India will launch the world’s biggest Covid vaccination drive on Monday, aiming to inoculate 27 crore people of age 45 and above in an effort to break the virus’s chain of transmission and end the pandemic in the country.

The registration for the vaccination in the Co-WIN 2.0 software will open at 9 am, and the slots for booking at more than 8,600 central government empanelled government and private hospitals will remain open till 3 pm.

Read | Registration for next phase of Covid-19 vaccination on Co-WIN 2.0 portal will open on March 1

The recipients, however, will not have a choice in selecting the vaccine as they will have to settle for the jabs offered by the hospitals.

While most of the vaccination will be carried out with the Serum Institute’s Covishield, some will be administered Bharat Biotech’s Covaxin — a homegrown vaccine that has been approved by the Drugs Controller General of India without the efficacy data.

“The major challenges will be both combating vaccine hesitancy as well as whether the programme will be able to access more distant, rural areas at the same level as it can in urban India,” Gautam Menon, a professor at Ashoka University, told DH.

After 45 days, only about 1.43 crore vaccine doses have been administered, which is nowhere near the initial plan of vaccinating 3 crore healthcare workers and frontline staff.

Only 24.56 lakh healthcare workers received both the doses whereas 66.70 lakh healthcare workers and 51.75 lakh frontline staff got a single dose of the vaccine so far.

Oommen John, a senior public health researcher at the George Institute of Public Health, said “vaccine hesitancy will be the biggest challenge”.

Also read: Inoculation Phase 3 from March 1: Here’s where to get the Covid-19 vaccine in Bengaluru

“Vaccine hesitancy will be the biggest challenge, as India doesn’t have the concept of a family practice or GP-led primary care that looks after all the health services delivery for a defined population. People will continue to rely on message forwards and their own advisory circles for insights on vaccination,” said Oommen John, a senior public health researcher at the George Institute of Public Health.

Notwithstanding all the planning, the key question is whether the benefits of vaccination would reach the most vulnerable who need the jab.

“In best of the scenario, it is possible that only half of the persons with comorbidities might get vaccinated as the other half is not aware of their diagnosis yet,” said Giridhar Babu, an epidemiologist at the Public Health Foundation of India.

“The missed out population is the most vulnerable. Unfortunately, they will also be missed from vaccination since most of the states don’t have a robust database of such vulnerable people. This is a major problem.”

Rijo John, a health economist who was a former consultant to the WHO, said “ensuring that private hospitals comply with the mandatory Rs 250 rate set by the government will be another major challenge”.

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