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Opinion

Polio and BCG promote vaccination plan

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India plans to use the expansive network of its 42-year-old universal immunization program to manage the logistics of administering Covid vaccines next year.

Officials involved in the planning process said, on condition of anonymity, that the existing infrastructure and human resources will be sufficient to vaccinate the first 30 million Indians, mainly health workers and first responders, when the country begins vaccinating people early next year.

“Out of the 2.39 lakh strength of vaccinators from the existing immunization program, at least 1.5 lakh workers will be used to deliver Covid vaccines to the first two priority groups tentatively from January to March 2021,” said one of the officials, a senior government official.

“The 29,000 existing cold storage facilities should be enough to store and distribute the 60 million doses required for priority groups during this period,” he added.

The universal immunization program depends on the Ministry of Health and covers 25 million children every year, vaccinating them against a variety of diseases such as measles, polio and tuberculosis.

“For us, the Covid vaccines will be an extension of our routine duty. Our universal immunization program started in 1978 and every year we vaccinate 25 million children in India against pulsed polio, BCG, hepatitis B, MMR and other diseases, ”said a second officer who oversees infrastructure and logistics preparedness related to Covid vaccines.

The Union Ministry of Health has also written to all the states and territories of the Union to identify the people who can be used for the massive Covid-19 vaccination campaign. “As you know, the Government of India has started preparations for the introduction of the Covid-19 vaccine, once it is available. As part of the preparations, one of the activities is the creation of a database of health workers (HCWs) who will be prioritized for the Covid-19 vaccine … It is reiterated that potential vaccinators among HCWs must be identified to receive support during the Covid -19 vaccination campaign “, said the letter sentNovember 23by Vandana Gurnani, Additional Secretary, Ministry of Health.

The first vaccine available in India will likely be that developed by AstraZeneca and Oxford University, and manufactured by the Pune-based Serum Institute of India (SII). While late-stage trials are ongoing in India, interim data from phase 3 trials elsewhere have already shown the vaccine to be effective (62% in one dosage regimen and 90% in another). SII’s Adar Poonawala said on Sunday his company would apply for emergency regulatory approval for the vaccine.

While three other vaccines (developed by Moderna, Pfizer / BioNTech, and the Gamelaya Institute of Russia) have also shown efficacy in phase 3 trials, India does not yet have agreements with any of these companies. Two Indian vaccines are in Phase 3 clinical trials.

Certainly, as vaccination coverage expands (the elderly will be covered first after priority groups), the government will have to substantially improve capacities beyond its universal immunization program. There are about 260 million Indians who are over the age of 50, a demographic considered especially vulnerable to the disease.

The expert group on vaccine development and procurement headed by Niti Aayog member Dr. VK Paul and co-chaired by the Union’s health secretary, Rajesh Bhushan, has identified four priority groups.The first comprises doctors, nurses, and other medical personnel; the second includes front-line workers such as the police, municipality personnel, and others directly involved in the country’s war against Covid. The third group comprises people over 50 years of age, while the fourth group is people under 50 years of age but with comorbidities.

The second official quoted above confirmed that while the vaccination program will be strictly controlled by the Union government, the facilities of private hospitals will also be used to administer the vaccine. “Private hospital officials and their people will not be allowed to administer vaccines, but their facilities will surely be used as they are now.” The government does not want to use the entire workforce of its immunization program because it does not want any interruption in the ongoing vaccination programs.

The big challenge, officials acknowledged, would come when India needs to give Covid vaccines to the next priority group: the 260 million over the age of 50. “Around March or April, we will need more vaccinators to serve the third priority group. But we will wait and see what should be done for that period, “said the first official, hoping that by then there will be a sharp drop in infections.

The recent grant to companies that allows them to use CSR funds to support the vaccine program may be helpful at this stage. The government expects many companies to fund additional capacity in storage lines and freighters. The Union Ministry of Health has already sent the required cold storage and deep-frozen specifications to the Ministry of Corporate Affairs and some other ministries so that companies interested in spending CSR funds properly can do so. Indian regulations require companies to spend their corporate social responsibility (CSR) funds on research and development (R&D) to find vaccines, drugs and medical equipment to combat the Covid-19 pandemic. The Companies Act requires companies with a net worth of ₹ 500 crore or more, or a turnover of ₹ 1,000 crore or more, or a net profit of ₹ 5 crore or more in the immediately preceding financial year, compulsorily spend the 2 % of average net profit. of the previous three years in CSR.

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