Pre Registration For Covid-19 Vaccination
India’s COVID-19 Vaccination Programme
In India, there are two vaccines that have been approved by the Drugs Controller General of India — Covishield and COVAXIN. These two vaccines are being produced in large numbers to be able to vaccinate the entire Indian population against the Novel Coronavirus. The government aims to vaccinate 300 million people by July.
The Covishield vaccine was created by the University of Oxford, together with AstraZeneca, and is being manufactured by the Serum Institute of India for Indian residents. COVAXIN, on the other hand, is India’s first indigenous COVID-19 vaccine developed in partnership with the Indian Council of Medical Research (ICMR).
1.1 crore vials of Covishield and 55 lakh vials of COVAXIN have been ordered by the Government of India. These have been assigned to the different centres in each state and Union Territory. On January 16, 2021, Day 1 of the nationwide COVID-19 Vaccination Programme, close to two lakh healthcare workers were vaccinated.
Over the past month or two, India has seen a dip in the number of new cases per day. On January 18, 2021, India recorded 13,788 new cases. This is significantly low compared to our highest record of 97,894 new cases on September 17, 2020. This significant lowering of our numbers indicates that we are closer now to flattening the curve than ever before.
What’s normal after the COVID vaccination
While the COVID-19 vaccination is safe, you may experience some side effects after the administration of the vaccine. These are quite normal and are signs that your body is building protection against the virus. Here’s what you can expect after the vaccinations but these symptoms should go away in a few days.
What’s abnormal after the COVID vaccination
An adverse event following immunisation (AEFI) is any abnormal medical occurrence following immunisation. This adverse event may be in the form of:
Minor AEFI: These are common self-limiting reactions. For example, pain and swelling at injection site, fever, tiredness and so on
Severe AEFI: These can be disabling reactions but rarely life-threatening. They do not lead to long-term problems. For example, high fever (>102 degrees, non-hospitalised cases of anaphylaxis) and so on
Serious AEFI: These reactions can result in persistent or significant disability, evoke significant parental/community concern, requires inpatient hospitalisation and often results in death
Frequently Asked Questions
Vaccines are available from Government and Private Health Facilities as notified, known as COVID Vaccination Centres (CVCs)
Online registration and appointment can be done through Co-WIN portal.
You will have to give some basic information about yourself and details of your photo identification card to get yourself registered online.
From one mobile phone number, one can register 4 people, however, each person will need their own photo identification document.
If Aadhar card is used as identification document, consent will be obtained and recorded.
Through the portal, you can find out the list of available CVCs and dates and time of available vaccination slots, to book an appointment as per your choice. You will need an OTP verification prior to registration and a confirmation slip/token will be generated after registration. You will also get a confirmatory sms later.
For all Private Hospitals, prior registration and appointment will be the only method of registration.
For Government hospitals, a proportion of slots will be available for online registration and appointment, the rest will be kept for on site registration and vaccination.
Appointments for any date for a Vaccination Center will be closed at 12:00 pm on the day prior to the date.
Those who cannot get themselves registered online can contact their local Government health workers, who will help the beneficiaries to the Government CVC for on the spot registration, appointment, verification and vaccination on the same day. Please ask your nearest Governmen health care worker to guide you about the nearest Government CVC where COVID vaccination will be available and the days of the week when this will be available. You need to carry your mobile phone and a photo identification document to get yourself vaccinated. The workers in the Government CVC will help you to register on the spot, get appointment and get vaccinated on the same day.
No, the registration of beneficiary is mandatory for vaccination for COVID-19 vaccine. Once registered, notification and information about the vaccine session date and time will be shared with the beneficiary. There will be a provision for walk-in to vaccination centres but they too would need to register on site before vaccination.
Any of the below mentioned ID with Photo may be produced at the time of registration:
- Aadhaar Card
- Driving License
- Health Insurance Smart Card issued under the scheme of Ministry of Labour
- Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) Job Card
- Official identity cards issued to MPs/MLAs/MLCs
- PAN Card
- Passbooks issued by Bank/Post Office
- Pension Document
- Service Identity Card issued to employees by Central/ State Govt./ Public Limited Companies
- Voter ID
- People with comorbidities will have to carry the certificate of comorbidities, in the format shared here by a registered medical practitioner.
The Photo ID produced at the time of registration must be produced and verified at the time of vaccination.
About the Vaccine
Two vaccines that have been granted emergency use authorization by the Central Drugs Standard Control Organization (CDSCO) in India are Covishield® (AstraZeneca’s vaccine manufactured by Serum Institute of India) and Covaxin® (manufactured by Bharat Biotech Limited).
Emergency Use Authorization (EUA) is a regulatory mechanism to allow the use of vaccines and medicines to prevent and/or reduce the impact of life-threatening diseases or conditions as caused by COVID-19. However, before grant of the EUA, rigorous assessments of laboratory and clinical trial data, including data on quality, safety, production of protective antibodies and efficacy is conducted. Safety is particularly critical aspect of this scrutiny and a risk-versus- benefit evaluation is done in the context of a public health emergency. Full licensure is obtained when the manufacturer submits the complete data. EUA by Indian regulators is aligned with global guidelines.
