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Coronavirus Vaccine: Indian saga so far

31st December 2020

Almost from last year, the world has been facing an unprecedented public health crisis in the form of COVID-19 pandemic. India has adopted a proactive and graded response for fighting COVID which includes imposing a timely lockdown, gearing up the health system, boosting the production of necessary medical supplies, and catalysing large-scale behavioural change, at the same time, by making citizens conscious about personal hygiene (hand and respiratory) and public hygiene, for protecting and improving the health of the community.

India has made substantial progress in the prevention, control, and elimination of major infectious diseases. Smallpox was eradicated worldwide, and Polio has been eliminated in India. India has substantially reduced the incidence of HIV infections by more than half in the last two decades. The COVID19 pandemic has further challenged the country. India rapidly ramped up its diagnostic capabilities and aligned its digital technology expertise that ensured there was a comprehensive tracking of the pandemic. As well, relevant information was widely shared with the public. India rapidly instituted both case-based (Trace, Test, Treat) and population-based measures (wear masks, wash hands, maintain distance, avoid crowding and closed spaces) for COVID19 prevention, management, containment, and control. COVID-19 is an excellent example of the country’s rapid response to a public health emergency of international concern, and its capacity to accelerate laboratory capacity and digitise, analyse and use the information for action.

The COVID-19 pandemic is unleashing a human development crisis. On some dimensions of human development, conditions today are equivalent to levels of deprivation. The crisis is hitting hard on all constitutive elements of it: economy, health and education. The pandemic has posed one of the biggest challenges to the entire humanity. In the wake of its outbreak, our lives have changed in ways we had never imagined before. The pandemic was superimposed on unresolved tensions between people and technology, between people and the planet, between the haves and the have-nots. These tensions were already shaping a new dimension of inequalities of enhanced capabilities and the novel necessities. But the response to the crisis carries the potential to shape strategies on how those tensions can be addressed and how inequalities in human development are reduced. The coronavirus has also revealed something profound about the way societies should treat knowledge. 

Currently, the world is in the midst of a COVID-19 pandemic. All the agencies and institutions are working together on the response – tracking the pandemic, advising on critical interventions, distributing vital medical supplies to those in need – for which, they are racing to develop and deploy safe and effective vaccines. Vaccines save millions of lives every year. Vaccines work by training and preparing the body’s natural defences – the immune system – to recognise and fight out the microorganisms they target. If the body is exposed to those disease-causing germs later, the body is immediately ready to destroy them, preventing illness.

Worldwide, there are currently more than 50 COVID-19 vaccine candidates in clinical trials, and around 150 vaccine candidates in preclinical trials. The Government of India has announced a dedicated stimulus package of INR 900 Crore for the Mission COVID Suraksha – The Indian COVID-19 Vaccine Development Mission. This grant has been provided to the Department of Biotechnology (DBT) for Research & Development of Indian COVID-19 vaccines. The COVID-19 Vaccine Development Mission, with end-to-end focus from preclinical development through clinical development and manufacturing and regulatory facilitation for deployment, aims to consolidate all available and funded resources towards accelerated product development, which, in turn, worked as an enabler for accelerating the development of approx. 5-6 vaccine candidates and ensuring that these are brought closer to licensure (with DGCI and CDSCO), and introduction in the market for consideration of regulatory authorities for introduction in public health systems, to combat further spread of COVID infection.

India is actively considering three vaccine candidates - BioNTech/Pfizer’s coronavirus vaccine; one being developed by the SII in partnership with AstraZeneca and Oxford University, and the last one is the indigenous inactivated vaccine based on the SARS-CoV 2 virus in collaboration with the Indian Council of Medical Research (ICMR) and the National Institute of Virology (NIV), Pune by Hyderabad-based Bharat Biotech. Following are the Institutions that have been granted test license permission to manufacture COVID-19 vaccine for preclinical testing, examination and analysis to the following manufacturers in India.

