Two situations are currently unfolding in Kerala (and probably other states too). On one hand, the Kerala government is urging the public to get the COVID-19 vaccine soon and are even making the two-dose vaccine regimen mandatory to gain access to certain public events or spaces. On the other hand, people above 45 years of age are scrambling to vaccination centres to get their second dose of the COVID-19 vaccine, except that it is not available. Those who want to get their second dose are also not able to find a slot on the Co-WIN portal. The Kerala government has also stopped the spot registrations on April 23. Amid this confusion, India is preparing to start its ‘liberalised and accelerated’ phase 3 for individuals between 18 and 44 years of age on May 1, which is just three days away.
With Kerala reporting between 25,000 and 35,000 COVID-19 cases per day, people above 45 years are thronging and queueing up at vaccination centres to take their second dose. The vaccination drive for senior citizens and people with co-morbidities in the age group of 45-59 years, started on March 1. The panic over reports of vaccine shortage across the country has been driving the people in this category to vaccination centres.
Visuals show serpentine queues and huge rush outside vaccination centres at districts such as Thiruvananthapuram and Palakkad. Many senior citizens, who have underlying health conditions, are seen collapsing due to the long wait outside these facilities. While some arrived before the allotted time, many arrived for spot registrations, without knowing that the state government stopped the option on April 23.
Many senior citizens complained they were not given clear instruction on getting the tokens. A health official at the Jimmy George Indoor Stadium in Thiruvananthapuram, which reported a major rush on Monday, told the Times of India that people are anxious about vaccine shortage, causing many to come before their allotted time. Some vaccine centres reportedly turned away people without citing any reason.
Watch: The huge rush at vaccination centres in Kerala
Palakkad native Lekshmi Menon had been trying to book an appointment for the second dose of vaccine for her 70-year-old father and 60-year-old mother for the past 15 days. She says that the Co-WIN portal had been showing that no slots were available.
“On April 15, I got a message on my phone mobile, asking me to schedule appointments for the second dose between April 5 and 19. I have been trying to book since then. I have seen a few slots opening in other districts. But when we check for slots in other states, there are vaccine slots. We are not sure why this is happening in Kerala,” says Lekshmi. On May 5, it would be 56 days after her parents received the first dose.
Sir , you will be surprised if you check availability of vaccines ( above 45 ) in the Cowin portal in Gujrat....
— V (@alwaysvishnus) April 28, 2021
In Kerala we have no dates avaliable online while in Gujrat , in any district, online avaliable is stunningly galore.
First two from Gujrat
Second two, from kerala pic.twitter.com/V9IvhYQm8O
Lekshmi said that her parents have been apprehensive about the delay. “Already, there was so much confusion about the COVID-19 vaccination. And now, when they finally took the first dose, there is the unavailability of the second dose,” she said.
Kochi native Alexander Shaju, too, shared concerns about his 81-year-old father getting the second dose. “My father’s main concern is whether the first dose will now go in vain due to delay,” he said, adding, “Even some government hospital staff I know shared concerns if people will get the second dose.”
“My son had booked an appointment for the first dose of vaccine on the Co-WIN portal. However, before the scheduled date, an ASHA worker asked us to come to the vaccine centre and get vaccinated. She said there was no crowd and that was sufficient vaccine shot. Now, we cannot register on the portal as there are no dates available, and I heard the next slot is available only after 42 days,” said Mariamma, a 64-year-old residing in Thiruvalla, Pathanamthitta district.
When India opened the registration for phase two of the vaccination drive via the Co-WIN portal, it also gave people the option for spot registration. However, according to many residents in Kerala, the state government gave prominence to spot registration over the Co-WIN portal, which might have led to confusion. Although the Karnataka government, too, allowed spot-registrations, it stopped the process soon.
In Kerala, spot registration began ever since the vaccination drive was opened on March 1. Since then, incidents of chaos were reported from the vaccine centres, following which, authorities requested the state government to go for online registration.
However, the situation turned worse when vaccination opened for all above 45 years on April 1, as the number of beneficiaries increased. Thousands of people rushed to vaccination centres for spot registration, which created a huge rush and breach of COVID-19 protocol. Finally, on April 23 Kerala government closed the spot registration.
Majority of those inoculated in Kerala have received #Covishield. Its 2nd dose can be taken up to 12 weeks after the 1st. Studies suggest that a 12 week gap yields better results. Those waiting for 2nd dose need not crowd vaccination centres.