Concept of EUA always existed to save the lives of people all over the world with vaccine and medicines for life threatening diseases while companies continue to obtain additional safety and effectiveness information to enable full licensure. Previously, EUAs have been granted to vaccines for outbreaks due to Anthrax, Ebola, Enterovirus, H7N9 Influenza, and Middle East Respiratory Syndrome. As of January 2021, nine COVID-19 vaccines were in emergency use in numerous countries around the globe.
Both the Indian COVID-19 vaccines have completed their Phase I & II trials. Covishield® has completed its Phase III trials in UK and the bridging trial in India.
Vaccine trial phases includes:-
- Pre-clinical: Vaccine development in laboratory animals
- Phase 1 Clinical trial (small number of participants): Assess vaccine safety, immune response and determine right dosage (short duration)
- Phase 2 Clinical trial (few hundred participants): Assess safety and the ability of the vaccine to generate an immune response (short duration)
- Phase 3 Clinical trial (thousands of participants): Determine vaccine effectiveness against the disease and safety in a larger group of people (duration 1-2 years)
COVID-19 affects all age groups; however, morbidity & mortality is several times higher in adults particularly in those above the age of 50 years. Children have either asymptomatic or mild infection. The general practice is to first evaluate any new vaccine in older population and then age reduction is done to assess the safety and effectiveness in paediatric population. The currently available vaccines have not been evaluated in children so far. There are some clinical trials now underway to test the effectiveness and safety of the COVID-19 vaccines in children.
Who Will Get The Vaccine?
Based on the potential availability of vaccines the Government of India has selected the priority groups who will be vaccinated on priority as they are at higher risk. The first group includes healthcare and frontline workers. The second group to receive COVID-19 vaccine will be persons over 60 years of age and persons between 45 and 59 years of age with comorbid conditions.
Person with confirmed or suspected COVID-19 infection may increase the risk of spreading the same to others at vaccination site. For this reason, infected individuals should defer vaccination for 14 days after symptoms resolution.
Is it necessary for a COVID-19 recovered person to take the vaccine? And if I had COVID-19 infection and was treated, why should I receive the vaccine?
Yes, it is advisable to receive complete schedule of COVID-19 vaccine irrespective of past history of infection with COVID-19. This will help in developing a strong immune response against the disease. Development of immunity or duration of protection after COVID-19 exposure is not established therefore it is recommended to receive vaccine even after COVID-19 infection. Wait for 4-8 weeks after recovery from COVID symptoms before getting the vaccine.
In the initial phase, COVID-19 vaccine will be provided to the priority group – Health Care and Front-line workers. The second phase vaccinations, starting March 1, 2021 will allow for all Indians above the age of 60 and Indians between the age of 45 and 59 with comorbidities to be vaccinationated. Registrations will be allowed on the Co-WIN 2.0 Portal, Aarogya Setu app etc. The comorbidities that make a person eligible for vaccinations are listed below:
- Heart Failure with hospital admission in past one year
- Post Cardiac Transplant/Left Ventricular Assist Device (LVAD)
- Significant Left ventricular systolic dysfunction (LVEF <40%)
- Moderate or Severe Valvular Heart Disease
- Congenital heart disease with severe PAH or Idiopathic PAH
- Coronary Artery Disease with past CABG/PTCA/MI AND Hypertension/Diabetes on treatment
- Angina AND Hypertension/Diabetes on treatment
- CT/MRI documented stroke AND Hypertension/Diabetes on treatment
- Pulmonary Artery Hypertension AND Hypertension/Diabetes on treatment
- Diabetes (> 10 years OR with complications) AND Hypertension on treatment
- Kidney/ Liver/ Hematopoietic stem cell transplant: Recipient/On wait-list
- End Stage Kidney Disease on haemodialysis/ CAPD
- Current prolonged use of oral corticosteroids/ immunosuppressant medications
- Decompensated cirrhosis
- Severe respiratory disease with hospitalizations in last two years/FEV1 <50%
- Lymphoma/ Leukaemia/ Myeloma
- Diagnosis of any solid cancer on or after 1st July 2020 OR currently on any cancer therapy
- Sickle Cell Disease/ Bone marrow failure/ Aplastic Anemia/ Thalassemia Major
- Primary Immunodeficiency Diseases/ HIV infection
- Persons with disabilities due to Intellectual disabilities/ Muscular Dystrophy/ Acid attack with involvement of respiratory system/ Persons with disabilities having high support needs/ Multiple disabilities including deaf-blindness
- Persons with history of:
- Anaphylactic or allergic reaction to a previous dose of COVID-19 vaccine
- Immediate or delayed-onset anaphylaxis or allergic reaction to vaccines or injectable therapies, pharmaceutical products, food-items etc.
