Gujarat: Doses up, confusion level down during drive for booster shots

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The urban health centre at Memnagar, officially the Bodakdev UHC, was busy, mostly with staff from the nearby private hospitals continuously dropping in for a good part of the day for their booster jabs. The UHC has several hospitals in the vicinity such as Kaizen Hospital, Sunflower Women’s Hospital and Mayflower Women’s Hospital. Some came with the elders in their families for booster shots.

A year of extending itself as a Covid-19 vaccination centre, the UHC is better experienced to deal with glitches that have also become fewer.
Apart from undertaking adult vaccination at the centre, the UHC also sends its staff to schools in the ward or to special targeted/designated vaccination sites within the ward such as bus depots, community halls, slums and homes to undertake Covid-19 vaccination for all, including adolescents aged 15-18 years.

At the UHC, the queues are long but fast-moving. The previous norms of a separate observation room post-vaccination has been done away with. Instead, chairs have been placed haphazardly outside the centre for beneficiaries to sit post their dose, if they wish to. However, most were seen taking the dose and walking out immediately to go about their day. The staff kept reminding many to mask up although social distancing went for a toss. “It is difficult to maintain social distancing with this kind of queue,” says a staffer at the site.

Since the Covid vaccination began nearly a year ago, vaccinators and health staffers at the UHC have been better equipped to deal with probable queries from vaccine beneficiaries and resolve their issues, as well as streamlining processes to facilitate quicker turnaround times. With two separate queues maintained at the UHC — one for walk-in registrations and another for those who booked a slot online — verification processes have been quickened.

“In the initial days, one of the key issues was of shortage of doses. We had to turn away people who would perhaps be waiting since 8 am. That was difficult to deal with, especially since all the frustration of the beneficiaries would be directed at us. There were CoWin software glitches as only online appointments were allowed with no walk-ins permitted. All these issues have now eased with more supply of doses and walk-ins allowed,” says a staffer.

Bhupendra Vaghela, a contractual AMC multipurpose health worker (MPHW), was been put in charge of handling the vaccination process at the UHC site but was laid off in November 2021 after the civic body decided to do away with its contractual staff due to a considerable reduction in Covid cases.

“We had not taken a break since April 2020 when we were recruited. We worked through Diwali, all holidays. Before the vaccination programme started, I was involved in door-to-door surveillance and only we know the difficulties we faced… I did not test positive, but many of my colleagues did. It was a difficult time because everyone has family and more than us testing positive, we are worried about compromising our family members’ safety,” says Vaghela.

Vaghela and other contract staffers were called back to duty early January in view of the third wave suspected to be driven by the Omicron variant.

Vaghela says four to five vaccination teams, each with three members, from the Bodakdev UHC were deployed every day.

The majority of the UHC staffers are contractual and prior to Covid, the centre primarily served as a centre for administering child immunisation, basic health services under state and national health programmes such as surveillance of pregnant women and child health, and birth and death registration office. AMC runs 77 such UHCs and seven Community Health Centres (CHCs) across the city.

A 44-year old man, working at the SAL Hospital in the administrative department, brought his elderly mother for the booster shot on January 11, three days before his mother completed nine months after getting the second dose, but was turned away.

“We thought an approximate nine-month gap would do but we appreciate that they are being thorough,” he said, not willing to be identified. While his parents were not exposed to Covid in the near two years of the pandemic, the man was infected during the second wave in April.
Several nursing staffers, dressed in blue or pink overalls, having booked online, were in and out of the UHC in five minutes. Mina Parmar, a nurse at a nearby hospital says, “As a healthcare worker, we are under constant threat so we came here as soon as we got time.”

Parmar has had two bouts of Covid so far — in September 2020 and August 2021 — although she was not working in the Covid ward. The symptoms were mild both times, she says.

State immunisation officer Nayan Jani says while documentary proof for the comorbid condition in those elderly eligibles for the precaution dose is not being asked for, vaccine doses are to be administered to only those who do have comorbid conditions and the same is to be verified orally by vaccinators on-site. “We are following the Centre’s guidelines and this is a priority order where the idea behind the guidelines is to prioritise those with comorbid conditions,” adds Jani.

While the Centre, in its guidelines, does not specify how long after a Covid bout post the second dose and pending precaution dose a beneficiary can take the booster, Jani says the basic principle of waiting for three months gap after infection for a dose holds even for the booster dose.

“The booster dose is to be administered nine months after the second dose. In this nine-month period, if someone had Covid within sixth months after the second dose, they can take the booster dose as scheduled. If later, they must complete three months after the infection to take the booster dose,” says Jani.

The Bodakdev UHC, until January 15, has administered 85,348 doses. Overall, AMC has administered a total of over 90.31 lakh doses so far — 51.83 lakh first doses, including 1.74 lakh doses on adolescents aged 15 to 18 years, 37.94 lakh second doses and 52,813 booster shots.

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