Home / Opinion / Views /  Vaccine awareness needs to go far beyond people like us

A news item in the The Indian Express caught my eye last week. It reported that in Gurugram, Haryana (where I live), the local district authorities are worried by an uptick in the number of covid cases and are planning to intensify and ramp up the government’s ongoing vaccination drive. The aim, according to the report, is to increase the number of hospitals administering covid vaccines.

However, a closer look at this ‘ramping up’ shows just how skewed the approach is: five hospitals have been selected to run 24-hour vaccination clinics, only one of which is a public facility. The other four are exclusive and expensive private hospitals. I would imagine that the poor, even if they wish to pay the 250 fee for a shot, will not easily be granted entry to these spaces. Another report, this one by Payel Majumdar Upreti in Hindu BusinessLine, states that, “During question hour in Parliament last month, the government said it would utilise the existing infrastructure of the Universal Immunisation Programme (Mission Indradhanush) to successfully implement its covid-19 immunisation drive. The rural sector would be dependent entirely on ASHA workers (Accredited Social Health Activists, i.e.) and PHCs (Primary Health Centres) for this to happen." Yet, if we look at implementation of the Centre’s immunization programme in Gurugram, PHCs and frontline workers are neither mentioned in official notices, nor are they deployed.

At the moment, the second phase of a covid vaccination drive is underway in India. The exercise currently covers persons over 60 years of age, as of 1 January 2022, and persons between 45 and 59 years with co-morbid conditions. The public health messaging to explain the government’s strategy has left a large number of people confused. The common understanding is that only people above the age of 60 are eligible. According to a BBC report based on data of the Union Ministry of Health and Family Welfare and the Co-Win dashboard, over 20 million people in India have so far been vaccinated. The health ministry aims to cover 250 million ‘priority people’ by the end of July.

Apart from the government’s Co-Win website, its Aarogya Setu app is also being used for people to book appointments for jabs. This requirement of registration via a website and an app is understandable, given the Centre’s attempt to systemize its vaccination drive, record data, and ease the burden on various facilities of a rush, which is necessary to maintain safe distancing protocols. However, the programme needs to factor in the fact that a majority of India may not be able to register. This would exclude a large proportion of the population who may be owners of smartphones but are yet not sufficiently literate or comfortable with using technology. At least not to the extent that they can easily enrol themselves for an appointment to be vaccinated.

The idea of offering slots for ‘walk-ins’, which allow for those who are unable to use internet windows (or are resistant to them), misses the crucial point that unless such slot timings, names of hospitals, etc, are widely publicized and circulated, most Indians will remain unaware of these and may not be able to get themselves vaccinated even if they are willing to.

In India, vaccine hesitancy is a significant problem. There is also a historic fear and distrust of public health initiatives that is rooted in earlier coercive drives of forced sterilization by previous governments; this could perhaps be among the reasons for a lower number of men, as a BBC report shows, opting for vaccination than women in southern Indian states. News of Prime Minister Narendra Modi and other senior leaders taking jabs was welcome but not enough to allay fears.

We need a far more proactive public health campaign. We urgently need to spread simple public health messages explaining the benefits of a vaccine, who is eligible, and why all those who can avail of a jab, must. Setting up help-lines is not enough. The objective should be to encourage people to get vaccinated, demystify the process, and explain potential side effects as well as the positives of vaccination, so as to allay fears and also convey to all that the pandemic is not yet over and safety protocols still need to be maintained. This public health campaign must reach out widely through TV, radio and also telephones in all Indian languages.. Besides front-line health workers such as ASHAs, etc, religious bodies and leaders, community-level leaders, self-help groups, much-maligned non-government organizations and other such grassroot-level entities could also be drafted for the dissemination of information.

At present, the messaging on the country’s vaccination process has been restricted to the upper and middle classes, and they too seem confused, even if a large number have been availing of vaccine shots. The challenge now is to expand this approach and include those who are falling through the gaps: the vast majority of our poor and working classes, especially in our cities.

When covid first hit India, the government’s public-health messaging efforts on preventive measures such as masks and hand washing were broadcast via TV and radio spots, with telephone voice clips lending support. An effort of similar reach and scale is now imperative for vaccinations to gain pace. Only then can we hope to meet India’s targets and return to normalcy.

Radha Khan is a consultant working in the field of gender, governance and social inclusion. She tweets @RadhaKhn.

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