We should leverage the learning from our Covid vaccination drive, and build on the innovations for higher immunization targets
January 16, 2023, marks the successful two years journey of one of the biggest vaccination drives in the world and most satisfying years of my career as public servant and also as an in-charge of this initiative. India’s Covid-19 vaccination drive has become a text-book example of dealing with a public health emergency unprecedented and unanticipated in nature.
It has become an illustration of India’s best qualities, grit and determination of its frontline and health workers as well as active participation of citizens in dealing with a crisis. This is a story of innovations and improvisation in policy and regulations; in logistics and supply chain management; in social mobilization; in governance and in strategic interventions.
Adequate and timely availability of safe and efficacious vaccines was ensured through various simultaneous measures such as providing a conducive environment for research and development, parallel testing of vaccines, expedited Emergency Use Listing (EUL) process without compromising the regulatory requirements, technology transfer, financial grants and advance payments in full to the manufacturers.
Efforts which equally deserve mention are the assessment and significant augmentation of the country’s capacity of vaccine storage (cold chains), extensive capacity building using a hybrid model of both virtual platforms and physical trainings, monitoring the quality of training of nearly 75,000 programme officers and medical doctors, 890,000 health workers and 300 national and state adverse events following immunization (AEFI) committee members using certain pre-fixed key indicators.
Leveraging digital capabilities, CoWIN (Winning over Covid) platform played a crucial role as it was based on the five core principles: inclusivity, accessibility, equity, transparency and scalability. It monitored and reported real-time vaccination numbers on its dashboard, ensuring transparency throughout and enabled seamless vaccine delivery across 29,000 cold chain points. Each vaccination centre was allotted a CVC ID and no vaccine was provisioned to any vaccination centre without creating a vaccination session on CoWIN, while each beneficiary was provided with a unique beneficiary ID and no beneficiary was vaccinated without being registered on Co-WIN.
The precept of the communication strategy generated the spirit of people’s participation (Jan Bhagidari). Campaigns such as ‘Har Ghar Dastak’ Teekakaran Abhiyaan and COVID-19 Vaccination Amrit Mahotsava expedited the identification and vaccination of missed/due beneficiaries. ‘Har Ghar Dastak’, drive was amplified by the involvement of local leaders and Gram Panchayats to motivate the beneficiaries for vaccine uptake and timely completion of dose schedule. Extensive involvement of CSOs/NGOs yielded widespread factual messaging and mass mobilization of beneficiaries, especially the migratory population.
Free precaution doses were administered to eligible beneficiaries under COVID-19 Vaccination Amrit Mahotsava through a camp-based strategy wherein special vaccination sessions were organized at various places such as public and private offices, schools, colleges, routes of religious yatras, industrial establishments, etc.
The most critical component for the success of the programme was its continued supply chain mechanism which was sustained throughout by increasing the frequency of vaccine supplies with reduced quantity of vaccines in each tranche to minimize vaccine stock in the pipeline. Vaccine wastage was minimized through regular review with cross-learnings between States/UTs ensuring efficient utilization of each dose of vaccine. A time-series of coverage of both the doses of covid-19 vaccine clearly illustrated that the gap closure was achieved between the first and second dose administered. India’s Covid-19 vaccination drive has maintained a healthy pace from the very beginning, thereby positioning our nation as the fastest in the world to vaccinate one crore beneficiaries With the administration of more than 220 crore Covid vaccine doses across the country, India displayed its capability to consistently achieve high levels of vaccination coverage for a sustained period of time. India has successfully covered more than 90 per cent of the eligible population aged =12 years with both the doses of COVID-19 vaccine.
To conclude, I feel that we should leverage the learning from our Covid vaccination drive, and adapt and build on the innovations towards ensuring 100 per cent coverage of giving vaccines to children and pregnant women under the Universal Immunisation Programme. The planning of which has already started under U-Win and I am fully confident that Team Health India will show to the global world the strategy and implementation process of achieving universal immunisation and saving lives.
(The author, a former Additional Secretary (Health), is a public health expert)
