Experts say more needs to be done by the government to address concerns and fears over the COVID-19 vaccines.

A medical professional vaccinating a womanImage for representation
news COVID-19 vaccine Monday, January 18, 2021 - 12:45

A 40-year-old sanitation worker, who works for the Chennai Corporation on contract, was working tirelessly during the complete lockdown without a break. And despite the real risk of contracting the novel coronavirus owing to her profession, she now says, “More than COVID-19, I am scared to take the vaccine.”

Like the 40-year-old sanitation worker, many other frontline warriors are also hesitant to take the vaccine, which is voluntary, in the first phase. Their fear stems from the lack of transparency about vaccine safety, and efficacy. “It’s not just me but several sanitation workers are scared to take the vaccine. Why are we selected for taking the vaccines first?” she asks. 

On Saturday, the Indian government launched the world’s largest vaccination drive to administer two vaccines—Covaxin and Covishield among healthcare workers and frontline staff. By the end of the day,  2,783 healthcare workers took the vaccine shots in Tamil Nadu with 2,684 healthcare workers taking Serum Institute of India’s (SII) Covishield vaccine and 99 individuals took Bharat Biotech’s Covaxin.

On Sunday, 3029 healthcare workers in Tamil Nadu received doses of COVID-19 vaccines and of the total, 182 people received Covaxin doses. However, Tamil Nadu recorded only 20.11% of its vaccination target on Sunday, only slightly higher than day 1, where the state achieved 18.83% of its goal.

While those receiving the vaccine will not have the option to choose between the two vaccines, they can volunteer to opt out of getting the vaccine. Those receiving Covaxin will have to sign a consent form as phase 3 clinical trials for Bharat Biotech’s COVID-19 vaccine is still underway. India’s drug regulator had granted approvals for Covaxin under ‘clinical trial mode’. At the time of getting approvals, the Hyderabad-based manufacturer was yet to submit efficacy. Several scientists have expressed criticism and concern over this. There have also been questions raised over SII’s Covishield’s approval, which was based on phase 3 trial data conducted in the UK and Brazil. Covishield was given the nod based on the interim analysis of the bridging study carried out to test the vaccine’s response on Indian population. But it’s unclear how many participants were involved in this interim analysis.   

‘Being used as guinea pigs’

This lack of transparency has as a result caused vaccine hesitancy among some healthcare and sanitation workers. A staff nurse working in Chennai’s Rajiv Gandhi Government General Hospital says, “We do not want to take the vaccines and we should also not be compelled to take them right now. There is no clarity yet on the efficacy of the vaccines and the complete test findings are yet to be displayed for the public. So I’m not ready to take the vaccine.”

She also says that her colleagues and many nurses from Chennai are hesitant to take the shots. “The vaccine testing usually takes up to 10-15 years and we agree that we cannot wait for so long during the pandemic scenario. However, we can at least wait till the three phases of trials are over in the country,” she observes.

The 32-year-old staff nurse also questions the need to launch the first phase of COVID-19 vaccination drive among healthcare and sanitation workers instead of public representatives, alleging that they were being used as ‘guinea pigs’. This sentiment was also expressed by a sanitation worker who works at a hospital near Vadapalani. “Why should we take the vaccines when the doctors and the nurses are not taking them?” he asks.   

Concerns over side effects 

The nurse says she plans to wait three months before taking the vaccine. “During the peak of the pandemic, we were already working two shifts and we know the difficulties we face due to the shortage of staff in government hospitals. So, in case there are any adverse events due to the vaccine, then we should be here to take care of the patients,” she argues, adding, “If we get side effects it will just increase the burden on the other working nurses and healthcare system. So, we have decided not to take it now.” 

Being the sole breadwinner of his family of four, the 43-year-old sanitation worker from Vadapalani says concern over side effects was adding to his hesitancy to take the vaccine. “I can even live like this but I cannot afford to get side effects and sit at home. So I won’t take the vaccine until I see that they do not create any adverse effects,” he says.

However, he adds, “But if the government tells me to choose between work and getting a vaccine. I’ll choose to work and take the shot. I am a temporary staff member of the Chennai Corporation and I cannot refuse if it becomes the order of the government.”

But experts point out that side effects are not specific to COVID-19 vaccines alone. Dr Jacob John, a reputed virologist and former professor of the Christian Medical College, Vellore explans, "Anytime you inject into the muscles, it will cause side reactions. If the injection has biologically active substances then it will create pain in the site, fever, body ache and tiredness. These are natural to any vaccine with biological components and not just to COVID-19 vaccines since they are mild self-healing reactions."

He, however, adds, "If a doctor advises a patient to get admitted or if a patient develops chronic acute illness or death these are serious side reactions and it needs to be investigated. But we cannot come to early conclusions that they are caused only due to the vaccine without any investigation." 

The senior virologist says side effects and adverse reactions are common questions among the people including doctors and these should have been addressed even before the vaccine launch. The problem here is not with the vaccine but the approach of the government.

“The Indian government is yet to address the apprehensions of the people and they are yet to respond with logical reasons. If this discourse does not take place then even if the vaccine is completely true people are not ready to trust the vaccine due to past events,” he observes.

Speaking to TNM, Tamil Nadu Health Secretary J Radhakrishnan, however, says vaccine hesitancy among health and frontline workers isn’t a question of awareness. “We cannot say there is no awareness but it’s just their choice.”

The Health Secretary, who had taken Covaxin shot on Sunday to help allay fears surrounding the vaccine, says, “Getting a vaccine is a right for the frontline workers in the first phase and we cannot force them. There can be fear surrounding the vaccine. I have personally addressed this with the people to allay their fear. However, if someone doesn’t want to take a vaccine despite knowing that there is no risk, we cannot force them.” 

As far as Tamil Nadu falling short on the vaccination targets, Radhakrishnan says the state has not set a daily target for administering the vaccine and blamed the low numbers on the Pongal festivities.  “The numbers are just the capacity to administer the vaccine. We believe that the vaccination drive will pick up in a few days. So our only target is to ensure that there isn’t any adverse effect to inoculated people.” 

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