. For the remaining population, self-registration method will be available on CoWIN app during the later phases. The registration process will include uploading a government photon I.D. or Aadhaar and identification. Following this, a date-time and venue will be allotted for the vaccination. No on the spot registrations will be allowed.
• Vaccination Process
Registered participants will have to assemble on the appointed day in their prescribed venue. After the vaccination, they will be kept under observation for 30 mins, to check for any adverse reaction. Two doses of the vaccine will have to be taken by an individual 28 days apart, to complete the vaccination schedule. A five-member vaccination team will be overlooking the process.
Challenges in the vaccination drive:
There are quite a few issues that have come to notice in carrying not the vaccination drive, which could be dealt with ease.
The first one being the sates, would be required to be prepared for any adverse side effect following the vaccination procedure. In cases of any side effects, which has been seen in the USA, the government should immediately address the issue, in the absence of which, the public will lose their confidence in the vaccine.
Secondly, those who are vaccinated can still be the potential carrier of the SARS-CoV-2 virus and could unknowingly spread the disease to others, especially their family members who are proximity. The government may have to consider vaccinating the family members of the frontline workers or the elderly, to avoid such situations. The third challenge raised is that the states need to prioritise vaccination elderly and people with choric diseases residing in clusters and are most affected by COVID-19. This could be a targeted approach in the first phase since the vaccine’s availability will also be scarce.
One main concern raised is that it is unknown whether the vaccine will have a uniform efficiency rate and that the vaccine’s efficiency rate is still unknown for a lot of groups like infants, pregnant women, Immunocompromised people, people older than 65 years etc. Most likely, an equivalent vaccine will have different efficacy rates in diverse populations. Hence, supported the relevant data, our vaccination strategy also will need to change/evolve. Because the efficacy data of phase three trials of various vaccines are released, they ought to be included within the public vaccination programme for those that cannot afford the vaccines. The inclusion of multiple vaccines from different manufacturers would enable the govt to negotiate prices with the manufacturers.
Another challenge is that whoever can afford these vaccines should be allowed to shop for the open market. But the private health infrastructure shouldn’t be inhibited from creating its distribution. This also features the prices of vaccination. There are not any grounds for immunisation to be universally free, subsidised by the government. The nationwide vaccination drive is generally a decentralised process, where state governments have been preparing the list of elderly, people with chronic diseases, healthcare and frontline workers. Having a national health I.D. could have made the task of identifying people with chronic diseases much easier.
Data privacy concerns of varied stakeholders should be addressed. The private data should be anonymised before being made available to government agencies. The patient’s consent should be sought at every instance, even when her data is shared with health departments for public health interventions like vaccination.
These issues are yet to be addressed, worsening by the timeline of the trials that got reduced.
Criticism on hasty approval of vaccine
Several experts have raised concern over the “hasty approval” granted to the COVID-19 vaccines despite the shortage of adequate efficacy data. Central Drugs Standard Control Organization approved for restricted emergency use of the Oxford COVID-19 vaccine Covishield, manufactured by the Serum Institute of India, and Covaxin of Bharat Biotech.
However, India’s approval has made many sector experts uncomfortable because the vaccines are still within the trial stage. In an interview to CNBC-TV18, Dr Gagandeep Kang, Professor, Christian Medical College, Vellore and president of the board of Coalition for Epidemic said, “I’m completely unaware of any data that means that Covaxin has any efficacy against any SARS-CoV-2 strain, including the U.K. strain.” In conversation with Times of India, Kang also mentioned that he is baffled after reading the SEC document and further highlighted unavailability of relevant data for the vaccine, indicating that there needs to be transparency for the country’s efficient vaccination process.
Health officials have defended India’s decision to approve the Covid 19 vaccine without any efficacy data. It was a move that faced a lot of criticism amongst the speculation that the regulators may have fastened the process under the government’s wish of having a vaccine alongside the ones now authorised in other countries.
Bharat Biotech, which has developed an entire virion inactivated coronavirus vaccine, submitted safety and immunogenicity data on nearly 800 participants showing that the vaccine is safe and generates a strong immune reaction. Venugopal Somani, the drugs controller general of India and chief and other health officials, has suggested that the inactivated vaccine’s approval would help India with “more options” to combat emerging mutant strains.
Over the past fortnight, Indian laboratories have detected over 70 patients in several parts of the country with the fast-spreading variant with the N501Y mutation. But researchers say there’s no evidence to back the claim that the inactivated vaccine would work better against specific variants. Satyajit Rath, a medical immunologist and a visiting academician at the Indian Institute of Science Education and Research in Pune, told the BMJ, “To say a selected vaccine might help against the United Kingdom variant is an illusion.”