  • Serum Institute of India Pvt Ltd, Pune
  • Dr Reddy’s Lab, Hyderabad
  • Cadila Healthcare Ltd (Zydus Cadilla), Ahmedabad
  • Bharat Biotech International Ltd, Hyderabad
  • Biological E Ltd, Hyderabad
  • Genova Biopharmaceuticals, Pune
  • Reliance Life Sciences Pvt Ltd, Mumbai
  • Aurbindo Pharma Limited, Hyderabad
  • Gennova Biopharmaceuticals Limited, Pune

 

National Expert Group on Vaccine Administration for COVID 19 was constituted on 7th August 2020, under the chairmanship of member (Health) from NITI Aayog and Secretary, Ministry of Health and Family Welfare (MoHFW) as Co-chair to guide the roll-out plan of COVID-19 vaccine. This committee is planning to prioritise population groups, procurement and inventory management, vaccine selection, vaccine delivery and tracking mechanism. The Indian government has started the preparatory activities to roll out the colossal vaccination drive through Co-WIN, the Digital Platform. Based on the electoral experience and universal immunisation programme, the multi-level coordinating mechanism will be used in collaboration with states/UTs at the level of states, districts, and blocks.

As per the strategy, prepared by MoHFW, 60 crore doses will be administered to the 30 crore Indians in the first phase. It would include one crore healthcare workers (HCWs), two crore frontline workers including the personnel from state and the central police department, armed forces, home guard, and civil defence organisation, including disaster management volunteers and municipal workers (excluding HCWs), and twenty-seven crore people above the age of 50 years. After this, vaccines will be given to those below 50 years of age suffering from a chronic critical illness. Data collection, uploading on Co-WIN software, monitoring, and verifying process are in progress.  The concern authorities planned and executed state steering committee meetings and state task force meetings from state to block level.

Here are the details of official press releases related to vaccine development and roll-out plan, in last one week:

1. Government gears up for roll-out of COVID-19 vaccine

25th December 2020, New Delhi

The Central Government is gearing up for the roll-out of COVID19 vaccine across the country. As the vaccine administrators will play an essential role in the vaccination process, trainers and those who shall administer the vaccine have been taken up across various States.

To strengthen the capacity of our human resource for COVID-19 vaccine introduction and roll-out, detailed training modules have been developed for different categories of vaccine handlers and administrators including medical officers, vaccinators, alternate vaccinators, cold chain handlers, supervisors, data managers, ASHA coordinators and all others involved in the implementation process at different levels. The training includes all operational aspects of activities like the organisation of vaccination sessions, use of Co-WIN IT platform to manage the entire vaccination process, deployment of HR Cold chain preparedness, management of adverse events, communications and inter-sectoral coordination, biomedical waste management, infection prevention protocols etc.

A total of 2,360 participants were trained during national level Training of trainers, comprised of state immunisation officers, cold chain officers, IEC officials, development partners etc. The State level training had been completed in all States/UTs with more than 7000 district level trainees, except Lakshadweep, which will soon conduct it (29th December). Cascading down, 681 districts (49,604 trainees) have completed Medical Officers’ training on operational guidelines. Vaccination team training was completed in 1399 out of 17831 blocks/ planning units. It is ongoing in the other blocks.

To facilitate redressal queries on COVID-19 vaccination and Co-WIN portal related queries, national 1075 and state 104 Helpline capacity have also been strengthened to address questions beyond their routine support.

