Karnataka’s MR experience handy for COVID-19 vaccination

Based on its experience during the combined Measles-Rubella (MR) immunisation campaign in 2017 wherein 1.58 crore children were covered in two months, Karnataka is well-placed to implement the COVID-19 vaccination programme, said experts on Tuesday.

Participating in a webinar on ‘COVID-19 and Vaccine’ organised by the Press Information Bureau, Lokesh Alahari, Sub Regional Team Leader – Karnataka, WHO India (National Polio Surveillance Project), said Karnataka has good vaccine storage and cold chain facilities with 2,855 cold chain points and 10 walk-in-coolers and four walk-in-freezers.

“The State was able to store and utilise nearly 1.8 crore MR vaccine doses supplied by the Centre in two months because of these facilities. Also, during the MR immunisation drive, the injectable vaccine had to be reconstituted with a diluent. And, for this dry storage facilities for diluents and syringes were also scientifically set up. All these will come handy for the COVID-19 vaccination,” said Dr. Lokesh, who is also a member of the State’s COVID-19 Technical Advisory Committee (TAC).

A majority of the 10,000 vaccinators identified by the State for the vaccination are those who had carried out the MR campaign as they are already trained.

Communication strategy

The MR campaign was marred by initial hiccups wherein there was a lot of hesitancy from parents to get their children immunised. However, these hurdles were resolved with active involvement of the private sector and medical professional bodies. Similarly, an aggressive communication strategy should be adopted for the COVID-19 vaccination. “Although there will be vaccine eagerness initially, there can be vaccine hesitancy even if there is one serious adverse event (related or unrelated). If such a situation arises, we may have to build confidence among people,” Dr. Lokesh pointed out.

Election-booth approach

The vaccination process will be based on an election-booth approach. Each booth will have two vaccinators, one assistant for maintaining data and records, one assistant for logistics, and two or three people for crowd management. “People will be registered and vaccinated in the jurisdiction of their residence. Although voter ID cards or Aadhaar cards are not mandatory, people need to have some identity proof, like even a college ID will be fine for MBBS students,” said Dr. Lokesh.

Possible adverse events

It is likely that vaccination will be associated with mild adverse events like soreness at the injection site, fever, fatigue, and myalgias, said Shashi Bhushan B.L., professor and head of the department of Pulmonary Medicine at Victoria Hospital, Bangalore Medical College and Research Institute.

“More serious reactions, such as otherwise unexplained neurological or inflammatory processes, would raise concerns. We will have to watch out for that,” he said. Clinicians should also understand the basics of how different vaccines perform and, if more than one is available, be able to recommend the best for a given patient, he said. “No vaccine will be 100% effective and a vaccine that protects against developing clinical illness may not prevent transmission to others. Also, the duration of naturally occurring immunity to infection with severe SARS-CoV-2 is unknown and may wane with time. Therefore, the likely duration of protection by new COVID-19 vaccines is unknown.” Dr. Bhushan added.