Bharat Biotech officials have indicated that their efficacy trial’s interim results involving 25,800 participants might be expected after March. Health officials have asserted that provisions in Indian drug rules permit accelerated approval under public health emergencies. Balram Bhargava, director-general of the Indian Council of Medical Research which has assisted Bharat Biotech in developing the vaccine, said, “In an epidemic situation, restricted use is taken into account on the idea of safety and immunogenicity while efficacy trials are ongoing. Immunogenicity data is a surrogate for efficacy.”
Some researchers have questioned the timing, remarking that India’s active cases of covid-19 have fallen from a peak of 1,000,000 cases in mid-September to under 230,000 in the week. However, on the average, around 18,000 new daily cases emerged over the past week.
ओमिक्रॉन वैरिएंट के चलते भारत में स्थगित हुई अंतरराष्ट्रीय हवाई यात्रा
कोरोना वायरस के ओमिक्रॉन वैरिएंट के कारण भारत में पूर्व निर्धारित अंतरराष्ट्रीय विमान सेवाएं रोक दी गई हैं। सरकार की तरफ से पहले यह फैसला किया गया था कि 15 दिसंबर से अंतरराष्ट्रीय उड़ानों को शुरू किया जाएगा। लेकिन ओमिक्रोन के खतरे को मद्दे नज़र रखते हुए अब इस फैसले को टाल दिया गया है। यानी अब भारत में 15 दिसंबर से अंतरराष्ट्रीय उड़ानें शुरू नहीं हो पाएंगी। डायरेक्टोरेट जनरल ऑफ सिविल एविएशन की तरफ से कहा गया है कि वो अपने पूर्व के फैसले पर पुनर्विचार करेगें।
— DGCA (@DGCAIndia) December 1, 2021
प्रधानमंत्री नरेंद्र मोदी ने 27 नवंबर को ओमिक्रॉन को लेकर बैठक की थी और इसी दौरान 15 दिसंबर से अंतरराष्ट्रीय उड़ानें शुरू करने के फैसले पर पुनर्विचार करने को कहा गया था। प्रधानमंत्री ने विदेश से आने वाले लोगों की सख्त निगरानी करने की बात भी कही थी। ओमिक्रॉन के चलते हाल ही में सिक्किम ने विदेशी यात्रियों के आने-जाने पर रोक लगा दी है।
पिछले वर्ष कोरोना के चलते एहतियातन देश में नियमित अंतरराष्ट्रीय उड़ानें रद्द कर दी गई थी। हालांकि कुछ समय बाद कई देशों के साथ सीमित हवाई सेवा शुरू कर दी गई थी। ऐसा माना जा रहा था की इस बार क्रिसमस और नए साल की छुट्टियों के मौके पर अंतरराष्ट्रीय उड़ानें फिर से शुरू कर दी जाएंगी लेकीन, दक्षिण अफ्रीका में पाए गए ओमिक्रॉन वैरिएंट के कारण अभी इस पर ब्रेक लगता दिख रहा है।
कई देशों में इस खतरनाक वैरिएंट को लेकर गाइडलाइंस जारी कर दी गई हैं, और इससे बचने के लिए अनेकों ऐहतियात बरते जा रहे है। WHO ने इसे ‘वैरिएंट ऑफ कंसर्न’, यानि चिंताजनक घोषित किया है।
जनरल वीके सिंह ने सोमवार को कहा था कि “अंतरराष्ट्रीय उड़ानों को फिर से शुरू करने के लिए हम पर जनता का जबरदस्त दबाव है”। हम सभी नियमों का पालन कर रहे हैं और सावधानी बरत रहे हैं। बाहर से आने वाले हर व्यक्ति का परीक्षण और जांच हवाई अड्डे पर किया जा रहा है। परिणामों को देखने के बाद ही, उन्हें अनुमति दी जा रही है।
कोरोना वायरस के नए वैरिएंट ओमिक्रॉन के खतरे को देखते हुए केंद्रीय स्वास्थ्य मंत्रालय ने भारत आने वाले अंतरराष्ट्रीय यात्रियों के लिए संशोधित दिशानिर्देश जारी किए हैं। इन दिशानिर्देशों के तहत अब यात्रियों को 14 दिन की यात्रा जानकारी और कोरोना वायरस की निगेटिव आरटी-पीसीआर जांच रिपोर्ट एयर सुविधा पोर्टल पर अपलोड करना अनिवार्य होगा। स्वास्थ्य मंत्रालय के दिशानिर्देशों के अनुसार खतरे की श्रेणी में आने वाले देशों के यात्रियों को भारत पहुंचने पर कोरोना जांच करवानी होगी और जांच का परिणाम आने तक एयरपोर्ट पर ही इंतजार करना होगा। अगर उनकी जांच निगेटिव आती है तो उन्हें सात दिन तक होम क्वारंटीन में रहना होगा और आठवें दिन फिर जांच की जाएगी। इस बार भी निगेटिव आने पर उन्हें अगले सात दिन के लिए खुद अपने स्वास्थ्य पर नजर रखने को कहा जाएगा।
