Once the second phase of the vaccination drive opened up, 61-year-old Suresh and his 56-year-old wife were among the first to receive the vaccination against the coronavirus in Hyderabad at a leading private hospital’s Secunderabad branch. They were surprised that their vital parameters like blood pressure, temperature and oxygen levels were not checked, especially considering the fact that they both have comorbidities. Assuming this was the case everywhere, they went ahead with the vaccination. Later, when they discussed it with family members from other places, they realised hospitals in states like Kerala, Karnataka and Tamil Nadu were testing vital parameters of beneficiaries before administering the vaccine.
When this was brought to our notice, TNM reached out to people from across Andhra and Telangana to find out whether the vital parameters were checked before they were administered the vaccine. They recalled their experiences at the vaccination centres.
All those that TNM spoke to who received the vaccine at private centres, said that their vitals were not checked before they got the jab. 65-year-old G Sudhakar, who received the vaccination at the Secunderabad branch of a private hospital, was the only one who said that his vital parameters were tested before being administered the vaccine. Those who said their vitals were not checked included 49-year-old Laxmi Kanth and his 70-year-old father-in-law, as well as Suma Joseph, who went to a private Hospital in Madhapur, a 60-year-old woman who did not wish to be named who went to a private Hospital in Vijayawada, and Satish Kumar’s parents who got vaccinated in another private Hospital in Visakhapatnam.
While the government hospitals checked the vital parameters, TNM found that private hospitals were giving the process a slip. 79-year-old SV Ramesam got vaccinated at the Primary Health Centre (PHC) in Neredmet while PV Subba Rao got the jab from the PHC in Malkajgiri and 62-year-old B Satyanarayana was administered the vaccine in Santhanuthalapadu PHC in Prakasam district of Andhra Pradesh. All three of them recounted that their vital parameters like blood pressure, temperature and oxygen levels were tested at the government hospitals.
Dr Sanjeev Singh Yadav, National Secretary of the Indian Medical Association’s Telangana unit feels it is necessary that the vital parameters are checked before a patient is administered the vaccine. “As per my knowledge, any injection which is given to a person who is not a regular recipient, just asking them if they have blood pressure and sugar will not suffice. The vitals need to be checked before as we don’t know when and which patient will have a reaction. It is necessary that pulse, temperature and blood pressure should be checked before the vaccine is administered. This will provide a more detailed knowledge about how the patient is doing. Checking the parameters gives the treating physician to have a basic knowledge about what exactly the patient is like.”
However, doctors have conflicting views on the matter. Dr Venkat Ramesh, Consultant Infectious Diseases at Apollo Hospital felt that there is no need for the vitals to be checked before administering the vaccine. He said, “We need to vaccinate as many people as possible in the shortest span of time and this calls for dismantling any barriers to vaccination. There is no point in checking vital signs prior to vaccination. This is an unnecessary waste of time and resources. If the person has a medical complaint then they should be directed to a physician/emergency room. The vital signs should then be assessed as a part of their evaluation as is the case with any other patient. Moreover, no international guideline or body mentions it.”
The Advisory Committee on Immunisation Practices (ACIP), is a committee within the United States Centre for Disease Control and Prevention (CDC) that provides advice and guidance on effective control of vaccine-preventable diseases in the US civilian population. They do not mention the requirement for vital signs to be checked prior to vaccination.
To clear the confusion, TNM looked up the operational guidelines laid down by the Government of India’s Ministry of Health and Family Welfare (MoHFW). Interestingly, it has no mention of the checking of vital parameters—it doesn’t mention if it needs to be done or whether it can be avoided.
According to Dr Pradyut Waghray, a senior pulmonologist in Hyderabad says that patients need not insist the vital parameters be checked before being vaccinated. He said, “COVID-19 is a new disease and hence the guidelines are not yet completely formalised like in the case of pneumococcal vaccines."
"ACIP is usually followed mostly for pneumococcal and influenza vaccines. However, the recommendations from WHO and CDC suggest the vital parameters have to be checked. ICMR has also not issued anything about the same. Theoretically, it needs to be checked but in maximum cases nothing irregular is found. Patients needn’t insist that the vital parameters be checked. It needs to be checked only if in case the patient himself points out that he is highly diabetic or is running a temperature etc”, added Dr Waghray.