Bharat Rakshak

Here are some data about vaccine hesitancy in the US. Hope we can get data about India as well.

That sort of data is quite a while off. It must be remembered that the US started vaccinations of high risk general population in mid December. India began last week.

Suraj wrote:That sort of data is quite a while off. It must be remembered that the US started vaccinations of high risk general population in mid December. India began last week.

Yes, I agree it is still early in the vaccination campaign. Having this data will have help in targetted messaging to address vaccine hesitancy.

https://timesofindia.indiatimes.com/wor ... TOIDesktop

6 European countries block Oxford usage citing blood clots

From speaking to elders, it is a combination of vaccine hesitancy and an attitude of the epidemic is almost over, what is the need for vaccine? People are saying that cases have fell so epidemic is over, why should we take the effort of travelling to the hospital and queue just to get vaccinated.

Then there are others who are worried of the side effects and are in a wait and watch most, although from my experience this number is quite small as compared to earlier case.

I think the government should open it up to domestic servants, delivery people and staff in shops etc.

Me thinks that GoI will watch till probably early to mid-April and if numbers don't pick up, which means that a lot of people are in hesitant mode, they might open up the vaccination to all folks by early May...no point in keeping most of the population waiting. Hopefully, GoI has already started working on upgrading Co-Win infra (if issues still persist) for massive scale registration & queries along with required infra for mass vaccination. Time to get rest of India moving forward as well...I am still hearing lot of hesitancy by many elders in our family/friends circle...many are in wait & watch mode.

Now if BB or any other vaccine makers want to introduce newer variants of existing vaccines which will cover newer Covid strains, should they repeat the rigorous Ph-1,2 & 3 trails all over again or some leeway is provided? Also are there any medicines which are in development specifically targeted towards Covid? Not some of the super expensive injections which will help in critical case but more like Fabiflu kind of tablets which might help in stopping replication of virus...

Cowin dashboard indicates 1.73 million total vaccinations (dose 1+2) for day till 8:00 p.m

ranneel wrote:Cowin dashboard indicates 1.73 million total vaccinations (dose 1+2) for day till 8:00 p.m

Glad to hear the rate is climbing back again.

ranneel wrote:Cowin dashboard indicates 1.73 million total vaccinations (dose 1+2) for day till 8:00 p.m

Very nice indeed. PIB MoHFW indicates 1.8 million up to 8 pm:
PIB MoHFW press release up to 8pm

Should easily cross 2 million again. The fact that Monday was strong, then just one demographic (>60) went down by half a million on Tuesday and Wednesday, right before a major holiday on Thursday suggests evidence of the earlier assumption that this was a religious holiday affected period.The PR data shows over 60 demographic is back up to 1.1. million on Friday up to 8pm, which is slightly better than Monday when the full day total crossed 2 million.

1.8 million is great. But, there is still a lot of unused capacity:

Though vaccination in the second phase appears to have picked up, there were only 1.7 million inoculations on Friday evening as opposed to the planned vaccination capacity of 5.4 million.

5.4m is a new number. As recently as 3 days ago, the figure was 3.6 million (quoted earlier by you) . This means that behind the scenes they have further scaled up supplies. Earlier, 2 million was just 60% of capacity. Now it is under 40% of capacity. We might recall that very recently there were claims of 'shortages of vaccines' but clearly there's been work done to make up for that, in real terms.

If they have a lot of supplies but can't do more than 2-3m vaccinations, it means they're probably constrained by doing vaccinations at hospitals and needs to expand the number of locations where it can be done.

Anecdotal information again, but hospitals outside the cities are just being roped in to the vaccination program. The vaccines need refrigeration, so apart from securing a refrigerator, the hospital also needs a generator to maintain electric supply. Vaccinations should rise as more infrastructure is made available outside the urban areas.

