Reporting for this story was supported by the Pulitzer Center.
MUMBAI, VELLORE AND NEW DELHI, INDIA –One Sunday morning in the early hours of the morning, when Mumbai was in a daze from the first weeks with a wave of COVID-19 and had imposed a curfew, Baliram Boomkar asked his neighbors in the city’s Kaula Bandar slum if they wanted a vaccine to protect them or had received one. Some said they had it, but only because their employers demanded it. One man said he would be vaccinated if his company gave him time off to recover from side effects. “COVID is nothing,” he said. “People only spread rumors. It’s all a lie. A woman said she was afraid of getting the shot because the clinic could possibly test her for COVID-19, find out she was positive and then force her to quarantine – as was done last year. “I know I can not avoid the vaccine, but I want to be the last in line,” she said.
“A lot of people [here] do not believe that COVID exists and that God will give if anything hpens, ”said Boomkar, who lives in the slums and works as a” barefoot scientist “for the NGO. Pukar, which conducts health-related studies and also seeks to improve living conditions. “They think it’s all politics.” The use of masks, despite the barefoot researchers distributing them and emphasizing their benefits, remained sparse.
A month later, India’s COVID-19 wave has become a tsunami with hospitals overwhelmed and funeral paths burning through the nights. Yet the country’s vaccination campaign disappears with less than 3% of Indians fully vaccinated per. May 16 The widespread shortage of shots has forced some vaccination clinics to close; in others, lines often form hours before they open. Some states limit doses to people over the age of 45, and to expand supplies, the government has recommended stretching the intervals between shots of the country’s most widely used vaccine, Covishield, a version of AstraZeneca – the University of Oxford vaccine produced by the Serum Institute of India. But supply is only half the dilemma.
To move vaccines to weapons in this country of 1.3 billion. Means reaching remote, hard-to-reach regions and tackling the deep divides between the lower and upper classes. And like almost everywhere in the world, India has to face the confusing challenge of vaccine hesitation. It is now prevalent in Indian society, far from limited to the slums that Pukar helps, but it is a new problem here. “India never had the vaccine hesitation” until COVID-19, says virologist Shahid Jameel, who heads the Trivedi School of Biosciences at Ashoka University.
Previous mass vaccination campaigns in India have focused on children. Adults, even the richest, are not routinely vaccinated against influenza, shingles, pneumococcal disease or anything else. “You do not want too many adults asking for a vaccine, nor do you want too many doctors prescribing it,” says Renu Swarup, head of the government’s biotechnology department. “There is a lot of advocacy that we need to do to bring the public on board.”
Many blame another rise to create India’s unexpected aversion to COVID-19 vaccines: the rumors that are constantly spreading on social media. “It is not a vaccine hesitation that is deeply rooted, as in Europe or the United States,” said Sai Prasad, CEO of Bharat Biotech, which manufactures Covaxin, the country’s second COVID-19 vaccine. “This is literally due to misinformation or misinformation.” Among the false claims to a large extent is that the vaccines make people impotent, are worthless because some vaccinated people become infected or even lead to death. “Adults are more picky than children: they change their minds through Whatsp University and Twitter second by second,” Prasad says.
India began its vaccination program on January 16, just 1 month later than the United States and the United Kingdom. But there was little sense of urgency. The nation was not hit as hard by the first wave of COVID-19 in 2020 as many expected. March 1, India, which has an internet portal which allows anyone eligible for a shot to draw attention to a local site had vaccinated just over 12 million people with a first dose.
Even health workers, the first in line for shots, were slow to get them. By Christian Medical College (CMC), Vellore, in the state of Tamil Nadu, a reputed training ground for doctors and nurses that has five campuses with more than 2,700 hospital beds, 30% of staff had still not been shot 6 weeks after the information campaign started. At the beginning of the period, after CMC administrators decided to post their own vaccination pictures on social media, emphasizing that 1,600 unvaccinated workers had been infected and 12 had become seriously ill, 99% of doctors and 90% of nurses had and other hospital workers received a shot.
