COVID-19 vaccines – Challenge of information dissemination and ensuring inclusion

For the past year, the whole world was hanging by a thread, trying to make sense of the alien, fatal, and cascading virus. Patients, along with the frontline workers, depended on God’s mercy and researchers pushed hard to come up with a cure or a vaccine for COVID-19. By January 2021, many nations had begun their vaccination drive to fight the pandemic, but many continue to struggle

India has over four decades of experience in running national immunity programmes and has also successfully conducted large-scale mass vaccination drives for many years to eradicate Polio from the nation’s soil. India not only emerged competent by creating two home-grown vaccines but also as a leader as it distributed vaccines to several nations.
India kicked off its vaccination drive against the COVID-19 pandemic from January 16 this year by announcing the administration of doses to frontline workers, including healthcare workers, on a priority basis, because they remain most exposed to the virus. The next phase of vaccination included vaccinating people above the age of 60 years and people above 45 years of age with comorbid conditions because reports described them as more prone to getting hospitalized if infected by SARS-CoV-2.
However, the sudden ‘tsunami’ of coronavirus infections and deaths in India during April 2021 prompted the government to start the third phase of the vaccination drive, including everyone above the age of 18 years in its vaccination programme.

Authorities trying to convince hesitant Indians


India’s two homegrown vaccines driving the world’s largest vaccination programme are Covishield and Covaxin. Both of them have been developed on similar grounds, using inactive or modified versions of the virus, which are to be injected intramuscularly in the upper arm muscles, and work as two-dose vaccines. Covishield vaccine, manufactured and marketed by the Serum Institute of India and developed by Oxford-AstraZeneca, consists of a viral vector vaccine that uses an adenovirus found in chimpanzees, ChAD0x1. This helps deliver spike proteins and mount a tolerable immune response in response to a live virus. Covaxin, on the other hand, is fully made, developed and produced in India by Bharat Biotech and uses an inactive/dead-virus strain to draft an immune response.
Having two different vaccines available for administration, people were quick to compare their effectiveness, which was followed by numerous rumours among the population, even though both the vaccines had matched standards set by the World Health Organisation. The Government of India and the Indian Council of Medical Research, through guidelines, social media, and speeches, have been actively trying to disseminate facts and provide correct information to squash continuous rumours emerging on the effectiveness of the vaccines.
Vaccine hesitancy has emerged as one of the major reasons for the lower vaccination rate in India. Concerns on the efficacy of the vaccine and long term side effects have been giving people cold feet. Rumours are another reason. Social media, on the one hand, has come out as a platform for the rapid spreading of false claims concerning coronavirus and its vaccine, even though people have been as active to share fact check pieces through it as well. People turned out more active than ever to make sure that only correct and credible information reached people. Journalists worked more than ever in keeping track of all the myths and rumours on the disease and its vaccine, simultaneously countering fiction with facts.

Range, out-turns of vaccine side effects


Much like any medication, vaccines show side effects. These include soreness, swelling, or redness at the site of injection. The COVID-19 vaccines around the world, much recently developed, have shown some side effects in some people after administration. The most common side effects reported so far due to every COVID-19 vaccine being administered around the globe include pain at the injection site, tenderness, fever, chills, and nausea. A few people also reportedly experienced headache, dizziness, abdominal pain, and tremors after getting their COVID jab. Countries, as they kicked off their vaccination drives, did their best to keep their citizens informed of the contents in the vaccine that could cause any allergic reaction and of all the possible immediate side effects. Government of India had released guidelines on who should avoid getting vaccinated and what side effects people can expect after the administration. Moreover, every COVID vaccination centre in India was asked to keep those getting vaccinated on the watch for 30-45 minutes after receiving vaccination to make sure that any major reaction to the vaccine is properly taken care of. India’s vaccination drive also established help centres for patients post-vaccine jab, but the hesitancy to get vaccinated has not completely worn off yet.
In a major controversial development, by February, European countries had started taking AstraZeneca’s vaccine out of circulation. Their concern was the formation of blood clots in people after vaccination. Although, the WHO said that the clotting of blood was recorded in people who had received the vaccine from two batches of doses produced in India, the news further weaponized the hesitancy among Indians towards COVID-19 vaccines.
According to European Medicines Agency, the European levels of risk of blood clots from the AstraZeneca vaccine are 1 out of a million, and 4 cases per million in the United Kingdom as reported by its Medical and Health Regulatory Authority. A study by Oxford University soon found that the number of people facing the problem of blood clots after receiving coronavirus vaccine is about the same for those who get Pfizer and Moderna shot, as they are for the AstraZeneca vaccine. The United States Centre for Disease Control and Prevention also said that of the 7.5 million doses given in the USA, around half a dozen women, aged 18 to 48, developed a rare type of blood clot in the brain or abdomen.
The National Adverse Event Following Immunization Committee recently submitted a report to the Government of India showing that there is a ‘very minuscule but definitive risk of bleeding and clotting’ cases emerging after COVID-19 vaccination among Indians as well. The reporting rate has been cited at 0.61 cases out of a million doses administered.
Reports of cases of blood clots post COVID-19 vaccination across the countries and vaccines, however minuscule they may be, have prompted researchers and developers to take a closer look at the cause behind such cases and how it can be avoided. However, no government has put a stop to the administration of any vaccine, despite accepting the existence of such side effects of the vaccines because these vaccines remain the only hope to get humans back their freedom to ‘live’.

Digital divide, a roadblock on the way to vaccination


India’s coronavirus vaccination drive tries to integrate all strata of society. Government centres are administering vaccine doses for free in contrast to private centres, thus allowing people to freely choose according to their comfort and financial situation on where to get themselves vaccinated. The first step in the drive involves registering on an app named CoWIN, and booking a slot. Low smartphone reach and prominent digital illiteracy in India, especially in rural India, has emerged as a major impediment in the vaccination drive. Experts believe that the government should allow people to drop by the vaccination centres and receive the vaccine like it was introduced for people above 45 years of age in the second phase of the drive. Many health experts are strongly suggesting door-to-door vaccination for people with no access to registration app or those who find themselves unable to visit vaccination sites such as the elderly and the disabled.
Until governments can ensure that COVID-19 vaccines reach everyone on time, the pandemic will continue to grow. Thus, augmenting vaccine supplies and clarifying rumours with regard to vaccines must be the priority of governments everywhere, particularly in India.

Low smartphone reach and prominent digital illiteracy in India, especially in rural India has emerged as a major impediment in the vaccination drive. Experts believe that the government should allow people to drop by the vaccination centres and receive the vaccine like it was introduced for people above 45 years of age in the second phase of the drive.
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