A nasal spray variant of Covaxin is going through Phase 1/2 trials now:
BHARAT BIOTECH’S INTRANASAL VACCINE FOR COVID-19: EVERYTHING WE KNOW SO FAR ABOUT BBV154

India’s apex drug regulator, the Drugs Controller General of India (CDSCO), approved Bharat Biotech's planned Phase I and Phase II trials of the nasal vaccine last month. The subject expert committee (SEC) of CDSCO added a recommendation for the company to produce safety and immunogenicity data from a Phase I trial in 75 volunteers. That said, other reports have quoted a higher number – around 150-175 – volunteers in the Phase 1 study.

"A nasal vaccine candidate has been identified. It has come for consideration for phase 1 and phase 2 trials. If it works then it could be a game-changer," VK Paul, a Niti Aayog member (health) told the Indian Express.

Forty-two days after the nasal spray has been administered, an interim analysis will be conducted of results. To take part in the vaccine trials, the volunteer must be a healthy adult with no comorbidities and should not have been infected with COVID-19.

Trials have already begun in hospitals in Hyderabad, Nagpur, Patna and Chennai, sources told The Hindu Business Line.

Something like this if it works, would enable saturation coverage of the whole population quickly.

Suraj wrote:5.4m is a new number. ............

If they have a lot of supplies but can't do more than 2-3m vaccinations, it means they're probably constrained by doing vaccinations at hospitals and needs to expand the number of locations where it can be done.

If I am understanding it correctly, the 5.4 million is not just the vaccine supply. It is the capacity to inject that many vaccines. So the shortfall seems to be due to a lack of demand. I hope the MoPH can make more granular data available to see what's going on. Maybe put it on Github and let our data scientists find out all the issues related to vaccination.

Overall, I am really happy to see the growth in vaccination. But, I still believe there is room to offer vaccines to more people than currently eligible.

Yes there's sometimes a lag when people try to register and find no slots available, and they assume it'll take time to resolve itself. But if the capacity is increased very rapidly, there'll be a while when people haven't yet gone back to try again.

Can someone explain the precise process of Cowin registration ? Does it let you waitlist yourself for the first available slot and venue, or do you have to explicitly pick your slot and location ? If it's mostly the latter, then it depends on how quickly people themselves keep up with the changes to the supply situation, and it may not be immediate.

The US COVID response team reported a new all time high daily vaccination rate of 2.92 million in US. We can easily overhaul that as early as tomorrow.

Suraj wrote: Can someone explain the precise process of Cowin registration ? Does it let you waitlist yourself for the first available slot and venue, or do you have to explicitly pick your slot and location ? If it's mostly the latter, then it depends on how quickly people themselves keep up with the changes to the supply situation, and it may not be immediate.

One cant waitlist , the process is to select the area of choice, followed by the hospital, and then the preferred date, which will show you the available slots at that center only, for the week. If there are none on your preferred day, just try again tomorrow, or for a later date.

Thanks. So if automatic population from a waitlist is not present, that makes aligning supply and demand that much harder.

There was a door to door survey carried out under most municipal limits more than twice last year, atleast here in Maharashtra (From personal and anecdotal experience from other systems). The survey listed down residents ages, and specifically comorbidities. They also stuck a piece of paper stating the same on everyone's door. I am sure they have that data while doing rough capacity planning in each zone.

Actually a lot of hospitals in mumbai (at least the private ones) are doing walk on vaccinations. They say no need to take an appointment, just register and come over. The total vaccination time is around 1.5 hours give or take and this includes the 30 mins after vaccine is given. First 30 mins are for administrative formalities.

So total for Friday was 2.05 million. Cumulatively 28.22 million.

So it seems like the dreaded SA variant is doing rounds in the country. How long will it take for existing vaccines to include newer strains?

Right now we are in a race of vaccinations against infections. The rate at which infections are going up (doubling about every 25 days), we are looking at a hundred thousand infections a day around late May. This was the worst caseload we saw in July-Aug before infections started declining again. Is the 2021 case rate going to peak at 250,000 people a day? I shudder to think how we will be able to cope. Vaccinating itself will become difficult when the caseload becomes really high and there is a shortage of medical staff! With crowds surging around vaccination centers, the centers themselves may become super spreader events!