To prep up for the administration of COVID-19 vaccine and assess the planned activities’ readiness, a dry run has been scheduled in four states to start with, viz. Andhra Pradesh, Assam, Gujarat, Punjab considering the geographical locations. Each state will plan it in two districts and preferably in different (five) session type settings, e.g. district hospital, CHC/PHC, urban site, private health facility, rural outreach, etc. This will exercise enable end-to-end mobilisation and testing of COVID-19 vaccination process (except the vaccine) and check the usage of Co-WIN in the field environment, the linkages between planning, implementation and reporting mechanisms and identify challenges and guideway forward before actual implementation including improvements that may be required in the envisaged process. This will also provide hands-on experience to programme managers at various levels. This two-day activity is planned on 28th & 29th December 2020. It will include activities from the necessary data entries in Co-WIN to vaccine receipt & allocation to the deployment of team members, mock drill of session sites with test beneficiaries to reporting and evening meeting. This will also include testing for cold storage and transportation arrangements for COVID19 vaccine and crowd management at the session sites with proper physical distancing.

An essential focus of the dry run will be managing any possible adverse events following immunisation (AEFI). Also, adherence and management of infection control practices at the session site to prevent disease transmission. The mock drill will include concurrent monitoring and review at the block and district levels, and preparation of feedback shared with the State and Union Health Ministry.

Detailed checklist has been prepared by the Union Health Ministry and shared with the four States to guide them in the dry run. The National Expert Group on Vaccine Administration of COVID-19 (NEGVAC) has recommended three prioritised population groups including  Healthcare Workers (HCWs) (about one crore), Frontline Workers (FLWs) (about two crores), and Prioritised Age Group (approximately 27 crore).   As vaccines are temperature sensitive and need to be stored in specific temperature, the present cold chain system consisting of 85,634 equipment for vaccine storage at about 28,947 cold chain points across the country will be used for the cold chain administration. The current cold chain can store the additional COVID-19 vaccine required for the first 3 Crore prioritised population, i.e. Health Care Workers and Front Line Workers.

2. National Task Force Discusses testing, treatment and surveillance strategies for COVID-19 in view of the new virus strain from the UK

26th December 2020, New Delhi

ICMR convened a meeting of the National Task Force (NTF) on COVID-19 under co-chairpersonship of Prof. Vinod Paul, Member NITI Aayog and Prof. Balram Bhargava, Secretary, Deptt. of Health Research & Director General ICMR. The meeting was also attended by Prof. Randeep Guleria, Director, AIIMS; Director General Health Services (DGHS); Drug Controller General of India (DCGI); Director, National Center for Disease Control (NCDC); other representatives from Ministry of Health and ICMR as well as independent subject experts.

The main objective of the NTF was to discuss evidence-based modifications in testing, treatment and surveillance strategies for SARS-CoV-2 in view of the recent reports of emergence of a new variant strain of the virus from the UK. The variant strain has 14 non-synonymous (amino acid altering) mutations, six synonymous (non-amino-acid altering), and three deletions. Eight mutations are present in the Spike (S) gene which carries the binding site (Receptor Binding Domain) of the ACE2 receptors, which are the point of entry of the virus into the human respiratory cells.

NTF deliberated in detail on the current National Treatment Protocol, testing strategy and surveillance of SARS-CoV-2 vis-à-vis the UK variant strain. It was emphasised that since the UK variant strain is implicated in causing increased transmissibility of the virus, it is critical to identify individuals infected with this strain and adequately contain them to prevent its transmission in India.

NTF concluded that there is no need to change the existing Treatment Protocol in view of mutations emerging in the strain. Further, since ICMR has always advocated using two or more gene assays for testing SARS-CoV-2, it is unlikely to miss infected cases using the current testing strategy.

NTF recommended that it is critical to conduct enhanced genomic surveillance for SARS-CoV-2, especially in incoming passengers from the UK, in addition to the existing surveillance strategies. It will also be critical to conduct genome sequencing in samples where there is a dropout of the S gene in lab diagnosis, proven re-infection cases, etc. Routine genomic surveillance of SARS-CoV-2 from representative samples all across the samples needs to be a continuous and well-planned activity.

NCDC informed that India’s Government had taken cognisance of the reports of a mutant variant of SARS-CoV-2 reported from the UK and other countries’ response to these reports. The situation is being monitored proactively. A strategy has been put under place to detect & contain the mutant variant.

