Getting vaccinated against Covid-19 – Access Issues and Discrimination

Non-BJP ruled states have voiced that they are being discriminated in the supply chain of vaccines by the Union Government.  With the opening up of the vaccines to the private health sector, the supply of vaccines to public health facilities is going to get further constrained. We are going to see another level of discrimination based on financial access, writes RAVI DUGGAL.

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June 21st 2021 was a significant day. It marked the summer solstice in the Northern Hemisphere and winter solstice in the Southern Hemisphere. It is now also the International Yoga Day. But this year it became even more significant as on 21st June, India vaccinated nearly 8.1 million people across the country making it the highest number ever vaccinated on a single day. I too got my first jab of the Covishield vaccine on this day.

The Press Information Bureau released vaccination data by states for June 21 at 9 pm as an important success highlight of India vaccinating over 8 million persons on a single day, the highest figure as yet. Certainly, this is a noteworthy achievement but can it be sustained given the current production rate for the vaccines and supply chain issues. For instance on 22nd June, the total vaccines administered dropped drastically to 5.2 million jabs. 

Discrimination Against non-BJP states

A quick look at the 21st June data indicated that the data was revealing clear discrimination across states in rolling out vaccinations against Covid-19. I took the data and calculated the vaccines administered in each state as a proportion of the states population and reorganised the states in descending order and what came out sharply is that the top half of the states were almost entirely states which were under BJP/NDA rule (Table 1 and Graph 1). And many of these states are certainly not the most populous nor those having high prevalence of Covid-19. The states in the bottom half are predominantly the non-BJP ruled states, though they do include UP and Bihar, and many of them are high prevalence states.

So is this pattern we see a consequence of discrimination against non-BJP ruled states by curtailed supplies which affect the roll out of vaccines in these states with periodic shortages resulting in disruptions of vaccine roll out.

Table 1: Vaccinations administered on June 21 across States

Source: https://pib.gov.in/PressReleaseIframePage.aspx?PRID=1729199 

Percentage of state population vaccinated on 21st June 2021

Source: https://pib.gov.in/PressReleaseIframePage.aspx?PRID=1729199 

Access Issues

Given the erratic and unpredictable vaccine supply to the states getting access to the vaccine has been a struggle for most people and especially the poor and digitally challenged.  

I take my own personal example. I live on the outskirts of Mumbai and registered on the Cowin website in early April and since then have been trying to obtain a slot for vaccination but since schedule announcements and opening up of slots is erratic due to availability of vaccines with my state, I was unable to get a slot until June 21. 

Suddenly, there was huge availability in my municipal area of Mira-Bhayander which has a population of 1.8 million. Getting a slot was like a game of fastest finger first and it is clear that someone like me with good digital access also had difficulty with capturing a slot. What about the poor and those digitally challenged?

My vaccination centre was a school and the team providing the vaccination was from the local Municipal Corporation. Being a school with open space, social distancing was well maintained. It took us one and a half hour including the 30 minute observation time to get vaccinated.  

In the waiting area as well as at the registration desk, there were many people who were walking in to get the jab as they were digitally challenged. While they were not given the vaccine they were asked to go to the health centre close by and request them to help with registration and then come again some other day. 

As regards the vaccination process, while the staff appeared competent they had various handicaps, the biggest being at the registration desk. The staff was having issues in confirming our registrations on their apps – the confirmation SMS was not coming through and this was delaying the process. 

The persons at the desk informed that they were using their personal mobiles and had erratic connectivity. That was surprising. Why were desktops or laptops not provided to the staff with LAN connections so that connectivity was smoother? 

Even though the  confirmation SMS did not arrive, we were told to go to the vaccination room. That was quick as the nurses were ready with the jabs. They already had the syringes loaded and I find that problematic. When I asked why this was so, they said this is to hasten the process so that people don’t wait in the vaccination area. Is the cold chain being compromised and reducing efficacy of the vaccine? 

We got the shot and were asked to go to the observation room to wait for 20 minutes where each of us was given two tablets of paracetamol to be taken at night before we left.

Even after leaving, the confirmation SMS did not come and my registration status on the Cowin site showed as “not vaccinated”. When I confronted the registration desk, they requested me to go to the nearby health centre to get it corrected. The clerk at the health centre was nice but it took him 20 minutes to sort this out before our status of being vaccinated with 1st dose appeared and we immediately got the provisional certificate.  So, it was quite an effort to get access to the vaccine. 

Friends in Kerala tell me that once your register on the Cowin website, the local health worker would call you and offer a date and time slot for the jab and that was it. In the good old non-digital days whether it was the small pox or the polio vaccine or any other vaccine, we would get it at the school, or health centre or even at home from the outreach health workers. Why has the covid-19 vaccine process been made so complicated?

(Ravi Duggal is an independent Researcher and Activist. He deals with Public Health Policy, Systems and Financing; Budget, Governance and Social Accountability. The views expressed are personal.)

The article was originally published in The Leaflet.