But in Tamil Nadu, one of the country’s most urbanized and industrialized states, the wider public remained lukewarm against the shots. One morning early in Vellore, CMC vaccine researcher Gagandeep Kang went downstairs from his office on the main campus to the hospital’s COVID-19 vaccination clinic for his second dose. Kang paid her 250 rupees (about $ 3) and was vaccinated. But only a dozen other people sat in the outdoor waiting area. No one took a selfie when they got the shot or loudly fived a nurse thank you. Across the city that day in the Salavanpet neighborhood government clinic, where the vaccine is free, only 22 people showed up. The hospital had 370 doses in the refrigerator left from a batch of 500 it had received 5 days earlier.
Tamil Nadu had not yet been slammed by COVID-19 again. But even in parts of India where cases were growing, COVID-19 was simply not always perceived as a major threat. “You’re in an environment where you see death so often,” says CMC chief JV Peter, a specialist in critical care. “When you see people die from other diseases with a higher frequency than COVID, why should people pump their fists and say, ‘Hey, I have my vaccine!’ or why should they push themselves towards getting a vaccine? ”
Kang is failing the government for not previously “preparing the ground” for a massive vaccination program for adults. “The systems were set up for 100 people a day in vaccination centers,” she says. “We could scale up to five times what we do.”
The challenges are multiplying in several rural areas. In Jawadhi Hills a few hours drive away, Kang and others at her college have done a project in the village of Vallithathankottai, which helps the Malayali tribe with everything from clinical services to improved sanitation. The village’s 99 houses are located up a steep mountain road, and a few dozen members of the tribe gathered one afternoon in their leadership house to discuss the pandemic with Kang and Science. Only three villagers had been vaccinated at a clinic 5 miles away. Others were non-committal. “If it’s for our protection, we’ll all take the vaccine,” said a villager who, like the others, was not eligible at the time. But there was some fear of the virus. “It’s not coming to us,” said a villager. Or it is simply harmless, the leader wondered. “We may have gotten it, and it would go without us knowing.”
In mid-May, as cases continued to climb in Tamil Nadu, but hopes arose that the devastating wave of COVID-19 had peaked nationwide, vaccination dustiness remained to varying degrees. In richer urban communities, the fact that the company that makes Covaxin has not yet published its efficacy data and that the version of Covishield used outside India has been associated with coagulation problems has continued to give some reluctance. Researchers speculate that many Native Americans will rush to get the messenger RNA vaccines, which are currently only available abroad. Ever-increasing demand. “There have been few signs of hesitation among the middle class, and they are encrypting for vaccine slots,” Kang says now.
Neonatologist Anita Patil-Deshmukh, who founded and operates Pukar, says the barefoot scientists report that the wave in the Kaula Bandar slum has led at least “a few” pandemic doubters to change their minds when they saw constant images of crematoria on television and had relatives in their hometowns become ill and unable to access care. But they remain exceptions. “Most people are still reluctant to take [the vaccine], ”Says Patil-Deshmukh. “Vaccination of people living in the slums is still a big problem.”
The government needs to make it easier for the poor, she says. “Most people at the bottom of the pyramid do not have the smartphones needed to make online registration, and the few who may have it do not know how to navigate the system,” she says, adding that Pukar soon hopes to set up registration stations. and Kaula Bandar.
Kang said the Indian government should fulfill an obligation to set up vaccination points within 2 kilometers of everyone. “We’re a big country and it’s challenging to reach people.” She suggests that some areas may need vaccinators to go door to door. “In India, in many places you have to think about outreach programs because the most vulnerable people do not come to vaccination centers.”
Despite India’s huge population, the effort could pay off quickly, some researchers claim. “Trying to vaccinate everyone is not the point,” says Anurag Agrawal, a pulmonologist who heads the Department of Genomics and Integrative Biology, a division of India’s Council for Scientific and Industrial Research. India has a relatively large population of young people who may be less vulnerable to severe symptoms. If immunization becomes widespread in those 45 years of age and older, especially in those with conditions such as diabetes and obesity that can exacerbate COVID-19, hospitalizations and deaths will crash, Agrawal claims. He calculates that this population only makes up approx. 200 million – a number of India’s vaccine supply should soon be able to cover.
“India does not really have a vaccine problem,” he says. “It simply came to our notice then. And this recovery can once again bring people back to reality. ”