India’s Covid-19 vaccine program has glaring data and communication issues

Far reaching.
Far reaching.
Image: REUTERS/Amit Dave
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India has fully vaccinated only about 23 million people, not even 10% of the 300 million it aims to inoculate by August. Lest we forget, there are 1.3 billion people in India.

To make things worse, the pace of vaccinations has slowed from 3.5 million doses a day in March, to an average of roughly 2.5 million likely due to acute shortages. With cases exploding and touching nearly 350,000 new infections per day, getting as many people as possible vaccinated fast should be an immediate priority. But besides vaccine stocks, India will also need to improve on its communications strategy.

Historically, India does not have strong anti-vaccine sentiment. Its universal immunization program, against diseases like measles, rubella, and tuberculosis, is among the most robust in the world, with the drive against polio often cited as a success. But with Covid-19, there has been hesitancy and skepticism; India even has a homegrown vaccine, which has been presented and lauded as an Indian success, but healthcare professionals are worried about the lack of peer-reviewed evidence of efficacy.

Address hesitancy with transparent data

Now, with India’s devastating second Covid-19 wave, several people who were fully vaccinated are also getting infected, which is normal given that no vaccine can offer 100% protection. India’s health ministry has tried to address this publicly by offering data on “breakthrough infections”—infections that literally break through a vaccine’s defenses.

But there’s a problem: the data are questionable.

The government claims a breakthrough infection rate of just 0.02-0.04%, which suggests that vaccines are working even better than manufacturers claim, already raising questions. But the data, released on Apr. 27, have no methodology attached. While the health ministry has data on the number of doses administered, there is currently no standardized mechanism to track who got infected after receiving a vaccine.

We don’t know as much as we should. For instance, people who take Covid tests are not asked by laboratories whether they have been vaccinated. There is a relatively straightforward way to gather the data, too: using Aadhaar, a biometric identification number that most people have, and that they often use to gain access to vaccines and tests.

Without joining the dots between vaccines and breakthrough infections, using data that ought to be available, it is harder to convince an already skeptical public that vaccines are safe and effective. In Delhi, even today, most laboratories do not ask those who book a test for their vaccination status.

The unequal internet

Besides data gaps like this, a looming problem for India’s healthcare system will be managing the digital divide in the country. According to the modified vaccination rules, starting May 1, no eligible vaccine beneficiary between the ages of 18 and 45 will be allowed to walk in at the vaccine centre. People this group will need to register on the government’s Co-WIN website, a platform for managing the vaccination program, and upload their identification information.

For many, this is alarming given that a large proportion of Indians—nearly 50%— do not have access to the internet. Even those that do have access are not necessarily comfortable using it for even basic services like healthcare.

Currently, according to the government’s Co-WIN dashboard, a little over 16 million people have registered online to receive the vaccine. The rest were walk-ins.