COVID-19 vaccination opens for public, but are you eligible?

 

Almost one year had passed since the onset of the COVID-19 pandemic, and finally India has started COVID-19 vaccination for public. A certain group of population (people at high risk) can register to receive the COVID-19 vaccine from March 1^st, 2021. Prime Minister Narendra Modi has himself taken the first dose of COVID-19 vaccine at AIIMS, New Delhi.

In the history of vaccine development, this is the fastest one, that mankind has achieved, thanks to our hard-working scientists. As First phase of vaccination, India had already started vaccinating the frontline workers from January 16^th, 2021. India had been the major supplier of COVID-19 vaccine doses for past few months to over 60 countries, especially the countries which cannot afford the costly western vaccines. Specially the African countries and countries around Indian ocean have received COVID-19 vaccine doses from India. The chief of the World Health Organization, Dr. Tedros Adhanom has immensely praised India and Prime Minister Narendra Modi for this outstanding commitment for supporting vaccine equity, expressing his hope for other countries to follow.

WHO CAN GET THE COVID-19 VACCINE?

As India enters the second phase of COVID-19 vaccination today on March 1^st, 2021, senior citizens (60+ years age) and those aged between 45-59 years with comorbidities (List of comorbidities given below) can register for obtaining the doses of COVID-19 vaccine. The second phase of COVID-19 vaccination targets the population which are at high risk of COVID infection. Eligibility list:

1.      Person turning 60 years of age before or by January 1^st, 2022.

(Age proof  is required for vaccine shot)

2.    For those aged 45- 59 years of age, apart from age proof, medical documents will be required as proof of co-morbidities. 

List of Comorbidities: 

·     Diabetes (for more than 10 years or with complications) and hypertension (must be presently on treatment)

Note: person with both diabetes and hypertension are eligible (not one)

·        HIV infection/ immunodeficiency disease

·        Severe respiratory disease including hospitalization in the last two years

·        Heart failure with hospitalization in last one year

·        Those with left ventricular assist device in end-stage heart disease

·     Those who have undergone heart transplant / kidney transplant / liver transplant / hematopoietic stem cell transplant

·        Left ventricular systolic dysfunction, moderate or severe valvular heart disease

·        Congenital heart disease with pulmonary arterial hypertension

·        Coronary artery disease with hypertension or diabetes (on treatment)

·        Angina (chest pain) with hypertension or diabetes (on treatment)

·        Documented stroke case with hypertension or diabetes (on treatment)

·        End stage kidney disease on dialysis

·        Those on immunosuppressants

·        Decompensated cirrhosis

·        Leukemia / Myeloma / lymphoma

·        Sickle cell disease / thalassemia / aplastic anemia / bone marrow failure

·        Those diagnosed with cancer on or after July 1^st, 2020, or those on cancer treatment presently

·        People with multiple disabilities: includes

                 i.  Blindness and deafness (both),

                ii.  Acid attack where respiratory tract involvement is there,

               iii. Muscular dystrophy, intellectual disabilities,

               iv.  Disabled requiring high support needs.

A person aged 45-59 with any one of the above illness (documented) can register to receive the COVID-19 vaccine.

Note: Obesity has NOT been included in the list of 20 comorbidities for eligibility for COVID-19 vaccination for aged 45-59 years. Experts have opined that obesity should be included in this list. Although obesity at a certain degree becomes a threat as a co-morbidity. So, IF included, obesity needs to be clearly defined, at what limit or degree can provide eligibility for COVID-19 vaccine.

It is clear how government has set the above eligibility criteria to target the high-risk population, but also keeping in mind that it will create much more problem if people flood the hospitals at once for their vaccine shots.

Registration had started from 9:00 AM, March 1^st on the upgraded version of app CoWIN. Although people may face some difficulties due to traffic and delay on the portal, as lakhs of people will attempt to register themselves. Government officials have stated that it can take a week for the system to settle.

HOW TO REGISTER FOR THE VACCINATION?

Registration can be done either via the Co-WIN app from the app store of mobile or people can navigate to the government website cowin.gov.in for the same purpose.

Co-WIN Vaccinator app

cowin.gov.in

1.      People can use their Mobile number or Aadhar number or any other government identification number to register here. As the new Co-WIN 2.0 app is GPS integrated, once registered vaccination centers in the proximity will be displayed based on the person’s mobile location (location service of mobile should be kept switched on).

2.      Next, a person needs to choose a center and time slot as per convenience.

Alternatively, for people who cannot operate mobile or computer, arrangement has been made by government, so that one can walk into a center without registration, but if the quota for the same day has been exhausted, the center can ask them to follow the next day.

 

v  When selecting a hospital and a time slot, it will not be told which vaccine the hospital has (Covishield or Covaxin). This information will be conveyed only at the center.

v  Once successfully registered, one cannot change the center.

Vaccination centers have been directed to reserve 40% doses to pre-registered recipients and 60% to for walk-ins (expecting that most people in India still cannot register digitally). This can change from center to center.

HOW MUCH THE VACCINE WILL COST?

If one is going to a government hospital, vaccination will be free, while in private hospitals, a recipient must pay a maximum of Rs 250 per dose. That means, for two doses one must pay up to Rs 500 (maximum).

Currently, from the private sector, only hospitals enlisted under Pradhan Mantri Jan Arogya Yojana (PMJAY) and Central Government Health Scheme (CGHS) have been allowed to participate in this phase of vaccination. Several states have requested government to allow charitable hospitals to join the vaccination drive.

WHAT HAPPENS IN CASE OF ADVERSE EVENT?

In case of adverse event, one must report to the same hospital, from where vaccine was received. In case of adverse events, the admission and hospitalization charges will be separate.

People need to know that the adverse effect of COVID-19 vaccines are very low. So far, CoWIN has registered 1.7 crore beneficiaries and immunized 1.1 crore until 28^th February. Till February 26^th, only 14,879 adverse events following immunization (AEFI) were recorded and 151 of them were severe. The portal has recorded death of 40 people so far following vaccination. Still, that is a very miniscule number compared to the number of beneficiaries, i.e. almost 0.001% (14,879 out of 1.1 crore). Most of these events were very mild starting from fever to body ache. And those 40 deaths have not been completely related to COVID-19 vaccine.

Adverse events following any immunization (OPV, DPT, Measles etc.) ranges from 0.001% to 0.01%. So, comparing to all the previous vaccines, the observed AEFI rate with COVID-19 vaccines is quite acceptable.

It is noteworthy that Indian government has maintained transparency on the reporting of adverse event following immunization.

PRIVATE SECTOR KNOCKING AT THE DOOR

Recently, stakeholders from the private sector reached out to health minister Harsh Vardhan, to allow availability of COVID-19 vaccine at community pharmacy level, bringing light on how United States of America has been able to ramp up vaccination drive despite making similar beginnings as India.

USA began vaccination on 10^th December 2020 and took 27 days to administer the first seven million doses- similar kick start as India, which started on 16^th January and took 26 days. However. Since then, USA has administered average of more than a million doses per day, whereas India has managed only 2,50,000 doses per day.