Will Assam be Equipped to Rollout Mass COVID-19 Vaccination?

The Assam government has revealed the priority for the distribution of vaccine when it is developed for public use. It has addressed that there is no public vaccine "currently" but is preparing a list of people who will receive the vaccine first once it is rolled out for the public. 

State Health Minister Himanta Biswa Sarma has revealed that around 70 lakh people will be the early recipients of the vaccine. "As of now there is no COVID-19 vaccine. Five vaccines are in the second or third levels of trials in the country and we are preparing to vaccinate about 70 lakh people in the state in the first go," the minister shared in the press conference.  

As per the minister, PM Narendra Modi had a video conference with all chief ministers of states and had listed four priority categories recipients. 

Accordingly, the list is being prepared which would contain around 70 lakh names in the state. A highly placed source in Assam's health department has stated the four categories: 

Govt never spoke about vaccinating whole country, says Health Secretary


In the line of such positive developments came an ambiguous statement by a senior official in India. The health secretary of India, Rajesh Bhushan, said that the "government has never spoken about vaccinating the entire country." He further said, "It's important that we discuss such scientific issues based on factual information only."

The statements have revealed that the priority has been to break the chain of transmission. The Indian Council of Medical Research (ICMR) also discussed the need to break the virus transmission.  

"If we're able to vaccinate critical mass of people and break virus transmission, then we may not have to vaccinate the entire population," added ICMR Director General (DG), Dr Balram Bhargava.

The viability of a vaccine 

The head Adar Poonawalla of the Serum Institute of India, which makes the AstraZeneca vaccine, said on November 23 last that the positive late-state trial result of the candidate will allow it to seek emergency use approval by year-end, before securing the nod for a full rollout by February or March. India is also conducting a late-stage trial of Russia’s Sputnik V.

Meanwhile, the UK has authorized Pfizer-BioNTech COVID-19 vaccine, to be made available across the country from next week. Pfizer and its German partner BioNTechsaid in November that the shot, relying on novel technology called messenger RNA, was 95% effective in a final analysis of clinical-trial data.

Moderna Inchas applied for US and European emergency authorisation of its Covid-19 vaccine based on full results from a late-stage study showing its vaccine was 94.1% effective with no serious safety concerns. On the other hand, trial data from Pfizer Inc with partner BioNTech SE, ModernaInc and AstraZeneca Plc have shown their experimental vaccines are effective in preventing coronavirus. 

The issue with Pfizer's vaccine is that it is required to be stored at a low temperature, which has caused a viability issue in India. The union health ministry has already confirmed on exploring possibilities for the issue of storing at cold temperatures. As such, India is focusing on the Serum Institute of India backed AstraZeneca Vaccine. 

India’s Serum Institute (SII) will also apply for an emergency license of the Covid-19 vaccine in the next two weeks. 

Adar Poonawalla, Head of Serum Institute of India, which makes the AstraZeneca vaccine, said on November 23 the positive late-state trial result of the candidate will allow it to seek emergency use approval by year-end, before securing the OK for a full rollout by February or March. India is also conducting a late-stage trial of Russia’s Sputnik V.

As per a NITI Aayog member, Dr Vinod Paul stated that there are five Covid-19 vaccine candidates under various stages of clinical trials in India of which two are in the third phase.

"India is one of the countries which is showing good progress in Covid-19 vaccine trials. Serum Oxford vaccine is in the completion of the phase 3 trials and Bharat Biotech's Covid-19 vaccine's candidate has begun phase 3 trials and the results for phase 2 trials can be announced any time. ZydusCadila has completed phase 2 trials" Dr Paul said.

Taking a political turn: Rahul Gandhi questions govt’s mass vaccination programme


Former Congress Party President Rahul Gandhi attacked the Centre over its statement that it had never spoken about inoculating everyone with a vaccine against COVID-19. 

Taking to Twitter, the Wayanad MP asked what Prime Minister Narendra Modi stands by thereby continuing the Congress' attack started from a day earlier.

"PM -- Everyone will get vaccine. BJP in Bihar elections -- Everyone in Bihar will get free vaccine. Now, GOI -- Never said everyone will get vaccine. Exactly what does the PM stand by?" Gandhi said in a tweet.

Gandhi attacked the government hours after the UK authorized Pfizer's Covid vaccine for emergency use, and asked if the Indian people will get the COVID-19 vaccine. The Congress, on its official Twitter handle, shared two screenshots claiming that the government of India has been issuing conflicting statements on COVID vaccination.

The corresponding roll-out in India and Assam

Keeping aside politics, the main question will be the practicability of a rollout in Assam. G Plus spoke to National Health Mission (NHM) Assam Director Dr Lakshmanan S, who exuded confidence in the distribution of the vaccine.  

He revealed a layer by layer approach amounting to 70 lakh people approximately out of the 3.2 crore population of the state.

On the issue of the viability of vaccinating lakhs of people, the director said, “The existing infrastructure of Assam’s immunisation program will help the COVID-19 vaccine when it’s rolled out.” 

Assam’s immunisation pushover the years

The NHM director accepted that to correlate the current vaccine achievements to that of a proposed COVID-19 vaccine is not accurate. However, he has assured that the state “will make the necessary infrastructure which is required.” 

Chart 1
 

With over six lakh vaccinations every year, Assam’s children have received multiple vaccinations. Mothers are also vaccinated in line with the Mission Indradhanush, whereas Pulse Polio programs cover the children. (See Chart 1) 

Chart 2 
 

In the last 4 years, Assam met over 90 percent of its immunisation targets for BCG-1, Pentavalent vaccine, OPV, RVV, IPV amd JE. All these vaccines are given to children from 0 to 1 year. (See Chart 2)
 

As for the pulse polio initiative, more than 95% of the targets have been met. (See chart 3) 

Chart 3 
 

This is not limited to children.Pregnant mothers who are given TT/Td 2 doses within first month of pregnancy have achieved majority of their targets.
 

“If we talk about all these programs, we already have the existing infrastructure to help the state during the rollout. Earlier it was just kids only.Now we have to think about the whole population,” added Dr Lakshmanan S.
 

As per a senior official, the tentative rollout for a vaccine trial in the state might start from middle of January or February. Assam has fixed the primary target, which is to get 60-70percent vaccinated.