Universal vaccination, expediting first dose drive need of the hour

Even a single dose will quickly bring down the susceptible pool of potentially infected people, says health expert

Public health experts are now pressing for a ‘Universal COVID vaccination drive’ just like the universal immunisation drive for childhood immunisations like DPT, measles and polio to quickly contain the transmission spread and vaccinate more people.

About 140 million doses were administered but we don’t know what proportion of the population has been vaccinated as the strategy was to offer the vaccine to priority groups. But, “in the face of a horrendous second wave gripping the country a strategic plan is necessary to quickly immunise the vulnerable, high-risk groups and others to control deaths and transmission”, asserted Indian Institute of Public Health (IIPH)-Hyderabad Director G.V.S. Murthy.

“Even a single dose gives an efficacy of 65-70% within 2-3 weeks of the vaccine dose and this will quickly bring down the susceptible pool of potentially infected people. So, the first dose should be administered at the earliest to flatten the curve quickly,” he said, in an exclusive interaction on Tuesday.

“I call this a ‘minesweeper strategy’ where you systematically search every inch of an area for landmines. It will be an effective way of dealing with ‘COVID mines’ especially when we don’t know where they are located and whom they are potentially infecting each time they breathe, eat or interact with,” he explained. Evidence available shows that if 70% of the population is vaccinated, the risk of COVID transmission can be reduced significantly to manageable levels. This cannot be achieved by fragmented vaccination campaigns mounted from hospital set-ups, hence the urgent need to quickly devise strategies to deliver vaccines at ward or village level, said the director.

COVID vaccines can be stored at 4-8 degrees Celsius and are already been used to transport in vaccine carriers used for childhood vaccinations. “We will know who are the people getting vaccinated and what percentage of population is getting covered. Social leaders and local volunteers can list out 18+ people in their areas along with AADHAR numbers and share the same with the designated vaccinators for their area,” he suggests.

Vaccinators can be from the government but hospitals desirous of making a difference can be subsidised for their efforts to help cover more people. “This will also reduce wastage as the beneficiaries’ number and sessions can be scheduled based on vaccine availability. First it should be for population aged 30+ and once stocks are available, others can be covered another day. The campaign can be started in different zones of cities/ towns/ villages at the same time so that there is no discrimination in vaccine access,” explained Dr. Murthy.

Such an approach will reduce crowding at vaccine centres which otherwise can be hubs of transmission without adequate distancing or protection. Since many are currently working from home, staggered vaccination timings will also reduce crowding, he said and affirmed that vaccines used across the globe have “dramatically reduced mortality and severe COVID”.

There is also evidence that transmission is also reduced by a substantial percentage “though there is no measurable evidence on this at the moment. “This is because all the vaccine trials looked at efficacy primarily in terms of severe COVID and deaths,” added Mr. Murthy.

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