कोरोना वायरस का नया वैरियंट ओमीक्रोन भारत में भी दस्तक दे चुका है। साथ ही साथ ऑस्ट्रेलिया, ऑस्ट्रिया, बेल्जियम, बोत्सवाना, ब्राजील, कनाडा, चेक गणराज्य, डेनमार्क, फ्रांस, जर्मनी, घाना, हांगकांग, आयरलैंड, इजराइल, इटली, जापान, मोजाम्बिक, नीदरलैंड, नाइजीरिया, नॉर्वे, पुर्तगाल, रीयूनियन द्वीपसमूह, सऊदी अरब, दक्षिण अफ्रीका, दक्षिण कोरिया, स्पेन, स्वीडन, स्विटजरलैंड, यूएई, ब्रिटेन और अमेरिका भी ओमीक्रोन के गिरफ्त में आ चुके हैं।
Hypocrisy of Federalism: Reply on Oxygen Related Deaths
On Tuesday, the Union Health Ministry reported to the Parliament that no deaths were recorded due to a lack of oxygen across the country during the second wave of the pandemic.
The officials and ministers in eight states also denied fatalities due to the lack of oxygen. Whereas reports indicate that approximately 320 patients may have died in the second wave of the COVID-19 pandemic due to oxygen shortage.
The report by the Union Health Ministry to the Parliament has triggered massive criticism across the country. It has also prompted some significant accusations against the Bhartiya Janata Party [BJP].
The denial of the officials and ministers of the eight states regarding the same has also triggered a major rebuttal from within their parties, accusing them of aiding the Centre in hiding oxygen-related deaths.
According to a volunteer-driven data collation effort, DataMeet, Media from across 20 states report that there were approximately 619 deaths recorded due to lack of oxygen. However, later the cause of deaths was disputed with other factors that attributed to the fatalities.
The state health minister of Maharashtra, Rajesh Tope also sided with the Centre’s stand of no-oxygen-related deaths.
“As far as Maharashtra is concerned, we have never said that any death due to oxygen shortage,” he said to a local TV channel on Wednesday.
However, in April and May, the shortage of oxygen supply in the state had prompted the Chief Minister, Mr. Uddhav Thackeray, to request the Prime Minister, Narendra Modi, to inspect the proposal of pressing the Indian Air Force to arrange additional oxygen supplies for the state.
A medical board in Hisar- a region in Haryana, had openly established oxygen shortage as a cause of deaths in the region.
Additionally, after an inquiry, 22 patients succumbed to Covid due to the lack of oxygen in Haryana.
According to the reports of DataMeet, figures indicated that approximately 68 deaths took place across the state of Madhya Pradesh due to lack of oxygen.
However, Vishwas Sarang, the medical education Minister, stated, “We received at least 10-12 complaints related to deaths due to oxygen supply disruption. Medical experts found the cause of death was other medical complications, not hypoxia,”
In Goa, between May 10- May 14, approximately 83 patients succumbed to death.
But according to Dr Shivanand Bandekar, the Dean of Goa Medical College and Hospital stated, “We can’t put this as a direct answer. People who come to GMC, they are all referred because we are a tertiary (care) center where criticality is high and most of the patients die because of Covid pneumonia where oxygen is a part of the treatment. So we cannot directly say this (disruption in the oxygen supply) is the reason why they have died,”
However, during the hearing at Goa at the time of these deaths, the state government had admitted that “some of the casualties may have taken place” due to supply disruption.
Within the same hearing, the Bombay High Court had said, “We have long passed the stage of determining whether patients are suffering from the lack of oxygen or not. The material placed before us establishes that patients are indeed suffering and even in some cases succumbing for want of the supply of oxygen, in the State of Goa.”
