Just Over Half Of Health Workers In India Accepted COVID Vaccine After Weekend Campaign Launch
Health care workers administered the COVID-19 vaccine on 16 January at Chacha Nehru Bal Chikitsalaya (children’s hospital) in Delhi.

The Indian government began the world’s largest COVID-19 vaccination program this weekend aiming to vaccinate more than 300 million people, beginning with 10 million health workers, but in the three days since, it appears there has been low uptake among that key demographic.

Based on Health Policy Watch’s estimate, only slightly more than half of the people registered have received their vaccine in the three days since the launch. 100 people are registered per session, with 7,860 sessions held. Despite this, only 4,54,049 have been vaccinated as of Monday night.

Additionally,  vaccination rates in three states  — Tamil Nadu, Punjab and Puducherry — were 40% lower than expected.

“It is sad that members of our medical fraternity – our doctors and nurses – are declining the vaccine,” said Dr VK Paul, member of Indian government think-tank Niti Ayog, said in a press conference on Tuesday.

“I request them to please take the vaccine. We do not know what shape this pandemic will take.”

The country, which began its rollout on Saturday 16 January, is distributing two vaccines: the Oxford/AstraZeneca candidate, known as Covishield, manufactured by India’s own Serum Institute, and Covaxin, developed by Indian-based Bharat Biotech in collaboration with the Indian Council of Medical Research.

Earlier this month, India’s chief drug regulator granted the Serum Institute vaccine an emergency use license based on Phase 3 data from trials in Brazil and the United Kingdom, where the vaccine has already been approved.

But the decision to authorize Covaxin, a vaccine developed by the local firm Bharat Biotech together with the Indian Council of Medical Research, was made without final Phase 3 data. And the lack of transparency around that approval process may also be fuelling vaccine hesitancy.

Anyone receiving a Covaxin shot will be asked to fill in a consent for which notes that “the clinical efficacy of Covaxin is yet to be established and is still being studied in Phase 3 clinical trial” – although Phase 1 and 2 trials indicated the vaccine produces antibodies.

Two people, aged 43 and 52, have reportedly died following their vaccination. It has been confirmed that these deaths were both due to cardiopulmonary disease, and were unrelated to the vaccine.

Dr Manohar Agnani, additional secretary with Indian Ministry of Health and Family Welfare, said: “So far no case of serious or severe adverse events following immunisation attributable to vaccination till date.”

Confusion over Rollout Of Experimental Covaxin Vaccine Fuels Hesitancy

Many doctors employed in national hospitals have been cautious as to go on record about the mixed sentiments the campaign is thus generating.  As one senior doctor in Safdarjung Hospital told Health Policy Watch: “There is a little bit of confusion over Covaxin. Everybody does not want to become part of a trial (as the vaccine is being administered under clinical trial mode). It would have been better if I was given a choice. I would have taken Covishield.”

He later clarified he would be taking his Covaxin shot when offered, however his colleague also expressed apprehensions due to the lacking Phase 3 data.

Each vaccination site has only been provided with one of the two authorized candidates, meaning that people who are registered in that hospital have no choice but to take the vaccine available at the center.

Of the 37 states and union territories in India, 12 received the Covaxin vaccine.

On Saturday, about 22 million health workers were vaccinated were vaccinated across India.

In the Dr Ram Manohar Lohia Institute of Medical Science in Delhi, resident doctors wrote a letter to their hospital’s authority on Saturday,outlining why they were not comfortable taking Covaxin.

The letter read: “The residents are a bit apprehensive about the lack of complete trial in case of Covaxin and might not participate in huge numbers thus defeating the purpose of vaccination.”

Signatories then requested to be vaccinated with the Serum Institute-manufactured vaccines.

But Dr D R Meena, Registrar of Safdarjung Hospital, Delhi, took the Covaxin vaccine on Saturday, saying he “had mild myalgia” – or muscle pain – and that he “did not even need paracetamol”.

There have also been some cases of death following vaccination that were widely reported in the media – although these have so far been attributed to pre-existing conditions.

‘A Proud Moment’: Vaccination As A Lifeline

For some doctors, however, the launch of the vaccine campaign process was still an emotional moment.

Dr Prashant Lohmore, 28, is a resident doctor working in the emergency ward at Max Smart Superspeciality Hospital, a private hospital in Delhi. He received his Astra/Zeneca vaccine on Monday.

“I saw a lot of patients facing respiratory distress after Diwali,” he said. “We did not have enough beds at the time.”

That the country’s vaccination program has now begun “is a proud moment for us”, he added.

Dr Meena – the doctor who said he experienced only mild muscle pain from Covaxin – spent 2020 working as an anaesthetist in the Intensive Care Unit. His wife, also a doctor, works about 80km out of Delhi, and was gone for several months.

Their two children – a nine-year-old daughter and a 17-year-old son – both had little contact with their parents. Dr Meena and his wife both received their vaccine on the same day.

“I used to isolate myself in a room. My daughter would insist on talking to me. She is a small girl,” he said.

“Those were the hardest months of my life. Vaccination provides hope to us.”

Image Credits: Press Information Bureau, India.

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