Experiences from a COVID-19 vaccination center at a tertiary care teaching hospital in Delhi, India: Challenges and solutions

Authors

DOI:

https://doi.org/10.5055/jem.0822

Keywords:

coronavirus disease 2019, coronavirus disease 2019 vaccines, Co-WIN, vaccine hesitancy, vaccine eagerness

Abstract

India began its nationwide coronavirus disease 2019 (COVID-19) vaccination program on January 16, 2021, in a phased manner. In this paper, we have discussed our experience at one of the COVID-19 vaccination centers in the country and have identified a few of the major challenges and their implications. The guidelines for COVID-19 vaccination in the country were changing frequently, leading to ambiguity among the beneficiaries. Co-WIN software, used for program implementation, had some glitches, which caused dissatisfaction among the service providers and beneficiaries. Vaccine hesitancy and eagerness caused low vaccine uptake initially and overcrowding at vaccination centers later. Some of the vaccination centers had the potential to become hot spots for further spread of the virus due to insufficient infrastructure. The disparity in access to vaccines for the homeless and other vulnerable groups was another hurdle for adequate vaccination coverage. These challenges could have been addressed by pretesting the information technology platform, long-term planning with a vision for handling vaccine hesitancy and eagerness, strong communication systems, removing disparities in vaccine access, and maintaining uniformity in messages for frequently updating guidelines.

Author Biographies

Priyanka Sharma, MD

Assistant Professor, Department of Community Medicine, North DMC Medical College and Hindu Rao Hospital, Delhi, India

Geeta Pardeshi, MD

Professor, Department of Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India

References

Pandey A, Sah P, Moghadas SM, et al.: Challenges facing COVID-19 vaccination in India: Lessons from the initial vaccine rollout. J Glob Health. 2021; 11: 03083.

Choudhary OP, Choudhary P, Singh I: India’s COVID-19 vaccination drive: Key challenges and resolutions. Lancet Infect Dis. 2021; 21: 1483-1484. DOI: https://doi.org/10.1016/S1473-3099(21)00567-3

Rackimuthu S, Hasan MM, Bardhan M, et al.: COVID-19 vaccination strategies and policies in India: The need for further re-evaluation is a pressing priority. Health Plann Manag. 2022; 37: 1847-1850. DOI: https://doi.org/10.1002/hpm.3321

Vashishtha VM, Kumar P: Responding to new challenges: Is there a need to relook and revise our COVID-19 vaccination strategy? Expert Rev Vaccines. 2022; 21: 1015-1018. DOI: https://doi.org/10.1080/14760584.2022.2077196

Ministry of Health & Family Welfare: Centre writes to states/UTs to increase the interval between two doses of Covishield to 4-8 weeks based on NTAGI and NEGVAC recommendation. Protection enhanced if the second dose of Covishield is administered between 6-8 weeks. Ministry of Health & Family Welfare, Government of India. 2021. Available at https://pib.gov.in/PressReleasePage.aspx?PRID=1706597. Accessed June 24, 2021.

Bharat Biotech International Limited: Fact sheet for vaccine recipients & caregivers. Restricted use of Covaxin under clinical trial mode. The Bharat Biotech COVID-19 vaccine. Covaxin. Hyderabad: Bharat Biotech International Limited. Available at https://www.bharatbiotech.com/images/covaxin/covaxin-fact-sheet.pdf. Accessed June 24, 2021.

Ministry of Health & Family Welfare: Guidance note for COWIN 2.0. Ministry of Health & Family Welfare, Government of India. Available at https://www.mohfw.gov.in/pdf/GuidancedocCOWIN2.pdf. Accessed June 24, 2021.

Health & Family Welfare Department: Operational time of vaccination sites in Delhi Govt hospitals increased for 24 hours. Health & Family Welfare Department, Government of National Capital Territory of Delhi. 2021. Available at http://health.delhigovt.nic.in/wps/wcm/connect/04fcde804238f468affebf28c2355f02/05OT24.pdf?MOD=AJPERES&lmod=-1243801621&CACHEID=04fcde804238f468affebf28c2355f02. Accessed June 24, 2021.

Ministry of Health & Family Welfare: Registration for next phase of COVID-19 vaccination on Co-WIN2.0 portal will open at 9:00 am on 1st March 2021 at www.cowin.gov.in. More than 10,000 private hospitals empanelled under Ayushman Bharat PMJAY, more than 600 hospitals under CGHS and other private hospitals empaneled under State Schemes can function as COVID Vaccination Centres. Free COVID Vaccination at all Government Health Facilities. Ministry of Health & Family Welfare, Government of India. 2021. Available at https://pib.gov.in/PressReleseDetail.aspx?PRID=1701549. Accessed June 24, 2021.

Department of Health & Family Welfare: Letter from secretary, MoHFW on clarification of vaccination of HCWs and FLWs. National Health Mission. Department of Health & Family Welfare. Ministry of Health & Family Welfare, Government of India. 2021. Available at https://arogyakeralam.gov.in/wp-content/uploads/2021/04/5th-April-Letter-from-Secretary-H-on-Clarification-of-Vaccination-of-HCWs-FLWs.pdf. Accessed June 24, 2021.

Unique Identification Authority of India: Aadhaar. Updating data on Aadhaar. Unique Identification Authority of India, Government of India. Available at https://uidai.gov.in/my-aadhaar/about-your-aadhaar/updating-data-on-aadhaar.html. Accessed June 24, 2021.

Ministry of Health and Family Welfare, Government of India: COVID-19 vaccines operational guidelines. 2020. Available at https://www.mohfw.gov.in/pdf/COVID19VaccineOG111Chapter16.pdf. Accessed June 24, 2021.

Health & Family Welfare Department: Minimum 6 COVID Vaccination Centres (CVCs) in each Delhi Govt Hospital Health & Family Welfare Department, Government of National Capital Territory of Delhi. 2021. Available at http://health.delhigovt.nic.in/wps/wcm/connect/4c1b1080420d9a2ea8abbb28c2355f02/ORD6VC.pdf?MOD=AJPERES&lmod=1757518360&CACHEID=4c1b1080420d9a2ea8abbb28c2355f02. Accessed June 24, 2021.

Subramanian SV: India faces a challenge with its mass vaccination efforts. Lancet Glob Health. 2021; 9: E1201-E1202. DOI: https://doi.org/10.1016/S2214-109X(21)00260-6

Ministry of Health & Family Welfare: Cumulative coverage report of COVID-19 vaccination. Ministry of Health & Family Welfare, Government of India. 2022. Available at https://www.mohfw.gov.in/pdf/CummulativeCovidVaccinationReport25Dec2022.pdf. Accessed January 30, 2023.

Ministry of Science & Technology: World’s first intra-nasal vaccine for COVID developed by India has got approval from the Central Drugs Standard Control Organisation (CDSCO) for restricted use in emergency situations in the age group of 18 and above. Ministry of Science & Technology, Government of India. 2022. Available at https://pib.gov.in/PressReleasePage.aspx?PRID=1880328. Accessed January 30, 2023.

Published

04/01/2024

How to Cite

Sharma, P., and G. Pardeshi. “Experiences from a COVID-19 Vaccination Center at a Tertiary Care Teaching Hospital in Delhi, India: Challenges and Solutions”. Journal of Emergency Management, vol. 22, no. 2, Apr. 2024, pp. 213-8, doi:10.5055/jem.0822.