3. Central Government gears up for roll-out of COVID19 vaccine

25th December 2020, New Delhi

The Central Government is gearing up for the roll-out of COVID19 vaccine across the country. As the vaccine administrators will play an essential role in the vaccination process, trainers and those who shall administer the vaccine have been taken up across various States.

To strengthen the capacity of our human resource for COVID-19 vaccine introduction and roll-out, detailed training modules have been developed for different categories of vaccine handlers and administrators including medical officers, vaccinators, alternate vaccinators, cold chain handlers, supervisors, data managers, ASHA coordinators and all others involved in the implementation process at different levels. The training includes all operational aspects of activity like the organisation of vaccination sessions, use of Co-WIN IT platform to manage the entire vaccination process,  deployment of HR  Cold chain preparedness, management of adverse events,  communications and intersectoral coordination, biomedical waste management,  infection prevention protocols etc.

2,360 participants were trained during national level Training of trainers, comprised of state immunisation officers, cold chain officers, IEC officials, development partners etc. The State level training had been completed in all States/UTs with more than 7000 district level trainees, except Lakshadweep, which will soon conduct it (29th December). Cascading down, 681 districts (49,604 trainees) have completed Medical Officers’ training on operational guidelines. Vaccination team training was completed in 1399 out of 17831 blocks/ planning units. It is ongoing in the other blocks.

To facilitate redressal queries on COVID-19 vaccination and Co-WIN portal related queries, national 1075 and state 104 Helpline capacity have also been strengthened to address questions beyond their routine support.

To prep up for the administration of COVID-19 vaccine and assess the planned activities’ readiness, a dry run has been scheduled in four states to start with, viz. Andhra Pradesh, Assam, Gujarat, Punjab considering the geographical locations. Each state will plan it in two districts and preferably in different (five) session type settings, e.g. district hospital, CHC/PHC, urban site, private health facility, rural outreach etc. This will exercise enable end-to-end mobilisation and testing of COVID-19 vaccination process (except the vaccine) and check the usage of Co-WIN in the field environment, the linkages between planning, implementation and reporting mechanisms and identify challenges and guide the way forward prior to actual implementation including improvements that may be required in the envisaged process. This will also provide hands-on experience to programme managers at various levels. This two-day activity is planned on 28th & 29th December 2020. It will include activities from the necessary data entries in Co-WIN to vaccine receipt & allocation to the deployment of team members, mock drill of session sites with test beneficiaries to reporting and evening meeting. This will also include testing for cold storage and transportation arrangements for COVID19 vaccine and crowd management at the session sites with proper physical distancing.

An essential focus of the dry run will be managing any possible adverse events following immunisation (AEFI). Besides, adherence and management of infection control practices at the session site, to prevent disease transmission. The mock drill will include concurrent monitoring and review at the block and district levels, and preparation of feedback shared with the State and Union Health Ministry.

Detailed checklist has been prepared by the Union Health Ministry and shared with the four States to guide them in the dry run. The National Expert Group on Vaccine Administration of COVID-19 (NEGVAC) has recommended three prioritised population groups including Healthcare Workers (HCWs) (about one crore), Frontline Workers (FLWs) (about two crore), and Prioritised Age Group (about 27 crore). As vaccines are temperature sensitive and need to be stored in specific temperature, the present cold chain system consisting of 85,634 equipments for storage of vaccine at about 28,947 cold chain points across the country will be used for the cold chain administration. The current cold chain can store the additional quantity of Covid-19 vaccine required for the first 3 Crore prioritised population, i.e. Health Care Workers and Front Line Workers.