The govt. has lost precious time in scaling up the vaccine operation and the optics of sending vaccines abroad but not vaccinating our own people are going to look terrible in short few weeks from now. We must utilize our existing national vaccine infrastructure. Unused vaccines sitting in storage or unused vaccine capacity at this time is a crime.

The total population above the age of 40 in India, the age at which Covid becomes a big threat to life is 450 million or so. Even a rate of 5 million vaccinations a day is going to vaccinate (fully) only about 150 million or around a third of the vulnerable population in 60 days. This is probably enough to slow down the virus somewhat but not achieve 'herd immunity'.

All said and done, it looks like 2021 summer season is going to see really large numbers again. We should prepare now to deal with whats coming and also see if we can mitigate the spread somewhat. N95 masks, ventilation and distancing protocols will again be the norm. Ventilation in particular feels like an easy low hanging fruit to reduce the spread.

Zynda wrote:So it seems like the dreaded SA variant is doing rounds in the country. How long will it take for existing vaccines to include newer strains?

Bharat Biotech's vaccine may already be effective against the SA variant, given its a whole virion vaccine. For the mRNA vaccines, its a really simple thing to modify the vaccine to be effective against the new strains. I am not sure if they will be trialled again. (Perhaps we will be willing to do challenge trials this time?)

sudeepj wrote: The govt. has lost precious time in scaling up the vaccine operation and the optics of sending vaccines abroad but not vaccinating our own people are going to look terrible in short few weeks from now. We must utilize our existing national vaccine infrastructure. Unused vaccines sitting in storage or unused vaccine capacity at this time is a crime.

It is unfortunate that the Govt is not showing any sense of urgency. When hospitals were running a racket charging Lakhs of Rupees for simple Covid treatment, all Governments (Central and State) did absolutely nothing to check this highly immoral profiteering. I am sure many politicians got huge cuts from them. Now, when it comes to vaccination, they set an upper limit of Rs. 250 as charges (including the cost of the vaccine).

Are there any trials underway to check if one dose of a vaccine is sufficient? Would go a long way towards stretching supplies and simplifying vaccination.

GoI should consider a polio style one day mass vaccination program. May be once a week or once every two weeks. It is difficult to retain pace on a daily basis, however a speed up once a while would be good.

Country wide one day mass vaccination: Get 10-15M done. Then continue with regular vaccination on other days.

If not entire country, target Mah, Pun, Kerala which are the worst hit.

In addition, GoI should encourage on-premises vaccination for employers/offices where WFH is not available. Facilities such as factories etc. already do have on-premises health/medical facility and these facilities can be reinforced by arranging a few nurses who are trained to handle adverse reactions as well as emergencies. Prevents these people from crowding to a hospital/vaccination center and the employers can manage the vaccination pace/crowd size as see fit. I know we should not be comparing to US, but Biden has announced an ambitious plan of vaccinating most of US (I think he said all of US) by July 4th. From May 1st, all adults in US will be eligible for vaccination. Hopefully, we will introduce similar moves here.

Suraj wrote:Thanks. So if automatic population from a waitlist is not present, that makes aligning supply and demand that much harder.

that is how and why the walkins get a chance.

Some smaller designated places for the vaccination run out of the vaccine very quickly. Larger hospitals have their own staff managing the vaccination process and so are able to handle much larger numbers and also control/minimize/eliminate wastage effectively but the smaller ones are still at the fanciful mercies of the BBMP nurse who may or may not turn up and when they do, they usually bring very few doses to administer.

but, on the whole, the vaccination numbers are rising daily as the kinks in the system gradually get ironed out

Very low numbers of post vaccination complications is also encouraging the fence sitters. The older age groups seem to be relatively less affected by the post vaccination complications

this input is bangalore specific.

https://timesofindia.indiatimes.com/ind ... 481228.cms
India to review blood clot concerns of Oxford.

