As India’s first vaccines were rolled out last month, New Delhi-based doctor Harjit Singh Bhatti decided he didn’t want one.
As a frontline worker in the middle of India’s COVID epidemic, Bhatti knew he was more at risk of getting sick than others. But for him, the risks posed by the vaccine felt higher than those of getting sick.
“It’s not because we are anti-vaccine,” he told VICE World News, referring to other doctors also resisting the injection, “but we want a good vaccine to come to India.
“We see a lot of promotion and marketing of vaccines, but the trials data and science behind it is not being shared. It’s like we’re still a part of the clinical trial mode.”
Since the vaccine rollout started on January 16, a little over 4.1 million healthcare and frontline workers have been vaccinated. Feb. 3 recorded 188,762 vaccinations. The pace, experts say, is too slow to meet the targets of the first phase.
Multiple reports show absenteeism and low turnouts at hospitals. A health officer in the southern Indian city of Bengaluru anonymously told The Times of India that he instructed a nurse to hold a ball of cotton to his arm to make it look like he had the jab. Another health worker in the southern Indian city of Hyderabad told the same publication that a few beneficiaries took a leave of absence on the day of their inoculation.
Jeemol Shaji, a New Delhi-based nurse, told the Wall Street Journal that she had to throw out a pile of leftover vaccine doses because only 30 of 100 scheduled healthcare workers showed up.
India’s Central Drugs Standard Control Organisation has provided emergency authorisation for the rollout of two vaccines: The first is the more internationally reputable AstraZeneca/Oxford vaccine, and the second is a state-funded treatment called Covaxin which was developed by Indian company Bharat Biotech. It’s been widely reported that Covaxin is still yet to complete phase three trials, but is already being rolled out nationally.
Prominent medical teams around the country have publicly voiced their concern about Covaxin. As New Delhi’s Ram Manohar Lohia Hospital’s medical superintendent stated in a letter, “Residents are a bit apprehensive about the lack of complete trial in case of Covaxin vaccine and might not participate in huge numbers, thus defeating the purpose of vaccination.”
In another example, doctors from the western Indian metropolis of Mumbai rejected Serum Institute’s Covishield for Covaxin shots.
India’s vaccination drive, which is attempting to inoculate 300 million people by August, is touted as the largest exercise of its kind in the world.
Malini Aisola, the co-convenor of an independent drug watchdog called All India Drug Action Network (AIDAN), told VICE World News that emergency approval of Covaxin has forced the drug regulator to impose extra safeguards such as monitoring and check-ups after administration.
“These extra procedures, combined with the lack of efficacy data, could be a factor affecting acceptance of the vaccine,” she said. “Some healthcare workers might be thinking that it’s easier to put off vaccines by a few months when more data become available and there may be more vaccine choices in the market.”
There’s little clarity or information on the nature of side-effects since the inoculation drive began. On Jan. 17, the second day of the vaccination, nearly 450 cases of side effects were reported from among 224,310 vaccinations.
Indian virologist Shahid Jameel said that vaccine risks are a part of the process.“If you’re trying to develop a vaccine during the pandemic, you don’t have the luxury of time. There’s always going to be some risks,” he told VICE World News. “People are not able to separate the two issues of safety and efficacy of the vaccines. The available data shows both vaccines in India to be safe. It is the efficacy of at least one that remains unknown.”
At least nine people have died so far after receiving the vaccines, although the Health Ministry has denied that these are cases of causation.
Meanwhile, the AIDAN has tracked at least 15 deaths after the vaccines. The latest was reported on Feb. 2 when a 40-year-old conservancy worker died days after his jab on Jan. 21. His family blames the vaccine and is demanding an investigation.
On the same day, the government told the upper house that the CDSCO doesn’t have any information about “severe adverse event” causally linked to the vaccines.
Aisola says that another concern has been the lack of public messaging around the safety of the vaccines. “What is concerning about the deaths—the majority of which occurred from hours to within a week—is the lack of transparency about how these cases are being investigated,” she said. “Sharing information about all serious adverse events that have taken place and the causality reports should be shared in the public domain. This is important for building confidence in the vaccines and quell misinformation and rumours.”
Meanwhile, back in New Delhi, doctor Harjit Singh Bhatti is concerned that hospital contract workers won’t have the agency to refuse Covaxin shots that are mandated by management.
“I see it around me,” he said. “The supervisor of staff such as security guards or cleaning staff tell them that they have to get it done. These workers are contractual employees. They will not question the vaccination drive.”
On Jan. 16, when Manish Kumar, a 34-year-old sanitation worker, became the first Indian to receive the indigenous Covaxin jab, he said he did it because his colleagues were “scared” to get it.
According to virologist Shahid Jameel, the issue at the heart of all this is a lack of transparent information.“When you put things in a black box, people get suspicious,” he said. “Only transparency can build trust.”
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