Govt weighs sops to boost covid-19 inoculation drive

Continuing vaccine hesitancy is prompting authorities to toy with some out-of-the-box solutions, including incentives ranging from free masks and transport to cash rewards for getting the jab.

India’s covid-19 vaccination drive has been held back by short supplies, hesitancy and misinformation. In general, it is thought, vaccines have received a cold response from the public even as the pandemic continues to rage.

To be sure, crippling supply constraints continue to crimp efforts to vaccinate every adult. Only around 3.5% of the adult population is fully vaccinated, compared to 11.07% in Brazil and 9.78% in Russia. The drive, now in its third phase, hasn’t even met its first phase-target of vaccinating all healthcare and frontline workers.

“Since health is a state subject, we have asked states to ramp up vaccination coverage. States have the freedom to implement ideas to cover more people under the vaccination programme.... Incentivization may be a good idea to address a potential vaccine hesitancy and we may discuss this in due course of time,” said Vinod Paul, member (health) in NITI Aayog and chair of the National Expert Group on Vaccine Administration for covid-19 (NEGVAC).

India’s roll-out of free vaccine for all adults begins on Monday, even as states such as Maharashtra and Delhi continue to complain of shortages. The government believes that after the switch to free vaccines, with the Centre buying 75% of all vaccines, supply will be streamlined.

“When we have surplus vaccines, we may also think of some interventions that include incentives for vaccination on similar lines as family planning for sterilization wherein people see some benefits to accept a public health intervention in larger interest of the country,” said a senior Union health ministry official.

“Though there is a debate over cash incentives for improving public health outcomes, such interventions have helped. In family planning, we try to control the population, here we may try to control a highly infectious disease,” said the official.

Meanwhile, states too are chalking out their own plans too motivate people with some incentives. “At present, we have hardly covered 10% of the population. After we cross 40 or 50%, for achieving last mile vaccination coverage, we can think of giving some incentive,” said a senior official in the Uttar Pradesh government.

There has been a demand in some states to give indirect incentives to help people reach vaccination centres. “Beyond prescribing a specific, the biggest incentive is that the government of Assam should make it as easy, simple and as convenient as possible for everyone in the state to get vaccinated— maybe take care of practical difficulties like travel which should include all sections of the society including remote communities, tea garden workers etc,” said Pradyut Bordoloi, a Congress member of Parliament from Assam.

With the supply of doses expected to ease by July-August with an estimated 10 million doses available per day, India should consider such incentives, public health experts believe.

“It may be worthwhile to consider the option of a direct cash transfer scheme to the beneficiaries of government welfare schemes in the country. The transfer could be conditional and given either in part with every jab or at once after the person is fully inoculated,” said Ashwajit Singh, managing director, IPE Global, an international health development consultancy. Singh said this could be a timebound and conditional cash transfer, similar to a successful programme called Bolsa Familia (Family Allowance) in Brazil where the government transfers cash to poor families if they agree to send their children to school, healthcare centre and for vaccination.