One gets a feeling couple more indigenous vaccines and Oxford will be booted out of India

Lets not get carried away by the "spoiled" EU countries who will only allow the most expensive vaccines for their population. UK is doing quite well with AstraZeneca and I highly doubt that we can manage to reach our goals without it.

IndraD wrote:https://timesofindia.indiatimes.com/ind ... 481228.cms
India to review blood clot concerns of Oxford.

One gets a feeling couple more indigenous vaccines and Oxford will be booted out of India

That would be terrible unless there is solid scientific data backing it for the government take such a drastic step. Already we've seen malicious propaganda against vaccines and hesitancy even among HCWs to get vaccinated . If after administering Covishield to a large % of our population the government does a "oopsie" then we may as well forget about anyone ever coming forward to get vaccinated.

We are inching closer to 25k new cases now with MH leading the way as usual. After Thane it looks like Nagpur is headed towards a lockdown. Silly measures considering a week or two of lockdown will have little to no effect in containing the virus spread . Karnataka too is mulling reversing in school teaching and weddings. Rapidly vaccinating the most vulnerable section of our population will hopefully keep the CFR low but i do expect the number of cases to continue to climb the next few months.

Nagpur will lockdown on 15 March.
https://indianexpress.com/article/expla ... e-7225332/

I think they should cut observation period from 30 min to 15-20 min which should double the numbers without much risk ? as per a relative... the doctor gives jabs to10 people then waits for 30 min observing ..and then the next round.

^^^Many places in the US it is 15 min wait. For me and family it was that way.

Heard from a knowledgeable but NOT reliable source that GoI might throw open the vaccination to all groups by mid-April itself. Hopefully this is true. Good news if KAR is thinking about reverting to online teaching for schools & colleges. Also WFH should be strongly urged & encouraged. Hearing reports of employees being asked to come back to BLR (folks who are staying outside BLR/KAR) to be ready to come in to office.

manjgu wrote:I think they should cut observation period from 30 min to 15-20 min which should double the numbers without much risk ? as per a relative... the doctor gives jabs to10 people then waits for 30 min observing ..and then the next round.

There's something else which is adding to the delay and this information is directly from someone who went to get vaccinated and was turned back after a lengthy wait. Apparently each covishield box contains 15 vials, and once the box has been opened all 15 vials have to be used within an hour. So they are taking in batches, waiting for 15 people to gather before opening the box. Unfortunately the person i was talking to waited for over 4 hrs for his turn, and when it was finally his turn there were only 8 other people, so they were asked for wait for an hour more to see 5 more people show up, and finally when they were unable to gather 15 people, all 9 who were waiting were turned away and asked to come back the next day.

Saturday vaccination performance was good - 975K by 7pm
PIB MoHFW press release

Suraj wrote:Saturday vaccination performance was good - 975K by 7pm
PIB MoHFW press release

If India is to avoid a terrible summer, this number should be five or ten times what it is.

a_bharat wrote:

sudeepj wrote: The govt. has lost precious time in scaling up the vaccine operation and the optics of sending vaccines abroad but not vaccinating our own people are going to look terrible in short few weeks from now. We must utilize our existing national vaccine infrastructure. Unused vaccines sitting in storage or unused vaccine capacity at this time is a crime.

It is unfortunate that the Govt is not showing any sense of urgency. When hospitals were running a racket charging Lakhs of Rupees for simple Covid treatment, all Governments (Central and State) did absolutely nothing to check this highly immoral profiteering. I am sure many politicians got huge cuts from them. Now, when it comes to vaccination, they set an upper limit of Rs. 250 as charges (including the cost of the vaccine).

I would say its the regular people, scared by anti vaccine propaganda of irresponsible opposition and press, who are showing a lack of urgency.