NEW DELHI — India is expanding its coronavirus vaccination drive beyond health care and front-line workers, offering the shots to older people and those with medical conditions that put them at risk. Among the first to receive a vaccine on Monday was Prime Minister Narendra Modi.
Those now eligible include anyone older than 60, as well as those over 45 who have ailments such as heart disease or diabetes that make them vulnerable to serious COVID-19 illness. The shots will be given for free at government hospitals and will also be sold at over 10,000 private hospitals at a fixed price of 250 rupees, or $3.40, per shot.
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But the rollout of one of the world’s largest vaccination drives has been sluggish. Amid signs of hesitancy among the first groups offered the vaccine, Modi, who is 70, got a shot at New Delhi’s All India Institute of Medical Science. He received the vaccine produced by Indian vaccine maker Bharat Biotech — which has been met with particular skepticism. He appealed for all to get vaccinated, tweeting afterward, “together, let us make India COVID-19 free!”
The drive, which began in January in the country of 1.4 billion people, has recently taken on even more urgency, since new infections have begun to increase again after months of consistent decline, and scientists have detected worrisome variants of the virus that they fear could hasten infections or render vaccines or treatments less useful.
Scores of elderly people started lining up outside private hospitals on Monday morning. Sunita Kapoor was among them, waiting for a vaccine with her husband. She said that they had been staying at home and not meeting people for months to stay safe from the virus — and were looking forward to being able to socialize a bit more. “We are excited,” said Kapoor, 63.
Many said that they had struggled with the online system for registering and then waited in line for hours before receiving the vaccine — problems that other countries have also experienced.
Dr. Giridhar R. Babu, who studies epidemics at the Public Health Foundation of India, said that long waits for the elderly were a concern since they could pick up infections, including COVID-19, at hospitals. “The unintended effect might be that they get COVID when they go to get the vaccine,” he said.
Even though India is home to the world’s largest vaccine makers and has one of the biggest immunization programs, things haven’t gone according to plan. Of the 10 million health care workers that the government had initially wanted to immunize, only 6.6 million have gotten the first shot of the two-dose vaccines and 2.4 million have gotten both. Of its estimated 20 million front-line workers, such as police or sanitation workers, only 5.1 million have been vaccinated so far.
Dr. Gagangdeep Kang, an infectious diseases expert at Christian Medical College Vellore in southern India, said the hesitancy by health workers highlights the paucity of information available about the vaccines. If health workers are reticent, “you seriously think that the common public is going to walk up for the vaccine?” she said.
Vaccinating more people quickly is a major priority for India, especially now that infections are rising again. The country has recorded more than 11 million cases, second in the world behind the United States, and over 157,000 deaths. The government had set a target of immunizing 300 million people, nearly the total U.S. population, by August.
The spike in infections in India is most pronounced in the western state of Maharashtra, where the number of active cases has nearly doubled to over 68,000 in the past two weeks. Lockdowns and other restrictions have been reimposed in some areas, and the state’s chief minister, Uddhav Thackeray, has warned that another wave of cases is “knocking on our door.”
Similar surges have been reported from states in all corners of the massive country: Punjab, Jammu and Kashmir in the north, Gujarat in the west, West Bengal in the east, Madhya Pradesh and Chhattisgarh in central India, and Telangana in the south.
Top federal officials have asked authorities in those states to increase the speed of vaccinations in districts where cases are surging, and to track clusters of infections and monitor variants.
“There is a sense of urgency because of the mutants and because cases are going up,” said Dr. K. Srinath Reddy, president of the Public Health Foundation of India.
He said that the consistent dip in cases over months resulted in a “reduced threat perception,” leading to vaccine hesitancy. “The (vaccination) drive began when perception was that the worst was over, so people were more hesitant,” Reddy said.
Others have also pointed out that the reticence to get vaccinated was amplified, at least in part, by the government’s opaque decision making while greenlighting vaccines.
But experts say that allowing private hospitals to administer the shots — which began with this new phase of the campaign — should improve access. India’s health care system is patchy, and in many small cities people depend on private hospitals for their medical needs.
Still, problems remain. India had rolled out online software to keep track of the shots and recipients, but the system was prone to glitches and delays.
The federal government will decide which hospitals get which vaccine and people will not have a choice between the AstraZeneca vaccine or the Bharat Biotech one, confirmed Dr. Amar Fettle, the nodal COVID-19 officer for southern Indian state Kerala. The latter got the go-ahead by Indian regulators in January before trials testing the shot’s effectiveness at preventing illness were completed.
But opening up the campaign to private hospitals may allow the rich to “shop” around for places that are providing the AstraZeneca vaccine — an option that poorer people wouldn’t have, said Dr. Anant Bhan, who studies medical ethics.
India now hopes to quickly ramp up vaccinations. But the country will likely continue to see troughs and peaks of infections, and the key lesson is that the pandemic won’t end until enough people have been vaccinated for the spread of the virus to slow, said Jishnu Das, a health economist at Georgetown University who advises West Bengal state on the virus response.
“Don’t use a trough to declare success and say it’s over,” he said.
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Associated Press journalists Krutika Pathi and Rishabh Jain contributed to this report.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
