Tackle trust deficit and software chaos

A health worker gets a shot of the vaccine at Nair hospital on Saturday. Pic/Ashish Raje

The launch of India's COVID vaccination programme will be remembered not only for its mega scale, but also for factors that created mental hurdles for recipients from the healthcare sector, especially the doctors. A software glitch forced the Maharashtra government to suspend the drive till Monday. The engineers can take care of the connectivity issues, but concerns remain about the efforts that should go into dispelling doubts over the ingenious Covaxin's efficacy, because they are raised by none other than the medical professionals selected for the vaccination. Reports coming from Nagpur's Government Medical College say that several doctors refused to take the Covaxin instead of Covishield, a widely circulated vaccine. In Mumbai's state-run JJ Hospital, only 39 of 100 listed people turned up for Covaxin, apparently because they didn't want a vaccine that has run into a controversy over its ‘still-under-trial' status. Speaking officially, the authorities concerned said the last-minute calls and weekend engagements kept most beneficiaries away. They hope to increase the numbers as the drive progresses further. However, the murmurs of Covaxin vs Covishield didn't stop on Saturday but became an open talk later in the day when the Covaxin producers announced compensation for affected beneficiaries. In Delhi's Ram Manohar Lohia Hospital, the resident doctors demanded that they be administered Covishield and not Covaxin.

Doubts about Covaxin
Certainly, this isn't an encouraging beginning to the world's largest vaccination drive which will inject 3 crore healthcare and frontline workers by the end of its first phase. Another 27 crore - comorbid people and senior citizens - are on the vaccination list. Prime Minister Narendra Modi did his bit in delivering assurance over the Indian vaccine developers' ‘international' credibility. He said that life-saving vaccines given to 60% children globally are made in India. The Congress party leaders have questioned the Centre over the approval for Covaxin. Social activist Saket S Gokhale moved the Bombay High Court against the Drugs Controller General of India (DCGI), urging that the safety and efficacy trial results of Bharat Biotech's COVID-19 vaccine Covaxin be made public. He said in the interest of millions of people in India the data should not be kept secret.

Actually, the doubts began piling up early with a public spat between Covishield's contract manufacturer Serum Institute of India (SII)) and Covaxin developers Bharat Biotech. SII's Adar Poonawalla had said that only three vaccines passed all scientific evaluations while the others were safe, "safe like water", their effectiveness had not yet been evaluated. Bharat Biotech Chairman Krishna Ella retorted, "Some companies have branded me like ‘water'. I want to deny that. We are scientists. We do 200 per cent honest clinical trials and yet we receive backlash. If I am wrong, tell me." The Centre stepped in to end the unsavoury spat and the companies issued a joint statement saying, "Both companies respect the great work being carried out by each other and put behind us the miscommunication and misunderstanding. We are fully aware of the importance of vaccines for people and countries alike, we hereby communicate our joint pledge to provide global access for our COVID-19 vaccines."

The statement notwithstanding, the sizeable refusals from the medical fraternity have marred the vaccination's inaugural drive, and the act is likely to play on the minds of the beneficiaries who may now want to pick and choose.

Doctors raise concerns
For Mumbai's JJ Hospital, 2,000 vials of Covaxin have been provided. They will be sufficient for 1,000 people. Likewise, other state-run healthcare stations across Maharashtra have been given the vaccine's 20,000 doses. While SII's Covishield is being given without any written consent at other stations, receivers of Bharat Biotech's vaccine shot are told to sign an ‘emergency use' form.

Speaking to mid-day, several senior doctors have raised concerns and suggested ways to rectify the haste. Some say that it is globally accepted to deliver the vaccine while phase III trials are underway. They say the compensation offered by Bharat Biotech against any adverse effect should be taken as a good sign, and the informed consent form should be made mandatory for Covishield as well. As of now, the number of Covaxin beneficiaries may not be as large as those of Covishield, but as the drive progresses, the government will have to increase the number of its recipients. The controversy should be laid to rest before it's too late.