4. Vaccines which are in the pipeline will work against the new variants of SARS-CoV-2

29th December 2020, New Delhi

This week’s significant development, Indian SARS-CoV-2 Genomics Consortium (INSACOG), was formed with 10 Government laboratories to ascertain the new variant of SARS-CoV-2 (SARS-CoV-2 VUI 202012/01) in the country. Its function is to establish sentinel surveillance for early detection of genomic variants with public health implications and determine the genomic variants in the unusual events/trends.  This apart, the number of active cases is less than 2.7 lakhs after six months and declining further. While cumulative positivity rate is 6.02% now, the positivity rate during the last week was 2.25%. In another landmark achievement,  daily new cases are less than 17,000 after six months now. Daily deaths are also less than 300 after six months. Union Health Secretary Shri Rajesh Bhushan has stated this in a media briefing on action taken, preparedness and updates on COVID-19, held at National Media Centre in New Delhi today.

The Health Secretary further informed that analysis shows that 52% of the COVID-19 cases are in the 18-44 years age group, and 63 per cent of all COVID-19 patients are males. Also, 55 per cent of deaths have occurred in the 60 years and above age group, and 70 per cent of deaths have occurred to males in the country. He further stated that India is still figures amongst the lowest in cases per million population, 7,408 and active cases per million people, 194. He informed, 110 new cases and two deaths per million have been reported in the last seven days. The Health Secretary also said that five states/UTs accounting for 60 per cent of total active cases in the country are Maharashtra, Kerala, West Bengal, Uttar Pradesh and Chhattisgarh

The Principal Scientific Adviser, Prof K VijayRaghavan, assured that vaccines in the pipeline in India and worldwide would work against the new variants of SARS-CoV-2. In this context, he explained that there is no evidence that current vaccines will fail to protect against COVID-19 variants reported from the UK or South Africa. He said, “The changes in the variants are not sufficient to make the vaccines ineffective. Most of the vaccines target the spike protein, in which there are changes in the variants. But vaccines stimulate our immune system to produce a wide range of protective antibodies”.

Prof Raghavan further explained, “Changes have been observed in the ‘S’ proteins on the surface of the new variants of coronavirus. The viruses undergo changes from time-to-time. Most of these changes do not affect the virus or even the spread of infection. But, sometimes changes are such that its intensity of transmission and other properties change. Such a concern has been raised at the UK and South Africa presently. This new strain of SARS-Cov-2 shows 17 changes in the spike protein, out of which eight are in which codes for the spike protein. One such change increases affinity for ACE2 receptor, used for entry in human cells. Thus its power of transmission has increased. Another change promotes entry into susceptible cells. These changes are causing concerns. Field data has also shown the UK variant to be more transmissible. This is spreading very rapidly and taking over the frequency of all other variants. It is also reflected in the enormous positivity in the UK. There is no evidence so far that it increases the severity of the disease. But, because it increases transmission, it will affect the number of affected people and, therefore, severely diseased people.

Consequently, we must take extraordinary precautions to prevent this kind of variants from dominating a population”. Speaking about India’s measures to control the transmission of this new variant in India, Dr Raghavan said, INSACOG consortium will do testing and sequencing of samples from not only international travellers but also from across the country and from those being admitted to hospitals. In a word of caution, Dr Raghavan advised that there should not be any complacency in our behaviour, despite a decline in positivity and death rate. “A vaccine will be available soon, and it will surely be an exit visa for the virus, but the process of rolling out the vaccine will take time. Till then follow all public health measures scrupulously”, he added.

Speaking about the new variant and mutation in viruses, DG-ICMR Prof (Dr) Balram Bhargava said that we mustn’t put too much immune pressure on the virus by which it will tend to mutate more. He advised judicious use of therapies for which benefits have been established and stopping use of all those therapies for which services have not been proven. In the context of the efficacy of vaccines on the new strain, he said,” Much of the #vaccines that are the front-runners are targeting the ‘S’ protein and also the mRNA. We find that they will continue to be effective from the available data. We have to be careful about any immunity break-through that may happen during #vaccination”. DG-ICMR also said, “Much of the vaccines that are the front-runners are targeting the ‘S’ protein and also the mRNA. We find that they will continue to be effective from the available data”.

