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Insights into Editorial: Boosting confidence: On need for efficient use of COVID-19 vaccine stocks




Context: Corona pandemic is on the wane in India:

The downward trend in fresh coronavirus infections in India continues to inspire confidence that the pandemic is on the wane. The daily new cases fell below 10,000 for the third time this month.

India’s tally is now 10.9 million cases and fresh reported fatalities were recorded below 100 for the eighth time this month, according to Health Ministry data.

On January 1, there were around 20,000 fresh infections, which fell to about 11,000 by the month end. Should this sharp decline continue for this month too, then it would be a truly propitious turn of events.


Supply seems to far exceed demand of Vaccines:

  1. Around 8.2 million doses of vaccine have been administered to healthcare workers and some frontline workers, though this is still below the first lot of 16.5 million doses of Covishield and Covaxin that the government commissioned from their manufacturers.
  2. India has also managed to donate vaccines to neighbouring countries.
  3. For now, supply seems to far exceed demand, with only around half of those enrolled for vaccinations showing up for their doses.
  4. The government is also considering administering vaccines to those above 50 and those younger with co-morbidities from March.
  5. India is also likely to get 97 million doses of Covishield by June half of them by March.


About Vaccine hesitancy:

  1. Vaccine hesitancy, which is defined by WHO as a “delay in acceptance or refusal of vaccines despite availability of vaccination services”, has been reported in more than 90% of countries in the world.
  2. Vaccine hesitancy is threatening the historical achievements made in reducing the burden of infectious diseases, which have plagued humanity for centuries.
  3. Either they are common people, or the frontline workers, vaccine hesitancy, if exists, it may obstruct the smooth implementation of the vaccination drive.
  4. If the healthcare workers are hesitant about getting vaccinated, it will not create a good impact among common people as they are the role model for the people who will be vaccinated next.
  5. There is uncertainty and suspicion about the side effects of the vaccine.


COVID Vaccination drive in India:

India began the “World’s Largest Vaccination Program” on January 16, 2021.

The Prime Minister of India said that India is entering a decisive phase of vaccination in the fight against COVID-19, with the approval of two made-in-India COVID-19 vaccines.

The PM has also said that two vaccines are more cost-effective than any other in the world and that India’s vaccine production & delivery capacity will be used to help all humanity in fighting this crisis.

Vaccine hesitancy is the main obstruction in the smooth vaccination drive, in order to defeat the pandemic, vaccine hesitancy should be eliminated first as it is not the vaccine but vaccination that prevents an infection.


3 categories need for eliminating Vaccine Hesitancy:

Vaccine hesitancy is a delay in acceptance or refusal of vaccines despite availability of vaccination services.

Though reasons for vaccine hesitancy are many, they fit in to 3 categories: confidence, complacency, and convenience.

  1. Confidence is the trust in the effectiveness and safety of vaccines, the system that delivers vaccines, competence of healthcare professionals, and the motives of those who establish policies on necessary vaccines.
  2. Being honest about vaccine side effects and reassuring parents of their safety can have an impact on confidence.
  3. This builds trust in the provider which is also shown to have a positive effect on vaccine compliance.
  4. In order to be successful in this endeavour, health care providers must be intentional in remaining current on vaccine information and providing reliable sources of information to patients and families who may be struggling with confidence.
  5. Complacency is the perception that risks of vaccine-preventable diseases are low and vaccines are not a necessary preventative action.
  6. Honest conversations about acute and chronic complications of vaccine preventable diseases and personal anecdotal evidence are appropriate measures for combatting complacency.
  7. Anecdotal evidence that includes what the provider would do or has personally done for his or her children and prior experiences with vaccine safety have been shown to be effective according to a survey of primary care physicians in the United States.
  8. Convenience is the extent to which vaccines are available, affordable, accessible, understood (language and health literacy), and appealing.
  9. Offering vaccine services at every clinic visit, before hospital discharge, and during prescription pick-up as well as informing patients of community resources such as immunization clinics and free or reduced cost immunization programs are a few ways that we can help overcome the issue of convenience.
  10. If additional issues related to convenience arise, such as lack of transportation, consider social work consultation to aid in resolution of the issues.
  11. From physicians to nurses, pharmacists to social workers, all play a vital role in reducing vaccine hesitancy.


However, the government’s message to not be complacent and continue to adhere to mask use is in the right scientific spirit, given the uncertainty about virus evolution.

Considerable hesitancy continues to exist as evidenced in Chhattisgarh. The Centre should work on furnishing efficacy data on Covaxin as well as improving public confidence, in ways that the available stocks of vaccine can be efficiently used.


The Co-WIN Application: Real time information of vaccine stocks:

To monitor the inoculation drive and track the listed beneficiaries for vaccination on a real-time basis, the central government has developed COVID Vaccine Intelligence Network or Co-WIN application.

Co-WIN will facilitate real time information of vaccine stocks and storage temperature during the COVID-19 vaccination drive.

The app will be used as a back-end software during COVID-19 vaccination drive. The self-registration module of Co-WIN App has not been released yet.



Vaccine hesitancy is not an easy issue to combat, and may take more than one visit and assistance from more than one provider to put parents and patients at ease.

Frontline workers should not find this as a point of frustration or discouragement but, rather inspiration to keep growing and learning as practitioners.

Our collective goal as a healthcare team is to do what is in the best interest of the patient because, as American author John C. Maxwell has taught us, “Teamwork makes the dream work.”