Monday , October 18 2021

Busting Myths of Vaccination

Government of India has been supporting the efforts of States and UTs for an effective Vaccination drive under the ‘Whole of Government” approach since 16th January this year. In order to streamline the availability of the vaccine doses to the last citizen in different corners of India’s geography, the Central Government had created the CoWIN platform to touch upon and capture minute aspect of Vaccination in what is the Largest Vaccine Drive ever to be undertaken.

There have been some unfounded media reports of the CoWIN platform creating a digital divide and allowing unscrupulous elements to hack the system to benefit a few sections of the population. The lack of basic comprehension about the complexity of a vaccination exercise has led to the false labelling of citizens not finding slots on the platform to problems of the platform itself.

These reports are incorrect and not supported by full information on the matter.

Dr. R.S. Sharma, Chairman, Empowered Group on Technology and Data Management to combat COVID-19 debunked such scare mongering misinformation and set the record straight.

CoWIN is the technological backbone driving vaccination in India. CoWIN encompasses all constituents of the vaccination process. Ranging from validation of the supply of authentic vaccines and managing vaccination centres to registration and obtaining certification by citizens, the entire value chain is administered through the CoWIN platform. It is essential to understand how such a technological platform is required to align all stakeholders to bring transparency, preventing information asymmetry and attempts at rent-seeking.

Some authors criticizing CoWIN Vaccine booking system have not fully comprehended the complexities and scale of India’s vaccination drive. To debunk the misconceptions, let us first address the larger role that CoWIN has to play besides registration. We will then elaborate on the current issues stemming in demand-supply, followed by an exploration of the multiple modes and methods of vaccine registration and the measures undertaken to drive an inclusive and equitable vaccination for a population of 1.37 billion citizens.

The CoWIN platform is not only citizen facing, but also has modules that assist vaccination centres and administrators in the physical operations and management. Discovery and registration of vaccination slots is only the visible tip of the iceberg. After the first dose, CoWIN aids citizens to track the schedule of vaccination based on the brand of vaccine by issuing provisional certification. This enables vaccine administrators to keep a check on those who are either jumping their schedule or lack the necessary information around it. Post the second dose, a centralised digital certificate is issued across the country that can be universally authenticated.

CoWIN further enables vaccine providers to publish their schedule of vaccination based on availability, and verify citizens at point of vaccination, while recording the event of vaccination and any Adverse Events Following Immunization (AEFI). The AEFI is crucial for making data-driven public health policy decisions. Additionally, at the time of vaccination, only name, age and gender of any individual are recorded, along with information on the vaccine and vaccination centre. These details of incidence are used to evaluate and ensure the coverage of the vaccination drive at a granular geographical level. Despite such practical applications and requirements, CoWIN is attacked as an instrument for mass data collection.

Examining the issue of unavailability of vaccination slots, the noise started surfacing after registrations for 18 to 44 years age group were opened up on April 28. One would be amazed to learn how steeply skewed the demand-supply for vaccines has been in this age bracket. The ratio of registrations to doses administered stands at 6.5: 1, which was an alarming 11:1 a week before. Overall, with over 244 million registrations and over 167 million receiving at least one dose(as per data on 7 pm 29th May 2021), the shortfall explains the current proceedings, which will naturally catch up as time passes and there is a larger supply of vaccines.

Over 167 million persons have been administered at least one dose of the vaccine in a nation of over 1.37 billion, translating to ~12.21% coverage or nearly 1 in every 8 Indians getting vaccinated. Looking at the actual target population of 18+ of 944.7million, the number goes up to ~17.67% or 2 in every 11 Indians. This data is updated on real time basis on the CoWIN website and is available to view for all, accurate down to the district level in a state.

Furthermore, the author seems to imply that besides online registration, there is no other form of registration. Offline walk-ins have been an integral part of the vaccination process since January. The proportion between online registrations and offline walk-ins has been modified time-to-time to manage overwhelming crowds and maintain law-and-order at vaccination centres. In fact, nearly 55% of the 211.8 million doses administered till date have been through walk-ins. The brilliance of CoWIN lies in its ability to allow changes on the fly for the proportion of slots made available between online registration and offline walk-in.

With a forward-looking approach, CoWIN has been designed to be an interoperable public good that facilitates technological innovations. CoWIN APIs for discovery of vaccination slots have been opened up to third party developers to support wider outreach. When we hear about coders like Berty Thomas (mentioned in one of the misinformedarticles) creating alert systems to assist their communities find available open slots, that is the cause of technology being furthered. Considering the skewed demand-supply, such innovations ensure vaccination centres don’t get overcrowded and that citizens only leave their homes on availability of vaccination slots. Such innovations don’t create a divide, as they are publicly available and democratised through applications such as Paytm or Telegram.

A divide is created when individuals or groups make anecdotal claims or try to fool innocent citizens that running scripts for 2-3 days is the only solution to their problem. Extorting money in the process for a service that is public and free is even more heinous. We strongly condemn such behaviour of profiteering out of someone’s misery and urge publications to not eulogise such coders and questioning this line of behaviour instead.

Moreover, third party developers only have access to discovery APIs, and registration is centralised through the CoWIN platform alone. The platform has undergone meticulous security testing. We state this with absolute certainty that no breaches have been found till date. No scripts can bypass the OTP verification and CAPTCHA to automatically register an individual. We wouldn’t have been able to smoothly scale to over 90 million vaccines till date through online registrations alone if citizens were paying IN₹ 400 to 3,000 (US$7 to 40) to illegitimate coders just for booking. Such claims are unsubstantiated, and we would request the public at large to not pay heed to such crooks.

Besides the previously countered contentions, there is the debate of digital divide and inclusivity, stressing that CoWIN is crippling the nation’s efforts to vaccinate equitably. To safeguard interests of those at a disadvantage, we have simplified the registration process to make it accessible to all. Monosyllabic / single word questions have been used to overcome language barriers. We are soon launching the option to choose from 14 vernaculars to further aid this concern. Sign-ups and registrations only demand mobile numbers, name, age, and gender. Further, CoWIN provides up to 7 options for identification, not restricting the choice to Aadhar.

To further drive inclusivity, one citizen can register up to 4 individuals with the same mobile number. We have equipped 250,000+ Community Service Centres (CSCs) to assist rural citizens with registrations. Additionally, we are in the process of initiating call centres at NHA (National Health Authority) to help individuals sign up over phone calls. And as mentioned previously, offline walk-ins have always been there for those that can’t register online, evident from the 110 million+ doses administered through offline walk-ins.

Taking a cue from our efforts, various densely populated African nations like Nigeria have also sought for our support in their efforts to digitise their vaccination drive to monitor equitable geographical coverage. The logistical challenges of scale faced by such nations are similar to that of India, and hence they understand that digital is the only way ahead.

In conclusion, it is vital to note that the author has not attempted to propose any alternate solutions to build a more effective system for vaccine administration. Destructive criticism only gives way to belittling and myopia, not to advancements or evolution. For a country showing growing affinity for digital technologies, CoWIN serves as the necessary technological backbone to overcome information asymmetry and ensure equitable vaccination access for all.

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