Cautioning about the new variant, Dr VK Paul, Member (Health), NITI Aayog, stated, “This new variant of SARS-CoV-2 strain may have its run. We have to be very careful. When a new virus enters, it is easy to suppress it initially as the transmission chain remains small then. Thus, we have to stick to the path of carefulness” Speaking about the work of the newly formed INSACOG, he stated, there are 10 Identified Regional Genome Sequencing Laboratories (RGSL) for genome sequencing in assigned regions. States have been tagged to these RSGLs for genome sequencing in assigned regions. INSACOG has also brought out SOPs for collection of samples and workflow, he added. NCDC, New Delhi, is the Nodal Unit that will maintain a database of all new variants’ samples.

Dr Paul stated that ICMR has decided to study the symptoms and clinical co-relation of those detected with the new variant of SARS-CoV-2. “Till now, it seems that it does not cause much seriousness, but transmits faster”, he informed. But, if transmission happens at a significant scale, it will cause damage, added Dr Paul. Hence, from the perspective of public health response, testing, tracking, and tracing will continue in the same manner at an incredible speed. A cluster is found where a containment zone will be formed, house-to-house search and isolation of positive cases will be done, added Dr Paul.

In reply to a media query about the efficacy of vaccine on the new variant, the Principal Scientific Adviser, Prof Raghavan stated that the UK variant or South Africa variant does not compromise the polyclonal antibody response all current vaccines are based. They target multiple parts of the protein, most of which is not affected by these strains. Hence, there is no reason to believe that the vaccines will not be effective, he said.

In reply to another media query about prioritisation of population groups for vaccination, Dr Paul replied, a committee has been constituted with experts coming from various specialities (like cancer, heart, kidney, lungs, etc.) who will decide upon the process of identifying and prioritising patients with co-morbidities for vaccination. The committee’s report is expected soon, he added.

5. Indian SARS-CoV-2 Genomics Consortium (INSACOG) Labs release initial results of Genome sequencing of the mutant variant of SARS-CoV-2

29th December 2020, New Delhi

Government of India took cognisance of the reports of the mutant variant of SARS- CoV-2 virus reported from the UK and placed a pro-active and preventive strategy to detect and contain the mutant variant.

This strategy includes, but is not limited to, the following steps:-

 The entire issue was examined at length by NTF on 26th December 2020. The NTF concluded that there is no need to change either the existing National Treatment Protocol or existing Testing Protocols in view of the mutant variant. NTF also recommended that it is critical to conduct enhanced genomic surveillance in addition to the existing surveillance strategy.

From 25th November to 23rd December 2020 midnight, about 33,000 passengers disembarked at various Indian airports from the UK. All these passengers are being tracked and subjected by States/UTs to RT-PCR tests. So far, only 114 have been found positive. These positive samples have been sent to 10 INSACOG labs (NIBMG Kolkata, ILS Bhubaneswar, NIV Pune, CCS Pune, CCMB Hyderabad, CDFD Hyderabad, InSTEM Bengaluru, NIMHANS Bengaluru, IGIB Delhi, NCDC Delhi) for genome sequencing.

A total of 6 samples of 6 UK returnee persons are positive with the new UK variant genome. 3 in NIMHANS-Bengaluru, 2 in CCMB-Hyderabad and 1 in NIV-Pune. All these persons have been kept in single room isolation in designated Health Care facilities by respective State Governments. Their close contacts have also been put under quarantine. Comprehensive contact tracing has been initiated for co-travellers, family contacts and others. Genome sequencing on other specimens is going on.

Under careful watch and regular advice, the situation is being provided to the States for enhanced surveillance, containment, testing & dispatch of samples to INSACOG labs.

