Experts and district officials from Delhi say beneficiaries have stayed away from the precaution dose because of fewer hospitalisations and deaths being reported in the third wave and a third dose certificate not being needed for travel. Of the 1.8 crore people who have received their first doses in Delhi, only 19.56 lakh have been administered a third precaution dose, putting the coverage of the dose at just 10.7% in the capital.
This is still higher than 5.6% who have taken the third dose nationally, according to data from the CoWIN portal. To boost numbers, the Centre has started a 75-day campaign to provide free precaution dose to all adults. It was earlier available for free at government centres for priority groups such as healthcare workers, frontline workers, and those aged above 60.
The Delhi government making the precaution dose free for all adults soon after the Centre opened the shots for them in April has resulted in better coverage than the national average, especially in the younger age groups. Of the total precaution doses administered in Delhi, 55.6% were in people between the ages of 18 and 59 years as compared to 19.4% of the precaution doses administered in this group nationally.
CM Arvind Kejriwal Sunday urged all adults in the city to get their precaution dose for free at government dispensaries and mohalla clinics. “Only 10% of those who took the second dose received the precaution dose. We have to increase this number for our health and safety,” he said.
Hospitalisations low, no need for certificates
Fewer hospitalisations and deaths resulting from a Covid infection during and after the third wave has resulted in low-risk perception among people. This, coupled with many getting the infection even after getting vaccinated, has resulted in lower turnout.
An official from the East district said, “Not only are people seeing that the disease is milder, they have also seen people getting the infection even after two doses. This is why fewer people are coming to get the vaccine, despite a door-to-door campaign.”
Low turnout is also a result of no requirement for a third dose certificate for travel and other activities. “We have seen more people getting the shot when there is a surge. Now that few cases are being reported, most people are going about their day-to-day activities. Also, there is no need for a vaccine certificate any longer for travelling from state to state. Even when travelling out of India, mostly a certificate for two doses is needed and even an RT-PCR is accepted instead of a vaccine certificate,” said an official from the Southeast district.
In fact, those from poorer backgrounds are lagging when it comes to precaution doses, said the official from the East district. “The uptake has been better when we conduct vaccination camps in colonies with the help of RWAs, especially on weekends, as it gives time to people to recover from any fever or pain at the site of injection. But when we organise camps in slums and other places where daily wage workers live, with help of ASHA workers, the turnout hasn’t been great. People do not want to miss out on work to get the shot,” the official said, adding that for the first and second doses, there was also a push from factories and other employers for workers to get the shot.
Booster vs precaution
Just the name of the third dose might have resulted in poorer coverage, said head of department of community medicine at Safdarjung hospital Dr Jugal Kishore: “The term booster dose is better recognised by people. If your immunity is going down, you boost it. Precaution dose doesn’t carry the same meaning. This, coupled with several news reports about reactions caused by vaccines — no matter how small a percentage — leads to negative perceptions about the vaccines.”
He added, “People are also apprehensive of getting a shot when they are healthy, especially when the number of cases, deaths, and hospitalisation is also low.”
Dr Suneela Garg, professor of community medicine at Maulana Azad Medical College and member of the Lancet Commission on Covid-19 in India, said, “The uptake of the precaution dose has been slow across the country, not just Delhi. Only 1% of people between the ages of 18 and 59 years and around 26% over the age of 60 years had received the vaccine before the government’s current 75-day drive. Now, we are also seeing fewer hospitalisations and deaths as people are vaccinated and have also been exposed to the infection, but we are seeing cases go up and down as the vaccines that were made using the original virus are not very effective against newer variants. However, there should be good and repeated information campaigns to improve vaccination, along with other Covid-appropriate behaviour.”
Mohalla clinics
To ensure vaccination close to peoples’ houses, the government has also started giving Covid shots at mohalla clinics across the city, with at least 10 centres operating in each district, according to an official from the health department. Around half of these centres offer the vaccines in a “camp mode”, with beneficiaries living around being asked to walk-in, whereas the others publish the number of slots available online for prior booking on the CoWIN portal.
Almost all mohalla clinics, barring eight to ten, will conduct Covid vaccination drives on Wednesdays and Fridays, when routine immunisation at government dispensaries leads to fewer Covid-19 shots being administered. “The tenure of ad hoc vaccinators who were working at our camps and school sites has been extended till September. They will be carrying vaccines from cold chain points — or the dispensaries the mohalla clinics are linked to,” said the official.
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Explained: Big step
Covid-19 vaccination being offered in mohalla clinics is significant as since the inception of the project in 2015, none of the clinics — barring the first one in Peeragarhi that has permanent staff — had immunisation of any kind. With only one doctor & pharmacist, and a multi-purpose worker running the clinics, most did not have a vaccinator to offer the service.
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Anonna DuttAnonna Dutt is a health reporter with the Indian Express. She writes o… read more
