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From the Factory to the Far Village: Behind India’s Gigantic Vaccination Campaign | India News

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KORAPUT: Reena Jani got up early, finished her chores in the cold of January, and walked up the hill to the road that runs alongside her remote tribal village of Pendajam in eastern India.
Riding as a passenger on a neighbor’s motorcycle for 40 minutes through rice-dotted hillsides, the 34-year-old health worker headed to the Mathalput Community Health Center.
Jani’s name was on a list of 100 health workers at the center, making her one of the first indigenous people to be vaccinated against Covid-19 earlier this month, as the country launches a vaccination program that the government considers the largest in the world.
But he had heard rumors of serious side effects and was concerned about what would happen if he got sick.
“I was scared for my son and my daughters. If something happens to me, what will they do?” Jani told Reuters, visibly relieved after the injection produced no immediate side effects.
The vaccine he received had traveled much further. They took him by plane, truck and van about 1,700 km from the factory to the clinic where Jani was waiting, and he had to be kept cold all the way.
His safe arrival in the Koraput district, where leftist guerrillas are waging a low-level insurgency amidst hills and thick forests, was testimony to the detailed planning and groundwork of the authorities in Odisha state.
But officials acknowledge that this is only the tip of the iceberg.
The 1.5 million vaccinated so far, aimed primarily at key workers like Jani, are a small first phase of a vaccine program that India hopes will eventually protect its 1.4 billion people from the coronavirus.
Only when the much larger third phase, targeting 270 million people considered vulnerable, is launched, will the government know whether its plan to distribute gunfire across sometimes hostile terrain and amid high temperatures will succeed.
“The problem will start in the third phase, when the public will start to arrive,” said Madhusudan Mishra, a Koraput district collector. “That will be a real challenge.”
Providing vaccinations is one thing. Convincing people to take them is another.
Skepticism about the safety and efficacy of Covid-19 injections is high in India, particularly in rural areas, officials say, and misinformation via social media platforms and word of mouth could undermine the effort.
The Covid-19 vaccine that Jani took was developed by AstraZeneca and the University of Oxford. India is also using another developed by Bharat Biotech.
The rollout comes as the number of coronavirus cases in India was approaching 11 million and deaths exceeded 150,000.
‘THE MOST EXPECTED VACCINE’
Manufactured in the western city of Pune by the Serum Institute of India, the world’s largest vaccine manufacturer by volume, some 40,800 vials of the AstraZeneca injection were flown by a commercial airline to the capital of Odisha on January 12.
A fire last week at the Pune plant killed five people, but authorities said vaccine production would not be affected.
India has distributed 16.5 million doses of the two approved vaccines to its states and territories, which dispersed them using an army of drivers and an infrastructure set up for existing but reinforced vaccination programs for the pandemic.
In Odisha, after a delayed start on January 13, government staff at the vaccine center removed jars from a cavernous refrigerator and carefully counted them, before packing them in insulated boxes with ice packs to keep them between 2 and 8 degrees. Celsius for up to three days.
Then he passed the veteran driver of the health department Lalu Porija. He drove his delivery van all night to get to the site, and now he had to transport the vaccines 500 km (310 miles) back to Koraput with an armed plainclothes policeman for company.
“I’m feeling a little tired,” Porija said, stopping for tea that night after a traffic jam delayed the trip for several hours.
Negotiating cows, debris, thick fog, and hairpin turns, and fighting fatigue, Porija drove nearly 24 hours in three days to collect and deliver the vaccines to the city of Koraput.
On January 15, at Koraput’s main vaccine store, health workers counted, packed and loaded smaller quantities for the five vaccination sites in the district, including the Mathalput Community Health Center some 30 km away.
A small white pickup truck left at noon, kicking up dust on narrow rural roads, to make a delivery to various locations. Once again, an armed policeman sat inside.
“The most anticipated vaccine,” a Mathalput health worker told colleagues as he unloaded a box of injections.
TEAR CHALLENGES
India has come up with a plan to vaccinate around 300 million people between July and August.
In the first phase, which started earlier this month, the target is 10 million health workers, including Jani. It is followed by 20 million essential services workers, followed by 270 million people considered susceptible to the coronavirus.
Beyond that, there is no clear roadmap, although the government has said that all Indians who want or need the vaccine will receive it.
In Koraput, a team of officials spent months developing a local Covid-19 vaccination plan, the officials said.
Since much of the district lacks internet access, they chose vaccination sites with good connectivity and conducted dry trials, said Koraput’s chief health official, Dr. Makaranda Beura.
And where mobile coverage was spotty, as in Jani’s Pendajam village, health workers were called into meetings to brief them on vaccination plans, followed by visits by supervisors to people registered for vaccination.
Despite initial failures, particularly with CO-WIN, a centralized digital platform for implementing and tracking India’s gigantic vaccination program, Koraput officials said the system would be sufficient for the first two phases.
For the much larger third phase, district collector Mishra said he anticipated the deployment of the entire local police force to handle crowds, as well as the acquisition of additional vehicles to support personnel working in remote areas.
But moving the vaccine deep inland, where Maoist insurgents are known to operate, also requires police to work with paramilitary troops and special forces, said Southwest Odisha Police Chief Rajesh Pandit.
“We have to be very careful,” Pandit said.
RUMORS AND DOUBTS
Jani became an accredited social health activist (ASHA) community health worker, a lynchpin of India’s rural health system, about seven years ago.
She monitors pregnant women in her village of 500, helps with malaria tests, and distributes basic medicines for fever and diarrhea.
Jani, the main breadwinner in her five-member family, receives a monthly salary of 3,000 rupees ($ 41), which helps her two daughters and a son attend school.
When she first learned that she was going to be vaccinated, Jani said she wasn’t worried. Then he heard a rumor.
“Someone told me that people are fainting, have a fever and some die after receiving the injection,” he said. “That’s why he was scared.”
In a survey by New Delhi-based online platform LocalCircles, 62% of 17,000 respondents were hesitant to get vaccinated immediately, mainly due to concerns about possible adverse reactions.
Fears also abound among healthcare workers, prompting India to appeal to front-line workers not to refuse vaccines after many states failed to meet initial vaccination targets.
Dr Tapas Rajan Behera, medical officer in charge of the Mathalput Community Health Center, said authorities were aware of a possible reluctance to take the vaccine and had instructed health workers to allay fears about safety.
A nervous Jani finally received her vaccine, vaccinating her in part against Covid-19 – a small step in India’s mission to defeat the pandemic.

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