COVID-19 and EVIN

The Electronic Vaccine Intelligence Network (eVIN) is being used by the State/UT governments in India to monitor the supply chain of Covid response material.

• This has been used with the requisite customization during the Covid pandemic for ensuring the continuation of the essential immunization services.

Key Points

• About: It is an indigenously developed technology system that digitizes vaccine stocks and monitors the temperature of the cold chain through a smartphone application.
• Objective: It is aimed at strengthening immunization supply chain systems across the country.
• eVIN aims to support the Government of India’s Universal Immunization Programme by providing real-time information on vaccine stocks and flows, and storage temperatures across all cold chain points in these states.
• Implemented by: It is being implemented under the National Health Mission (NHM) by the Ministry of Health and Family Welfare in partnership with the United Nations Development Programme (UNDP).
• The integrated solution combines:
• Technology: Online real-time information on vaccine stocks and storage temperature to facilitate evidence-based decision-making.
• Governance: Systemizing record-keeping, upgrading logistics and encouraging good practices to ensure efficient vaccine logistics management.
• Human Resources: To empower the state cold chain network by building the capacities of handlers and managers at each stage of vaccine supply.

Universal Immunization Programme

• It was launched by the government in 1985, to prevent mortality and morbidity in children and pregnant women against 12 vaccine-preventable diseases.
• Under UIP free of cost vaccination is provided against twelve vaccine-preventable diseases i.e. Tuberculosis, Diphtheria, Pertussis, Tetanus, Polio, Hepatitis B, Pneumonia, Meningitis due to Haemophilus Influenzae type b (Hib), Measles, Rubella, Japanese Encephalitis (JE) and Rotavirus diarrhoea.
• The programme is one of the largest health programmes in the world. Despite being operational for many years, UIP has been able to fully immunize only 65% of children under 1 year of age.

Way Forward

• This strong platform has the potential to be leveraged for any new vaccine including the COVID-19 vaccine, as and when available.
• eVIN can be a powerful contribution to strengthening health systems and ensuring equity through easy and timely availability of vaccines to all children, pregnant mothers and other vulnerable groups.
• eVIN can be upscaled to build VALUE (Vaccine and Logistics Utilisation Evaluator), which is a held device for capturing the data of vaccines administered, to monitor reach till the last-mile beneficiaries.
• It can help to fully automate the process of indenting and supplying vaccines based on the historic actual consumption of vaccines and forecasting.

Eight months ago, India had begun a decline in daily Covid-19 infections to the extent that many experts believed that a devastating second wave was unlikely in India. However, the second wave of Covid-19 has brought health infrastructure to a near collapse.

Moreover, India’s options for containing the pandemic are narrowing as it can ill-afford another lockdown now. In this context, the combination of panic, public pressure, and the magnitude of the crisis has prompted the Union Government to authorize vaccines to anyone above 18 and give states more control over procurement.

Though these are positive steps, there are many challenges that will act as a roadblock to the universalization or even accelerating the rollout of the Covid-19 vaccine in India.

Associated Issues with Accelerated Rollout of the Vaccine

• Vaccine Shortage: At the optimistic rate of three million doses a day, it would take at least 260 days from today for every adult to get at least a single shot.
• Given the shortage of vaccines, India cannot afford to have a single or universal policy and needs to make it more targeted.
• Under Financing: It is unclear if merely the policy move of liberalizing vaccine supply will leave States in India with the finances and negotiating power to procure enough stocks of vaccines.
• Shortage of Raw Material: The inability of getting the much-needed raw materials from the United States – bags, vials, cell culture media, single-use tubing, specialized chemicals, etc. that have now been banned for export has disrupted the vaccine production in India.
• Balancing Global Commitments: Another issue is concerning international obligations. Of the 38 million doses the global alliance program Covax has so far distributed to 84 countries, 28 were from India.
• Further, under the vaccine diplomacy initiative, India exported 60 million doses, half on commercial terms and 10 million as grants.
• That obligation may have to be followed up perhaps as they would need for their second dose.

Way Forward

• Massive Multimedia Campaigns: If fresh lockdowns are to be avoided, we need to enforce masks by investing in massive multimedia campaigns for information, education, and communication, like it was done for polio and HIV.
• Supporting Domestic Production: It should also speed up approvals and financial packages for ramping up domestic production for expanding supply, expanding age bands.
• Further, as supplies improve and decentralize implementation decisions to states to enable better efficiencies, and allow export after ensuring at least five months stock.
• Also, there is a need to improve efficiencies in utilization and drastically reduce vaccine wastage
• Strengthening VaccineSupply Chain: Enhancing Electronic Vaccine Intelligence Network (eVIN) system will enhance real-time information on vaccine stocks and storage temperatures across all country’s cold chain points.

Conclusion

India’s Covid-19 vaccine drive will be a monumental mission, not just in terms of vaccinating its own population, but also vaccinating a large part of the world thanks to its position as the world’s leading vaccine producer.

Addressing the issues associated with the development and distribution of vaccines will augment the effort to efficiently get vaccines to hundreds of millions in the shortest period of time.