He’s Mr Roll-out, tasked with planning and overseeing the unparalleled programme to immunise India against Covid-19, and lead us from fear to normalcy. The first pahase alone targets 30 crore, most-vulnerable people by mid-2021, though no vaccine has been licensed for use yet. Dr V K Paul , member (health), NITI Aayog and chair of the Covid-19 committee, tells Bachi Karkaria about the strategy, tactics, armoury — and resistance.

What are the three biggest challenges of the Covid vaccine drive? Can they be overcome?

One, covering such a massive adult population with multiple doses over a relatively short period. Nowhere has such a technical/ logistical challenge been faced. Our weapons are our globally acknowledged universal immunisation programme (UIP) plus scientific and technical expertise. Two, misinformation and false narratives; this we hope to counter with transparent, science-based communication. Three, that global bogey of AEFI (adverse event following immunisation). We do not expect serious side-effects once we begin, but such a related or unrelated possibility is there with any vaccine. We have instituted a robust investigation and rapid response system which follows established protocols.

That programme already covers 100 million children and 30 million pregnant women every year, so that’s nine million immunisation sessions for administering 650 million doses. We have custom-purposed this for Covid-19 with microplanning, logistics and monitoring systems. For Phase 1, we need 29,000 cold-chain points, 240 walk-in coolers, 70 walk-in freezers, 45,000 ice-lined refrigerators, 41,000 deep-freezers and 300 solar refrigerators. Closing the supply gap is already under way. So is getting and training the thousands of additional vaccinators. State, district and block-level steering and coordination mechanisms have been activated. Co-WIN, the robust IT platform being developed will facilitate logistics, individual immunisation sessions and e-certification.

Does any exercise compare in scale, complexity and hazards? Has it been given a name? How about Operation CoVictory?

The closest is our massive Lok Sabha elections and this paradigm has been coopted too. Vaccination booths will be set up to reach the furthest corners. (Laughs)Yes, ‘Operation CoVictory’ is worth considering!

Frontline workers are easy to identify. What big data will you rely on to pick out vulnerable members of the public? What about our notorious queue-jumping by the influential?

The first priority group is 27 crore individuals above 50, those below 50 years with significant co-morbidities, plus three crore health care and other frontline workers. The responsibility for smooth and rules-based immunisation lies with state and district administrations. They are the ones also to prevent ‘queue-jumping’ and any other distortion of protocols.

What’s a realistic schedule for roll-out of the vaccines?

It appears feasible to achieve this priority target of most-vulnerable in 6-8 months after launch — conditional on licensure for multiple vaccines and optimum supplies. Even though not a single vaccine has yet been licenced for use here, we have reason to be optimistic.

What are the key elements of the SOP, and how will you ensure adherence? There’s already a mismatch between your 100-a-day and Maharashtra’s stated 200.

The on-ground team must comprise at least two vaccinators, two for data and logistics, plus volunteers for queue management and general support. We have carefully estimated that such a team can safely immunise 100 beneficiaries each day. This number can increase if the team and logistics are strengthened. The beneficiary will be allotted a specific booth and given an appointment through either SMS or verbally for the first dose, and after that for the second. Once both doses have been administered, a QR-based digital certificate will be issued. Adherence to SOPs including social distancing will be closely supervised.

Forget ‘vaccine nationalism’, we’ve already seen state jockeying. How can this be kept free of politics, especially in these unequal times?

Listen, Covid-19 pandemic response is a whole-of-government, whole-of-nation, whole-of-society effort. Centre and State governments are working together tirelessly on a daily basis. Prime Minister has repeatedly interacted with Chief Ministers on the control strategy. He recently met with leaders of all political parties on the roll-out; they whole-heartedly supported the approach we’ve taken. Cooperation is the only way.