In Kerala, the Pathanamthitta district has the highest percentage of citizens in the age group of 60 years. The district officials focussed on getting this age group in each ward inoculated.

gloved hands inject covid-19 vaccine into the arm of a man, who has his t-shirt pulled down at the
news COVID-19 vaccine Saturday, May 15, 2021 - 16:25

“The vaccination drive in Pathanamthitta was like a competition among the panchayat leaders — who will vaccinate the residents in their respective wards faster,” said AL Sheeja, the District Medical Officer (DMO) as she explains why the district has better COVID-19 vaccine coverage compared to other districts in Kerala. As of May 14, Pathanamthitta, which has a population of 11.97 lakh (2011 Census) has covered 29.93% of the total population with the single dose.

According to the data compiled by Kerala-based civil engineer and data mining enthusiast James Wilson, Pathanamthitta has vaccinated 28.68% of its total population with a single dose of vaccine, while 10.58% of them have received their second dose, as of May 13 — the highest among other districts. James compiled a series of maps showing the district-wise percentage of the population in Kerala that received the COVID-19 vaccine so far. He used the district-wise figures on the Kerala government’s COVID-19 dashboard and the projected population for 2021 to compute the figures. “With a population of 12.44 lakh, Pathanamthitta has vaccinated 3.57 lakh people with the first dose and 1.28 lakh with both doses,” he said. However, Pathanamthitta is one of the districts with a smaller population. As per the 2011 Census, the district has a population of 11.97 lakh, while the projected 2021 population shows 12.44 lakh. 

Even if one were to consider the population in other districts, Pathanamthitta has fairly better coverage. For example, Malappuram, which has the highest projected population of 42.72 lakh, has covered 11.75% and 2.92% of the population with the first and both doses respectively. Similarly, in Wayanad, which has the least population of 8.49 lakh, 22.6% and 8.51% of the population has received the first dose and both doses respectively. “The higher the percentage, the better it is; so Pathanamthitta district is doing well,” said Rijo John, a health economist. 

Elderly citizens, ward-wise focus: What helped   

The Pathanamthitta district administration focused on two factors across panchayats and municipalities for its vaccination drive — elderly citizens and ward-wise vaccine. According to the Economic Review 2020, Pathanamthitta has the highest percentage (17.9%) of citizens in the age group of 60 years and above. There are 1,042 wards across 53 gram panchayats and four municipalities in the district. 

Each panchayat has two primary health centres (PHCs). The ASHA workers in each ward mobilised the residents to these PHCs. “They knew how many residents in their ward are above 60 years of age. Besides, in mid-2020, we had compiled a list of persons above 60 years as part of the reverse quarantine measures; so we used this list to reach out to them,” explained Sheeja, the DMO.  

While residents in municipality areas could access the vaccine in major hospitals and register online, the DMO said they focussed on spot registration for citizens above 60 years in gram panchayats. “Many older residents’ children live abroad. They live alone and don’t have access to technology. So, ASHA workers register for them. In some cases, some non-resident Indians book online spots for their older parents in private hospitals,” she explained. 

Notably, the district officials also encouraged healthy competition among the PHCs. “The PHCs competed with each other over who would achieve 100% vaccine coverage faster. All panchayat and ward members, too, actively participated in the vaccination drive,” said Sheeja. 

The district officials planned the vaccine coverage for 2.5 lakh beneficiaries above 60 years. With beneficiaries in the age group of 45-59, too, becoming eligible, the officials estimated 4.8 lakh beneficiaries. 

The officials identified 22 private hospitals to administer the vaccine. They allotted 100 to 150 slots per day for PHCs and 250 slots for Community Health Centres (CHCs). Beyond the PHCs, they also set up vaccine centres in each ward when required.

Of course, as expected, the unwillingness to take the vaccine was one of the challenges for the district officials. They had initially planned to administer 10,000 doses per day. However, citizens were reluctant to take the vaccine three months ago, said the DMO. 

“We were administering only 9,000 doses per day at a time when we had enough stock. But thanks to competition among the PHCs and ASHA workers mobilising citizens in each ward, our daily doses went up to 12,000 and 14,000. At one point, it reached 15,000 doses. That is how panchayats got good vaccine coverage,” she said.  

Panchayats such as Parakode and Pramadom have recorded 90% coverage of the first dose of the vaccine. 

“However, as we were gradually expanding the coverage, and quickly completing the first dose, we were hit by the vaccine shortage in Kerala,” she added, with disappointment evident in her voice. 

How the vaccine drive slowed down

In March 2021, the district administration officials had planned to cover the 60+ population with the first dose by April 10. But, on April 1, the nationwide drive opened for citizens above 45 years of age. Gradually, when the Kerala government stopped spot registration on April 22, online slots were mostly availed by people in the age group of 45-58 years, said Sheeja. 

Soon, states started reporting vaccine shortage. While the previous batch of free vaccines from the Union government has been exhausted, Kerala has still managed to efficiently reduce the vaccine wastage and administer extra doses accordingly. Despite this, many citizens above 45 years of age, especially the older citizens, were finding it difficult to get a slot to get their second dose. 

“Initially, we used to get the batch of dose we requested; it helped us plan better. In March, we received about 75,000 doses for citizens above 60 years. Then, as the state started seeing a shortage, doses were distributed to districts that had lesser vaccine coverage. And so, we got lesser doses. Now, we get only 5,000 doses,” Sheeja told TNM. 

“We will think about vaccinating people in the age group of 18-44 when we get liberal doses. For now, our priority is giving the second dose,” she said.