The Indian government on Monday allowed states to open on-site registration, appointments, and administration of doses for adults below the age of 45 seeking coronavirus vaccines, after repeated calls to abandon the digital-only system that critics said was leaving out people who did not have access to smartphones or the internet.
The feature at present is being enabled only for government vaccination centres, the health ministry said, and it will depend on the state government to decide whether they want to allow on-site registrations and appointments based on the "local context".
The move comes at a time when vaccines for the younger adult age group became available from May 1 but the demand soon surpassed supplies, exhausting stocks, and halting the drive in several states, including Delhi, Maharashtra, Andhra Pradesh, and Telangana.
"Based on the various representations given by the states and inputs received by Union health ministry for the vaccination of 18-45 year age group, the Union government has now decided to provide facility of on-site registration/facilitated cohort registration on Co-WIN digital platform for 18-45 years age group," the statement said.
The statement noted that "even though Co-WIN provides for features such as registration of up to 4 beneficiaries with a mobile number, facilitated registration and appointments through applications, such as AarogyaSetu and Umang and through the Common Service Centres etc, people requiring cohort's facility and those without access to internet or smart phones or mobile phones may still have limited access for vaccination".
The move was also meant to reduce vaccine wastage, the government said, suggesting states to open up vaccination centres to walk-in recipients if they have doses left over from appointment no-shows.
"In case of sessions exclusively organised with online slots, towards the end of the day, some doses may still be left unutilized in case the online appointee beneficiaries do not turn up on day of vaccination due to any reason. In such cases, on-site registration of a few beneficiaries may be necessary to minimise the vaccine wastage," the statement said.
Experts pointed out that while the walk-in option may not immediately alter the pace of vaccination, it is a big policy shift whose impact will be visible when next month's supplies are available.
"It will help in hastening the pace; care should be taken to prevent super-spreader events at vaccination sites. For meaningful increase in the pace of coverage, comprehensive micro-planning and mobilisation strategies are needed," said Dr Giridhara R Babu, head, epidemiology, Indian institute Of Public Health.
The Indian government opened vaccinations for the under-45 adult age group on this month, but people need to first register online and book a slot before they can be served at vaccination centres.
The demand has been such that several states have run out of the limited supplies of vaccines they received for the 18-45 age group, including Delhi where deputy chief minister Manish Sisodia said on Monday that the 400 vaccination centres for this group have been shut from this week due to a lack of doses.
Sisodia earlier wrote a strongly worded letter to Union health minister Harsh Vardhan, saying the vaccination for the youth in the country has been "messed" up due to policy "missteps".
"In spite of early advantages given by our scientific community and Indian manufacturers, we have squandered away the great opportunity of timely vaccination of our people. The missed opportunity by the Government of India has resulted in extraordinary loss of lives during the current wave of Covid pandemic," he wrote to Vardhan.
The rate of vaccinations has fallen gradually in the country, after recording a peak of over 4 million doses that was delivered in a single day in early April. In the week ending May 10, this number was down to 2.15 million doses on average, followed by 1.82 million in the week ending May 17 and 1.48 million in the 7-day period after that.
In addition to Delhi, Maharashtra, Andhra Pradesh and Telangana are among states that halted vaccinations for this age group. Many of these have floated tenders to procure doses directly from foreign developers but have not been able to draw much interest.
The Centre has also directed states to issue clear instructions to all district immunisation officers, to strictly adhere to decision regarding the extent and manner of using the on-site registration and appointment feature for this age group.
"State/UT must decide on opening of on-site registrations/facilitated cohorts' registration and appointments for 18-45 years age group based on the local context just as an additional measure to minimize vaccine wastage and for facilitating vaccination of eligible beneficiaries in the age group 18-45 years. Also, abundant caution should be exercised and extreme due care should be taken while opening up of on-site registration… in order to avoid overcrowding at vaccination centres," the statement further read.