Six days into the COVID-19 vaccination drive, vaccine hesitancy continues to persist. Tamil Nadu vaccinated only 7,762 healthcare workers against the targeted 17,100 on January 20. The total number of vaccine recipients in the state is now 42,947, which is far below target.
Many of the vaccination centres have met less than 10% of their daily targets. Only 11 of the planned 500 were vaccinated in Tiruvarur district, while 20 out of 400 were immunised in Nagapattinam on Wednesday, January 20. However, three districts - Salem, Coimbatore and Namakkal - overshot their targets.
It has been reported that vaccines are being wasted in Tamil Nadu because recipients are refusing to show up for the vaccine shot.
Like in other states, incomplete standardisation of vaccines, lack of awareness and being ill-informed of the vaccines are the common reasons for vaccine hesitancy in Tamil Nadu. To meet targets, the state is forcing vaccines upon health workers.
Additionally, poor use of the federal structure between the state's ruling-AIADMK government and the central BJP government is a reason for concern. The upcoming Assembly elections seems to be an obstacle for the All India Annatra Dravida Munnetra Kazhagam and Bharatiya Janata Party alliance on making informed decisions with the vaccine drive.
Public intellectuals have compared the present vaccine drive to the 1970s National Emergency’s forced sterilisation programme. Reports from the ground seem to reaffirm this stance.
Komathi K., a Village Health Nurse (VHN) from Perambalur district, told NewsClick, “We are manipulated into taking the vaccine. We are told to come for meetings and when we show up, the Deputy Director tells us to take the vaccine.” On being asked whether nurses are resisting the vaccine, she said, “The nurses are being told that it is compulsory. Though we are permanent employees, nurses know they will be punished citing other reasons if they do not comply.”
Also see: COVID-19 Vaccination Drive in India and Controversies Around it
However, the vaccine against COVID-19 is not compulsory, health workers have the choice to opt out. Given that the state is compelled to meet daily vaccine targets while a large section of health workers are resisting vaccines, coercion of different forms are being used.
It is the “secondary and tertiary care workers - sanitary workers, health inspectors and other community staff - who are coerced into taking the vaccine shots” said health activist Suresh Dhandapani of Makkal Nalvazhvu Iyakkam. He pointed out that the number of doctors taking the vaccine is comparatively low.
FORCED CONSENT ADDED TO REGULAR EXPLOITATION
The existing hierarchies in the healthcare sector are affecting the freedom of choice to vaccinate. Primary care workers have the agency to reject the vaccine. In that secondary and tertiary health workers become the easy targets of the state.
Adding to this, Komathi said, “It is not possible to force doctors, they will oppose. Village health nurses are just above the sanitation workers in the hierarchy of work. We are vulnerable, even though we are permanent employees.”
She further added, “Doctors got seven days of rest for every week of work during the lockdown. We carried out surveys in remote areas working from 7 AM to 7 PM all week long. Some of us even went thirsty without water. And what do we get in return? Forced vaccination.”
Tertiary and secondary health workers are already exploited and treated poorly. Having to take the vaccine under forced conditions is only an extension of the poor treatment.
These frontline workers were hailed as ‘COVID warriors’ by the entire country, but they were not compensated for overworking during the lockdown. They feel betrayed after having worked hard at containing the disease. They play an important role in grassroots healthcare and are at a high risk of being exposed to the virus. Yet, they do not want to be vaccinated.
Expressing the sentiment of fellow nurses, Komathi said, “We cannot afford to fall sick and be unproductive after taking the vaccine, our families are dependent on us,” adding, “we have seen some nurses fall sick after taking the vaccine, one of them was even admitted to the ICU. It is difficult not to connect these reactions to the vaccine, so nurses are hesitant.”
Though some workers have rejected the vaccine, they feel that the government would compel everyone to take the vaccine.
CENTER IS HASTY, BUT HEALTH IS A STATE SUBJECT
When the National Disaster Management Act was invoked to enforce the nationwide lockdown in March 2020, the state governments and departments of the state governments had to cooperate and implement the NDMA. Experts say that it is the same top down approach which is continuing without any criticism.
Also read: Forced Consent and No Transparency Can Create a Backlash against Vaccines
Commenting on this, Dr. C.S. Rex Sargunam, president of Tamil Nadu Health Development Association, said, “States can surely use discretion with respect to what is coming from the Centre and what is utilised by the state. Especially when there is so much hesitancy over the vaccine, strict data can be requested from the Centre, and health professionals from the state can analyse the data prior to distributing the vaccines.”
Health professionals are of the opinino that conscious and meticulous work from the state government can facilitate the momentum of immunisation. At present, any reactions and deaths are being attributed to the vaccine because there is no simultaneous blind study for Bharat Biotech’s Covaxin.
The state should have a choice in picking the vaccine, doctors say. Speaking to NewsClick, biologist Dr. S. Krishnaswamy said, “TN Government can decide to administer Covishield at present and once the third phase of the trial is over for Covaxin, both can be administered together. Health is a state subject, the state has the right to make this choice. But, the state is blindly going by the Centre’s decisions.”
“The Ministry of Health and Family Welfare should make objective decisions, but there is an undue push from the ruling party to say ‘we have found the vaccine',” he said, adding, "This is a scientific project, this achievement should not be linked with nationalism.”
The All India People’s Science Network (AIPSN) in its statement released on January 15 urged all the state governments to withhold Covaxin and administer them upon greater clarity.
However, the Tamil Nadu Government does not seem to be lending a ear to the scientific community’s apprehensions. It seems to be making hasty decisions like the Centre, prioritising politics over healthcare.
While there is pressure from the public for politicians to take the vaccine, scientists say that it is not sufficient for the Minister of Health and Health Secretary to take the vaccine. “The state has to provide objective reasons for encouraging the immunisation drive, which includes being critical of the Centre’s directives. AIADMK's alliance with the BJP in the upcoming assembly elections should not come in the way, experts have said.