Days after it was called out for having a purported vaccine wastage rate of 17.6%, the highest in the country, Telangana has written to the union health ministry, stating that there has been a “miscommunication between both governments over the vaccination figures”. It has added that the vaccine wastage rate in the state is less than 1%.
It may be recalled that apart from Telangana, the ministry of health and family welfare pulled up three other states and a union territory, Andhra Pradesh (11.6%), Uttar Pradesh (9.4%), Karnataka (6.9%), and Jammu and Kashmir (6.6%), for wasting over 20 lakh doses of Covid-19 vaccines. It also highlighted that the situation was particularly grim in both Telugu states where the wastage rate was in double digits.
DATA VERSUS DATA
Telangana’s public health department has set up an exclusive Covid-19 war room to glean data across the state. According to the latest report released on March 21, a total of 9,93,030 doses were issued to the state (as per the Centre’s eVIN portal), of which 40,540 doses were allotted to the armed forces, and 1,270 in buffer stock were given to private and government vaccination centres for advance scheduling.
The state’s net vaccine consumption, till the time of writing this report, stood at 9,51,220 doses out of which 9,43,921 doses were successfully administered to beneficiaries (aged 45-59 with comorbidities and senior citizens), resulting in wastage of 7,299 doses, which is about 0.76%.
In fact, all the reports released by the state government since March 18 have shown vaccine wastage around 0.75-1%.
Quoting the Centre's Covid-19 vaccination guidelines, Dr Srinivasa Rao, Telangana’s director of public health, said 10% programmatic wastage was normal, but he was surprised to see such a vast difference in the statistical data released by the health ministry.
“Health ministry manages two portals, one is eVIN (electronic vaccine intelligence network) which tracks vaccine stocks and consumption, and the other is CoWIN software which tracks the number of vaccinations done in a state. Both the portals are not integrated, which is why there are data discrepancies and miscommunication with the Centre,” he said.
He also explained that the cumulative figure of vaccine consumption, in this case 9,43,921, does not include the 40,540 doses given to the armed forces as well as the buffer stocks given to private hospitals, as they directly purchase vaccines from the government of India and the job of the state government is to only facilitate the supply.
“Centre takes real-time data from CoWIN dashboard, but on the backend at every vaccination centre, there is a lag in feeding the updates because the CoWIN site used by data entry officers to create sessions and register people is too slow. In most cases, there is always a difference of 90,000 doses at a time. We have raised this issue before the union health ministry," Dr Rao said.
'LOW TURNOUT BEHIND VACCINE WASTAGE'
The state government has set a target of inoculating a minimum of 200 beneficiaries in over 560 centres across the state. While the vaccination drive in urban areas has picked up momentum, the turnout hasn’t been as expected in rural areas due to vaccine hesitancy and lack of awareness.
The Fever Hospital in Hyderabad vaccinates 95 to 100 beneficiaries on an average daily. Every day it receives 10 vaccine vials from the state department out of which, on most days, only 8 are used while the rest go back to the nearest upper primary health centre for storage.
Dr Chandrasekhar, resident medical officer, said, "Vaccines need to be utilised within four hours of being opened. Most of the time, we return unused bottles, but partially used bottles are usually destroyed because of less shelf life."
He also added that there is a steady flow of beneficiaries during morning sessions, but towards the afternoon, the number starts dwindling and by the time the vaccination drive ends at 4.30pm, there are hardly any people.
The same problem was also pointed out by senior medical personnel at the Gandhi Hospital, one of the biggest Covid-19 hospitals in the state.
"We can't turn away anyone, but chances of wastage are more when a new bottle is opened towards the end of the vaccination drive and there are less than 10 beneficiaries. Wastage has been more in the case of Covaxin which contains 20 doses," he said.
In addition to that, at least three private and government hospitals that News18 reached out to said that they have been finding it difficult to source auto-disable syringes due to high demand. This type of syringe draws the exact amount of vaccine, which in this case is 0.5ml for both Covishield and Covaxin. The supply chain in rural areas is also affected.
"The spillage issue can be easily solved if all hospitals start using auto-disable syringes, but there is a massive shortage. Single-dose vials will be a better option, provided they are cost-effective," a medical officer with the Greater Hyderabad Municipal Corporation said, requesting anonymity.
MIXED RESPONSES TO 'VACCINATION FOR ALL' DEMAND
There is a growing chorus among medical experts that vaccination should be made open for all.
"Instead of having a priority group, we request the government to allow anyone above 45 to get vaccinated so that there is minimum wastage. Walk-in vaccination 24/7 should also be encouraged," said Dr JA Jayalal, president, Indian Medical Association.
But many voices within the private hospital sector have argued a 24/7 vaccination drive will only be possible when they have enough supply of vaccines.
"Unlike government hospitals, we have been vaccinating at least 800 beneficiaries a day between 9am and 4pm. There is a shortage of vaccines and if the government lifts the cap on priority groups, then there will be total chaos. We need more vaccines," a senior doctor working for a top private hospital said, requesting anonymity.
The state's public health department said Telangana has received only 25 lakh doses of vaccines, while the target is to vaccinate more than 55 lakh people, including frontline workers.
"We want to expand the vaccination drive to every village in Telangana to safeguard people against the coronavirus. We have requested the Centre to allocate more vaccines so that there is equitable distribution especially in rural areas where the turnout is low," said Dr Srinivasa Rao.
ANDHRA PRADESH RAMPS UP VACCINATION DRIVE
Like Telangana, Andhra Pradesh has also scaled up the vaccination drive, especially in rural and tribal areas due to vaccine hesitancy.
“The vaccination drive has been going on successfully in urban areas. But in villages, most of people are reluctant to take vaccines fearing adverse reactions. We have deputed ASHA and Anganwadi workers to dispel rumours and create awareness among people through a door-to-door campaign,” said an official working within the state health department, requesting anonymity.
“While there may have been some gaps, vaccine wastage in the state is less than 5%. There seems to be some issue with data collection. Hope the Centre addresses it soon,” the official added.