9.2 million miss second dose: Asha workers battle odds to meet target
Data from the state shows that the average daily vaccinations or second dose dropped from 760,955 in September to 525,121 in October, and further declined to 463,389 this month. Nearly 70,000 Asha workers have been on the ground throughout the pandemic, encouraging people to get tested, flagging suspected patients in the villages for quarantine and encouraging the population to take jabs
Padama Dhisal, an accredited social health activist (ASHA) from Kolhapur’s Vadange village, has already visited the house of a 50-year-old woman, due to receive her second jab, four times this month. The woman was due for her second dose in early November. Mid-November, when 42-year-old Dhisal visited the woman for the second time to remind her to take her second dose, the woman said that she was busy with Diwali festivities and missed the date. In the past week, Dhisal has visited the woman twice and the woman said that she was unwell. “I have tried everything to convince her. I even told her that a lot of benefits like the ration shop will be linked to full vaccination soon,” said Dhisal.
The 50-year-old is among the 150-odd people who have missed the second dose in Vadange village alone. She is among the 9.2 million people across the state who have missed the second dose due dates. Maharashtra’s target population is 91.5 million. While the state is close to 80% first dose coverage, its full vaccination or two-dose coverage is merely 41%.
Infectious disease expert Dr Om Srivastava said that one dose definitely provides some protection but the second dose is important to ensure immunity against severe disease and hospitalisation.
“The pace of vaccination has definitely slowed down,” said state’s immunisation officer Dr Sachin Desai. “Initially, we dealt with a shortage of doses, there was also a momentary shortage of syringes but the drive stabilised as doses started to come in. But the pace of the drive declined again during Diwali,” he said.
Data from the state shows that the average daily vaccinations dropped from 760,955 in September to 525,121 in October, and further declined to 463,389 this month.
Nearly 70,000 ASHA workers like Dhisal have been on the ground throughout the pandemic, encouraging people to get tested, flagging suspected patients in the villages for quarantine and encouraging the population to take the jabs since the Centre rolled out universal adult vaccination on April 30.
Yet, many like Dhisal find themselves struggling to motivate people to get their second jabs on time. The reduced number of Covid-19 cases, availability of vaccines and decreasing fear of Covid infection have resulted in people delaying their second doses, health workers said.
According to Dr Pradeep Vyas, principal secretary of the state’s public health department, recent daily vaccination trends showed that the number of second doses administered were higher than the first dose. “The number of people due for the second dose is a dynamic figure, which changes every day, as some of them take the second dose and new names get added to the list as and when people become due for it,” he said.
“Some senior citizens fear the side effects, as they had fever and body ache for a few days after the first jab. Some people have flatly denied taking the second dose because of the reducing Covid-19 cases,” said Dhisal, who has been an ASHA worker for 12 years.
Kolhapur is among the half a dozen districts in the state that have more than 80% first dose coverage (86.69% in this district), but its full vaccination coverage is only about 41.2%. In some of districts where the gap between two vaccines is high, ASHA workers have started telling the community that no vaccination could lead to other sufferings.
For instance, in Nandurbar, which has achieved only 60% first dose coverage and 30% full vaccination coverage, health workers are telling community members that they may soon not get ration or will be barred from visiting marketplaces if they are not fully jabbed.
“We have to warn them about worse case scenarios, even if the state doesn’t come up with such mandates,” said Leela Pawra (40), an ASHA supervisor from Nandurbar’s Dhadgaon block. She has 11 ASHAs in six villages working under her. Each one has at least 10 to 15 people under their jurisdiction who have missed the second dose.
A large section of the population from Nandurbar migrates to other parts of the state and the country for work. They return just before the Holi festival, which falls in March. “The state has no mechanism to track this migrant population,” said Laitka Rajput, a social activist from Nandurbar. “When these migrants return, there will be a huge risk of a spurt, if they are unvaccinated or partially vaccinated,” she said.
Many districts are trying to incentivize people to get the second dose. The Thane Municipal Corporation said that it would not pay salaries to employees who are unvaccinated. In Aurangabad, the district officials have mandated grocery shops, fuel pumps to make sales only to people who have taken at least one dose. In Mumbai local train travel and entry to the malls among other things are linked to full vaccination. Mumbai currently has around 400,000 people who have missed their second dose.
Health minister Rajesh Tope in a media conference on Wednesday said that the last mile is challenging. “We have asked staff to put all focus on the districts that have vaccination coverage below the state’s average,” he said.