Tamil Nadu recently released the action plan for preparatory activities for Covid-19 vaccine such as identifying frontline workers and assessing cold chain space. Tamil Nadu Medical Services Corporation managing director P Umanath and director of public health Dr T S Selvavinayagam speak to TOI about the state’s preparedness. Excerpts:
What kind of vaccine are we expecting for Tamil Nadu?
Umanath: We have some idea about the vaccine we are likely to receive. It is unlikely that we will use an mRNA vaccine manufactured by Pfizer or Moderna for many reasons. First, they have several pre-orders to fulfil. Second, they may be too expensive for us compared to other vaccines that are in the pipeline. Also, we may not be able to fulfil their cold storage conditions. Whereas, the other vaccines like the desi Serum Institute of India vaccine can be more available, affordable and accessible. In Tamil Nadu, we have the infrastructure in place.
How many centres in the state will offer vaccinations?
Dr Selvavinayagam: Covid-19 vaccination will cover a large population in a phased manner. We expect a large population to be covered in each phase. For instance, there are more than 1.2 lakh allopathic doctors in the state, who will be part of the 5 lakh frontline workers to be vaccinated during the first phase. For this, as of now, we have identified 47,000 vaccination centres.
How many vaccines will Tamil Nadu receive in the first phase? Do we have the storage capacity for them?
The number of vaccines will be based on the number of health workers each state has. Under the national universal immunisation programme the centre supplies vaccines to the state government. They are sent to the centralised warehouse from where it is picked and sent to different government hospitals and health centres across the state. The public health department maintains storage with a varied capacity at 2,665 sites. This includes a statewide vaccine store, 10 regional stores, 44 district vaccination stores, 23 units at medical college hospitals and 2,286 PHC, besides storage facilities at private medical colleges and cantonment hospitals. For the universal vaccination programme, the state has 5,488 cold chain equipment including 15 walk-in freezers, 2,769 ice-lined refrigerators and 2,661 deep freezers. We are also creating additional storage for Covid-19 vaccines.
What is the additional storage we are creating for the new vaccine?
Umanath:TNMSC has storage facilities for non-vaccine drugs such as snake venom serum and insulin. There are 50 walk-in coolers in TNMSC warehouses in 32 districts with a total capacity of 11.9 lakh litres. Of these 50 coolers, 14 of them are functional and 37 have been newly installed at a cost of ₹2.78 crore. This should be enough for us to store about 2 crore vaccine doses. We have strengthened the non-vaccine facility so there will be no hindrance to the vaccine programme.
Do these coolers have the capacity to store vaccines at the required temperature? Do we have the capacity to maintain a cold chain while this is being transported to the vaccination centres?
Dr Selvavinayagam: Walk-in coolers and freezers have the capacity to maintain drugs at 2›C-8›C. We still do not have clarity on the kind of requirements, but it can be arranged. Since we have been immunising lakhs of children and pregnant women under the immunisation programme at the PHC and health centre level, we should be able to handle transport and cold chain management of Covid vaccines too. The state has also made a request to the Centre for about 1,500 more ice-line refrigerators, 1,000 deep freezers, walk-in coolers and freezers, and refrigeration vaccine vehicles.
Do we have a list of frontline workers who will be vaccinated in the first phase?
Dr Selvavinayagam: The state has identified the institutions — public and private — with healthcare workers, and is preparing a list of those workers with their identity. In addition, we will be vaccinating people from state and central police, armed forces, home guard, civil defence organisation and disaster management staff. We are also asking districts to be ready with the names and details of citizens who are above 50 years of age and those with comorbidities, so they can be prioritised in the second phase.
Do we have a system in place for monitoring the vaccination programme?
Umanath: As of now, the state has formed three committees — a state steering committee chaired by chief secretary that will meet every month, a state task force headed by the health secretary that will meet every 15 days and a district task force headed by district magistrate that will meet every week. These teams will plan for the vaccine rollout step by step. Initially, the meetings may take up review of cold chain preparedness and status of database on health workers, while plans for other activities such as site micro planning and capacity building will be added later.
Views expressed above are the author’s own.
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