It is important to note that the new UK Variant’s presence has already been reported by Denmark, Netherlands, Australia, Italy, Sweden, France, Spain, Switzerland, Germany, Canada, Japan, Lebanon, and Singapore.

6. Union Health Minister Dr Harsh Vardhan nominated to the Board of GAVI, The Vaccine Alliance

29th December 2020, New Delhi

The Global Alliance has set Dr Harsh Vardhan, Union Minister of Health and Family Welfare for Vaccines and Immunisation (GAVI) as a member on the GAVI Board.

Dr Harsh Vardhan will be representing the South East Area Regional Office(SEARO)/ Western Pacific Regional Office (WPRO) constituency on the GAVI Board. Mr MyintHtwe of Myanmar currently holds the seat. Dr Harsh Vardhan will be representing India from 1st January 2021 until 31st December 2023.

The Board typically meets twice a year in June, and November/ December and holds an annual retreat, generally in March or April. All these meetings are usually attended in person.

The GAVIBoard is responsible for the strategic direction and policy-making, oversees the Vaccine Alliance’s operations, and monitors programme implementation. With membership drawn from a range of partner organisations and experts from the private sector, the Board provides a forum for balanced strategic decision making, innovation and partner collaboration.

GAVI, the Vaccine Alliance as part of its mission to save lives, reduce poverty and protect the world against the threat of epidemics, has helped vaccinate more than 822 million children in the world’s poorest countries, preventing more than 14 million future deaths.

Dr NgoziOkonjo-lweala presently serves as Chair of the GAVI Alliance Board.

7. Dry run for COVID-19 vaccination successfully conducted in four states

29th December 2020, New Delhi

Union Ministry of Health & Family Welfare (MoHFW) completed a two-day dry run for activities entailed in COVID-19 vaccination in four states Assam, Andhra Pradesh, Punjab and Gujarat on 28th & 29th December 2020.

Backed with the experience of rolling out Universal Immunization Programme (UIP) and conducting nationwide multiple wide-range injectable vaccination campaigns such as measles-rubella (MR) and Adult Japanese Encephalitis (JE) campaign, required steps are being undertaken to vaccinate priority population groups such as Health care workers, Frontline workers and people above 50 years for Covid-19.

The dry run exercise is aimed at end-to-end testing of COVID-19 vaccination process and will include planning & preparations as per the Operational Guidelines; creation of facilities & users on Co-WIN application, session site creation & mapping of sites, Health Care Workers (HCW) data upload, receipt of vaccines and vaccine allocation by the district, session planning, deployment of vaccination team, logistics mobilisation at session site, mock drill of conducting vaccination and reporting and review meetings at the block, districts and state level. The objective of dry the run is to undertake and confirm the field implementation of the IT platform Co-WIN and guide the way forward before actual implementation.

District Collector with district and block task force engagement was made responsible for conducting the dry run. It was expected to provide insights on any gaps or bottlenecks during the actual conduct of vaccination.

The two-day end-to-end dry run was undertaken in Krishna district in Andhra Pradesh, Rajkot and Gandhinagar in Gujarat, Ludhiana and Shaheed Bhagat Singh Nagar (Nawanshahr) in Punjab and Sonitpur and Nalbari districts in Assam.

Specific teams were formed for various tasks by the district administration. Activities like uploading dummy beneficiary data, session site creation, vaccine allocation, communication vaccination details to vaccinators& beneficiaries, and beneficiary mobilisation were carried out.

Field feedback on the first day of the dry run was also reviewed on 29th December 2020 through Video conferencing with State & District Programme officers by Joint Secretary (Public Health). All states expressed satisfaction in terms of the operational approach and use of the IT platform to ensure transparency and effective monitoring of vaccination processes expected to cover many people. Additional suggestions on IT platform were also noted for further enhancement of Co-WIN platform.

Detailed insights and feedback will help enrich the operational guidelines and IT platform and strengthen the COVID-19 vaccination roll-out plan.