- Pregnancy & Lactation:
- Pregnant & Lactating women have not been part of any COVID-19 vaccine clinical trial so far. Therefore, women who are pregnant or not sure of their pregnancy; and lactating women should not receive COVID-19 vaccine at this time
- Provisional / temporary contraindications:
- In these conditions, COVID-19 vaccination is to be deferred for 4-8 weeks after recovery
- Persons having active symptoms of SARS-CoV-2 infection.
- SARS-COV-2 patients who have been given anti-SARS-CoV-2 monoclonal antibodies or convalescent plasma
- Acutely unwell and hospitalized (with or without intensive care) patients due to any illness.
How will we be vaccinated?
The safety and efficacy data from clinical trials of vaccine candidates are examined by Drug regulator of our country before granting the license for the same. Hence, all the COVID-19 vaccines that receive license will have comparable safety and efficacy. However, it must be ensured that the entire schedule of vaccination is completed by only one type of vaccine as different COVID-19 vaccines are not interchangeable.
Does India have the capacity to store the COVID-19 vaccine at temperature of +2 to +8 degree Celsius and transport them at required temperature?
India runs one of the largest Immunization programme in the world, catering to the vaccination needs of more than 26 million newborns and 29 million pregnant women. The programme mechanisms are being strengthened/geared up to effectively cater to the country’s large and diverse population.
We request you to rest at the vaccination centre for atleast half an hour after taking the COVID-19 vaccine. Inform the nearest health authorities/ANM/ASHA in case you feel any discomfort or uneasiness subsequently. Remember to continue following key COVID-19 Appropriate Behaviours like wearing of mask, maintaining hand sanitization and physical distance (or 6 feet or Do Gaj).
What to expect before vaccination?
The way we do in a clinical trial phase: first, the recipient will be asked to give a written consent. Additionally, the recipient will be followed up actively to see if the vaccine has led to any side effects. In short, it will be an extension of the Phase 3 trial. But in this, the person would know that he or she has received the vaccine, and not the placebo. It is completely voluntary.
To ensure that a vaccine is safe, we need to try it on a large number of people. The vaccine developers have not reduced the sample size at any stage of clinical trials rather it was bigger than what we usually test a vaccine on.
When a vaccine is tested, most of the adverse events or unwanted effects, if any, occur in the first four to six weeks of its administration. So, in order to ensure that it is safe, we keep a close watch, for the first two-three months, on the people it has been given to. This data help us decide if a vaccine is safe. All concerned in the line of vaccine development, testing and evaluation have followed these procedures to the T. Both Indian vaccines are considered safe on this yardstick.
As for the efficacy of the vaccine, we need time to tell how effective a vaccine is. All the global agencies have set the benchmark that only those vaccine candidates which show an efficacy of at least 50-60% will be considered. Most of the vaccines have shown an efficacy of 70-90% within the short period of two to three months of observation. Besides when a vaccine is given an emergency use authorizations/permission for restricted use, as in the case of the COVID-19 vaccine, the trial follow-up continues for one-two years to assess the total duration of protection the vaccine will provide.
There is no head-to-head comparison done between the two vaccines being used in India so one cannot choose one over the other. Both would work fine in preventing the infection as well as prevent a person from going into severe state of the disease. As a long-term effect, it would be preventing death for elderly people or those who have comorbidities.
Currently, there is no such instruction. One can take one’s regular medication uninterruptedly. Just inform the vaccinator about the medicines you consume.
Chronic diseases and morbidities like the cardiac, neurological, pulmonary, metabolic, renal and malignancies etc. are not contraindicated. In fact, the benefit of COVID-19 vaccines to reduce the risk of severe COVID-19 disease and death is for those who have these comorbidities.
What to expect after vaccination?
Yes, it is absolutely necessary that everyone who has received the COVID-19 vaccine should continue to follow the COVID-19 appropriate behaviour i.e., mask, do gaj ki doori and hand sanitization to protect themselves and those around from spreading the infection.
Longevity of the immune response in vaccinated individuals is yet to be determined. Hence, continuing the use of masks, handwashing, physical distancing and other COVID-19 appropriate behaviours is strongly recommended.
The body responds to vaccination by making more than one type of antibodies to virus parts including spike protein. Therefore, all vaccines are expected to provide reasonable amount of protection against the mutated virus also. Based on the available data the mutations as reported are unlikely to make the vaccine ineffective.
Adequate immune response takes 2-3 weeks after completion of entire vaccination schedule i.e., after the second dose of COVISHIELD® and COVAXIN®.
As per experts, there is no evidence of alcohol impairing the effectiveness of the vaccine.
Both the vaccines are safe but in case of any discomfort or complaint, ask the beneficiary to visit the nearest health facility and/or call the health worker whose phone number is given in the Co-WIN SMS received after vaccination.