Centre's refusal for on-site jab leaves old-age homes seething

The Centre’s decision to reject a proposal by the state to hold vaccination drives in old-age homes, long-term care facilities and other locations has left some seething.

On Thursday, the state government made public a letter by the Ministry of Health and Family Welfare in New Delhi, which rejected a proposal to “allow Covid-19 Vaccination Centres (CVCs) beyond health facilities (such as old-age homes, long term care facilities, apartment complexes and polling booths)... to ramp up Covid-19 vaccination coverage among the elderly.”

The chief minister had sought permission from the Centre to take up vaccination in large apartment complexes and old-age homes during the video conference with the Prime Minister.

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Officially, an expansion of vaccination centre was rejected because it was determined that such locations lack four certain requirements, such as adequate space for vaccination (waiting area room, vaccination room and observation room), adequate cold chain arrangements for vaccine storage, adequate number of vaccinators, and adequate arrangements for the management of adverse event following immunization (AEFI).

In recompense, the Ministry of Health and Family Welfare has issued guidelines for sub-health centres to be turned into Covid vaccination centres (CVC), in a bid to improve accessibility for senior citizens. Private health facilities empanelled under AB-PMJAY/CGHS/State health schemes can also be designated as CVCs.

However, this has not gone down well among old-age homes. Dr Radha S Murthy, the Managing Trustee of Nightingales Medical Trust, said that the decision does not properly consider the implications on the lives of more than 2 lakh elders residing in old-age homes in India.

“There are 4,000 long-term eldercare facilities and old-age homes in India. Many live with comorbidities, dementia, mental disorders and are bedridden. Globally, about one-third of deaths due to Covid were from such care facilities. The sub-health centres are not an option because there are not only logistical challenges but also serious health concerns to such elders if they have to visit hospitals for vaccination. Since there are two shots required, this will be highly impossible,” Dr Radha said.

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It was a view echoed by other old-age homes that DH contacted. Sudharshan, the owner of a centre in Kumaraswamy Layout said that on-site vaccinations would have been effective as the attenders of many senior citizens are reluctant to see them leave the homes, even for vaccinations. “Many attenders feel their relatives are insulated from the virus in old-age homes,” he said.

The requirement of cold chain infrastructure at the on-site locations was also criticized. “Vaccines such as DPT, BCG, measles, which also need to be kept at the temperature of 2-8 degrees Celsius are administered successfully at village level by nurses. If this could be possible, the same can be replicated for Covishield or Covaxin,” Dr Radha said.