Officials and ministers of several states like West Bengal, Odisha, Bihar, and Uttar Pradesh took a similar stand while siding with the Centre on their “no deaths due to Oxygen shortage” statement.
Even though various reports and data reflect a significant number of deaths due to a shortage of oxygen supply within different states, the Center and the state officials have refused to acknowledge them and have denied that these fatalities are attributed to the lack of oxygen supply.
Health Activist Amulya Nidhi from Madhya Pradesh, claims that volunteer groups from across the country have clear case studies and data that report deaths of patients across various states due to a lack of oxygen supply. “If they are so sure about it, they should allow an independent team of experts to probe the matter,” he said.
Why Are people Not Taking Covid Vaccine?
Since the beginning of the Pandemic in 2020, all people have wanted is to find a way back to normal. A way from virtual lives to real, social lives. Being trapped at home with limited movement has been fun for no one. And yet, when a solution is finally being offered, people are hesitant to embrace it. Vaccines are the solution to once and for all immunise us against this virus, but many people fail to embrace the cure. Even though the vaccination reduces risks in exposure to the mutating variants of the Novel Coronavirus, there are people reluctant to take the possibly life-saving shot.
A vaccine race began throughout the world to curb the spread of Covid, India being one of the leaders. Immunisation is proven to be the most successful means to prevent diseases. Still, there is always hesitance that follows with the process. Many reasons cause vaccine hesitancy, but three of the main reasons are inadequate knowledge and fear of side effects, the speed of vaccine development, and rumours and myths.
The biggest fear that prevents people from taking the vaccine is a fear of side effects caused by inadequate knowledge. Many of us might show reluctance in taking the vaccine, fearing the severity of side effects. This tends to happen because most people do not understand how a vaccine works and nudges our bodies to create antibodies in our system to immunise us to the virus.
Many people reason that the side effects make them sick when they have been in perfect health for so long. They believe that it is the vaccine that makes them sick. This cannot be further from the truth. The public needs to be made aware of the workings of the vaccine to promote the vaccination drive around the world.
The other cause for hesitancy is the speed at which the vaccines have been developed. Many people believe that simply because the development speed of Covid immunising shots was quicker as compared to past viruses, corners have been cut in the process. It is essential to know that this is not true as all the procedures have been followed during the development of vaccines. None of them have been permitted for distribution without clinical trials and the approval of the FDA.
The last reason is that of rumours and myths. The rural population, a key demographic in our country, is reluctant to take the vaccine due to a lack of information provided to them. The inadequacy makes them quick to believe in rumours and myths surrounding immunisation, consequently making them reluctant to participate in the process. Reports of death post the vaccine have fanned the rumour mills in rural areas regarding the fatality of the vaccine.
Hesitancy in vaccination can also be seen in another key demographic, women. The proof for this in India is the disparity in men’s vaccination ratios which are starkly contrasting. Rumours and myths surrounding vaccines have led the population to believe that taking the jab affects fertility in women. It is essential to know that vaccinations do not cause infertility in men or women. It is this kind of rumour-mongering that causes fear in people.
Misleading tweets by prominent figures also cause vaccine hesitancy. One prime example is senior advocate Prashant Bushan, whose tweets about the efficacy and safety of covid vaccines were tagged as “misleading” by Twitter.
Misinformation being spread by prominent people is another cause of reluctance in people not taking the vaccine, which must be stopped to defeat the Pandemic.
Many people who have already suffered from Coronavirus also believe that they do not need the vaccine as they are already immune to the disease. This is a falsehood that needs to be cleared as a vaccine prolongs the effectiveness of the immunisation, keeping the person safe for a more extended period.
Vaccines are preventative medicines that allow us to acquire immunity against the virus, preparing our bodies to protect us in case of exposure to the disease. While vaccination may not provide complete safety, it reduces the severity of the infection and the chances of death.
With newer and stronger variants emerging as mutations of the Coronavirus, all of us must be fully vaccinated. It is the only way to ensure the safety of ourselves and those around us. It is also the only way to make a return slowly but surely to what we knew as “normal” and stop living life as we have known for the past one and a half years.
"No one from govt has come to visit us or order an enquiry into my wife's death.I still curse myself for persuading my wife to take the vaccine.I thought it would save us from the virus, but it killed her".
The govt is not monitoring adverse events from vaccine nor releasing data pic.twitter.com/pcJv9cqUYW
— Prashant Bhushan (@pbhushan1) June 28, 2021
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