— CMO Kerala (@CMOKerala) April 22, 2021
“There was less awareness about the Co-WIN portal registration in Kerala. We never saw any interactive video on any of the news channels or any of the press conferences from the CM or Health Minister. The only information about Co-WIN was the pre-recorded message that was played as the caller tone,” said a resident in the state, who requested anonymity.
Opening mass vaccination centres in Kerala with spot registration facility was a HUGE mistake by GoK. Could turn superspreaders! They should’ve continued with the ongoing vaccination drive with CoWin registration by publicising the registration procedure via interactive videos.
— അപ്പു - Appu - Double Mask & Avoid Crowds (@appooz) April 22, 2021
An accredited social health activist (ASHA) worker, who assists people in the vaccination drive, also expressed a similar concern. “Things are worse for the elderly, especially those living alone and who do not have smartphones. When there was spot registration, they could come directly and get registered. Now, since online registration is mandatory but cannot get a slot and do not have smartphones, their only option is to seek help from Akshaya centres (government-run IT centres providing various e-services),” said Thangamani, an ASHA worker from Thiruvananthapuram. Akshaya centres are helping people register and schedule on Co-WIN.
Most of the first doses were given via spot registration, said the ASHA worker. As a result, Kerala is one of the few states that reported zero or minimum wastage.
It is not clear as yet if this caused a shortage of vaccine in the state. However, an official from the Kerala Directorate of Health Services told TNM that the state did not plan the vaccination drive efficiently. “Instead of giving first shots to the maximum number of people possible, we should have kept aside the vaccinations for those who took the first dose. We should have anticipated that there would be shortage from the Centre,” the official said.
However, he also pointed out, “As far as I know, if a state doesn't use the given vaccinations at a particular time, it won’t get more. So, maybe, to ensure zero wastage and expecting enough supply from the Union government, states provided the first dose to many. This is the same in many other states, where a number of people, who ought to take a second dose, are worried,” he said.
According to the Kerala government’s COVID-19 dashboard, as of April 28 (Wednesday), 71,07,072 (71 lakh) vaccination doses have been administered in the state. While 59,47,415 (59 lakh) people have received the first dose so far, 11,59,657 (11 lakh) have been given the second dose.
Of this, under the second ‘Age Appropriate category’ — persons over 60 years of age, persons between 45 and 59 years with comorbidities, and the general public over 45 years of age — 49,62,763 (49 lakh) people received the first dose and 4,79,008 (4 lakh) people were given the second shot. This means the state would require 44,83,755 (44 lakh) additional shots to complete the two-dose regimen for those who received the first dose.
However, per the dashboard, as on April 28, the state has only 4,44,330 doses (1,34,390 doses of Covishield and 3,09,880 doses of Covaxin) remaining, a shortage of 40,39,425. According to the Press Bureau of Information, about 3,20,000 doses are in the pipeline.
“We did not get enough vaccinations as expected from the Union government,” the official from Kerala Directorate of Health Services told TNM. In a letter to Prime Minister Narendra Modi on April 20, CM Pinarayi Vijayan said that Kerala has only received 5.5 lakh doses of the vaccine, although it had requested 50 lakh doses. “Due to this, we have been constrained to stop on-the-spot registration affecting our effort to deal with the rapid surge,” he said, pointing out that buying from companies will add to their financial commitments amid the pandemic.
As per the latest vaccination policy, the Union government will procure 50% of the stock from the vaccine manufacturers and distribute it to the states. If the states require more vaccine doses, they can procure it from the manufacturers directly at a price set by the companies. This put many states in a predicament as it was already facing a vaccine shortage.
Meanwhile, sources in the Kerala Health Department told TNM that the state government is not allowing people to book on the Co-WIN portal as there is no vaccine stock. “We cannot allow people to schedule for the second dose of the vaccine without a stock. If it is not halted now, the booking list will go endless, without people actually not receiving the shots,” said the official.
Amid the shortage, CM Pinarayi Vijayan, on Wednesday, said the state will purchase one crore doses of COVID-19 vaccines — 70 lakh doses of Covishield and 30 lakh doses of Covaxin — in the next three months, for Rs 483 crore. "Priority will be for the second dose," he said, adding, "Our vaccination drive will go ahead, uninterrupted."