Covid-19: Experts Suggest ‘Targeted Vaccination’ To Help Cover Vulnerable Populations Faster

A Health Ministry press release on August 17 claimed that India achieved the highest-ever single day vaccination on August 16 when the country inoculated over 88.13 lakh adults in a single day.

“With the administration of the more than 88.13 lakh doses, the cumulative vaccination coverage has increased to 55.47Cr (55,47,30,609). This translates to 45% of all adult Indians receiving the first dose. 13% of all adult Indians have received both doses of vaccine and are protected against COVID-19,” the press release said. 

Though India has inoculated the highest number of people in the world yet the percentage of fully inoculated individuals against its total population looks dismal.

In seven to eight months while more than 15 countries such as Singapore, Qatar, Uruguay, Portugal, Denmark, Chile, Spain have vaccinated more than 50 percent of its population, India’s coverage is merely 13 percent.  

A section of experts say that the current vaccination drive in India is random and it doesn’t prioritise any section of population-based on their age or history of Covid-19. They advise a targeted vaccination drive where vulnerable and naïve populations (non-infected individuals) should be covered on priority. 

When the country had started the drive on January 16 this year, it only included people of or above the age of 45. However, the second wave witnessed the younger population falling to prey Covid-19. This forced the government to amend its vaccination policy from May 1 onwards and include even those who are of or above 18 years of age.

This has led to the shortage of vaccines and trained vaccinators. The exorbitant cost of mass vaccination has also become a cause for concern among health experts. 

Many experts have questioned that India cannot have a vaccination policy similar to any other country as its population is over 16 percent of the total world population. The population of India is four times more than that of the USA.

These experts are of the view that the recent seroprevalence survey has already established that about 60 to 70 percent population is already infected and studies, so far, have also shown that people who are naturally-recovered have a very low rate of reinfection. Even such reinfections rarely become severe and lead to death.

In such a situation, they argue that it is advisable to vaccinate those who are uninfected till now so that more and more vulnerable population can be covered within a shorter period of time.

“I believe India should look at multiple strategies to speed up its vaccination coverage. One of them is to postpone those who are confirmed cases of naturally recovered because so far we know that they are well-protected and chances of reinfection are low,” Dr Jugal Kishore, Director Professor & Head of Community Medicine at Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, said.

He added, “Another suggestion is to vaccinate people Intradermally (ID) from the current practice of Intramuscular (IM). Studies have shown that IM injections consume 5 ml of vaccine for one person. The benefits remain the same if 5 people get 1 ml dose through ID injections.”

Though the government has issued an advisory for the deferment of the inoculation for three months to those who are naturally recovered there is no effective mechanism to implement it.

Dr Rajesh Kumar, Ex-Professor and Head in the Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh agrees that in case there is a shortage of vaccine, this strategy of targeted vaccination should be adopted to prioritise inoculation to the vulnerable population.

Dr Kumar says that at the vaccination centre, everyone should be asked about his Covid-19 experience and advise accordingly but this is not being done properly.

Dr Vikas Maurya, Director and HOD, Pulmonology, Fortis Hospital in Shalimar Bagh suggests the need to increase the production and procurement of the vaccinations in India. 

“We also need to involve schools, colleges, and other industries to build a recall value for vaccinations in rural areas and also ensure that vaccination wastage does not happen – it was seen that after second wave the wastage factor came down significantly as more people booked and showed up for their appointment. These are the ways in which vaccinations can reach the rural population,” Dr Maurya said.