After making through the first wave of COVID-19 in reasonable shape and announcing that it had crushed the pandemic, India was then completely shattered by a massive second wave in early 2021. At its peak in May, official sources were reporting over 400,000 cases and 3,500 deaths each day, although we don’t know the true extent of the toll due to deliberate governmental suppression of the true numbers.

As vaccines are rolling out worldwide, and countries like the US, the UK, and Israel are lifting restrictions, India is still trying to find its feet again. Despite being a key link in the international vaccine supply chain, only 14.7% of Indians have received at least one dose of a COVID vaccine, and just 3.4% two doses. In contrast, in the UK, 61% of the population received one dose and 44% both doses.

While new infections do seem to finally be on the wane in India, the total number of people infected remains second only to the US.

India hosts not one but two major companies with vaccine manufacturing plants, so the real problem isn’t access to vaccines. It’s getting them where they need to go. The government has even invited bids for a tender to use drones for delivering vaccines to rural areas.

India has a number of challenges to vaccine distribution, namely a large rural community; challenging mountainous terrain; poor transportation infrastructure with some routes barely passable during the summer rainy season; inadequate communication between the main cities and the hinterland; and large segments of the population who are still highly superstitious and distrustful of modern medicine, all of which adds up to a logistical nightmare.

Can technology help resolve it?

1. Monitoring Vaccine Supply Chain

India isn’t using Pfizer, the hardest vaccine to transport which requires extreme cold storage at -80°C. But the Oxford/AstraZeneca vaccine, produced in India as Covishield by the Serum Institute of India (SII), and the homegrown Covaxin, developed by Bharat Biotech in Hyderabad, still need to be kept refrigerated.

Maintaining an average temperature of 2-8°C is challenging in rural India, where electricity can be patchy, delays in the mountains are common, and average summer temperatures are around 28-30°C.

India needs an effective logging solution that monitors shipment conditions constantly, so healthcare personnel know if the vaccines that reach them are usable and how long until they expire, because the expiration limit for vaccines varies depending on the temperature. The solution must be easy to use and low-resource, like Logmore, which uses QR codes that are trackable through any smartphone. Unlike RFID tracker systems, Logmore doesn’t require proprietary software or high computing power, so it’s usable even in areas without sufficient internet coverage.

India’s vaccine chain also has to protect against contamination before vaccines arrive, using special tamper-proof seals and a transparent supply chain that makes it impossible to hide unauthorized stops. Logmore’s digital supply chain monitoring platform can help here too.

 By tracking the shipment from start to finish, it can confirm that the vaccines which arrive in rural Uttar Pradesh are the same which left the Serum Institute two weeks ago, for example.

2. Improving Vaccine Education

Vaccine hesitancy can be a major obstacle preventing successful vaccination coverage, and the only real way to combat it is through solid education and information.

Digital communication platforms like local WhatsApp groups, and Facebook Messenger or social chatbots that can address individual concerns at scale, can play a key role. Microsoft is supporting health chatbots that answer vaccine questions from patients, for example.

It’s also crucial to ensure that local healthcare workers have the resources, training, and time to hold conversations with citizens to address their concerns. At the same time, health authorities need to educate local political, religious, and communal leaders to support vaccination and stamp out disinformation in their neighbourhoods.

3. Managing the Vaccine Campaign

In order to run an efficient vaccine campaign, those in charge need to know how many vials to send to each area, how many trained healthcare workers to send to administer them, and when to send in a mobile vaccination unit for the second dose. That in turn requires knowledge about exactly who needs to be vaccinated, who is high-risk and should be prioritized, who has health conditions that are contraindicated, etc.

India is currently using a digital vaccine management system called Co-WIN, which offers a downloadable app for Indians to enter their details and receive a vaccination appointment, but this platform is proving highly glitchy.

Experts suggest using a different platform that connects with Aadhaar, the Indian equivalent to a social security number that Indians use to pay taxes, to record and track doses.

Between 88% and 95% of the population (reports differ) have an Aadhaar card. It could connect with a secure project management platform that records all healthcare sites, workers, and the number of vaccine-eligible people near each, to identify areas which need temporary additional sites.

However, hundreds of millions of Indians don’t have smartphones or internet access, so they can’t use any digital platform. India has large-scale vaccine drives each year, when approximately 55 million women and children are vaccinated against polio and measles. These drives are managed the old-fashioned way, by sending workers door to door to compile lists of eligible patients.

A combination of new tech, for educated urban citizens, and old-school tactics, for rural dwellers without connectivity and those who aren’t digitally native, could be the way to go.

New Tech Hand in Hand with Traditional Strategic Planning

Tech can help India’s vaccination program with a number of key issues, especially logistics monitoring, vaccine education, and identifying and tracking vaccine recipients.

However, there are still challenges like training healthcare workers, creating sufficient vaccination locations, and organizing mobile vaccination teams for the housebound, which can only be dealt with through strategic organization, although tech tools can ease the planning process. Only time will tell how the India vaccine distribution will play out.

An earlier version of this article was published in The Asian Age.

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