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Chandigarh,(Aditi) : Punjab Chief Minister Captain Amarinder Singh has written to Prime Minister Narendra Modi, seeking priority allocation of Covid-19 vaccine to the state, on account of its higher mortality rate resulting from the population age profile and high levels of co-morbidities.

In his letter, the Chief Minister said despite its relatively low case load, the higher fatality rate due to Covid in Punjab, which thus needs special dispensation in the allocation of the vaccine. Pointing out that the vaccines currently under consideration would not perhaps reduce transmission so much as prevent serious disease, Captain Amarinder said that the best use of these vaccines would therefore be in preventing serious illness in the most susceptible groups, including elderly and persons with high morbidity.

Captain Amarinder Singh also sought clarity as to whether the Covid-19 vaccination would be entirely funded by the Government of India, including the cost of vaccines and vaccination supplies. He further asked for clarity on the principles based on which the prioritized groups are to be identified for sequential immunization phases, and leave the preparation of the list of prioritized groups to the state.

The Chief Minister also sought expansion of the definition of frontline workers for the purpose of immunization to include administrative officials and others responsible for essential functions. While the definition of healthcare worker was relatively precise and Punjab had compiled data based on it, but the definition of frontline workers lack clarity, he noted, adding that as of now it seemed to include only security forces (Police, Armed Forces) and Municipal Workers, with some mention of primary school teachers.

The Chief Minister said that while it appeared that private sector healthcare workers would be enumerated and that the Centre also intends to provide vaccines for them, apart from government sector healthcare workers, the question did arise if the vaccines also be provided to other priority groups and the general population, should they wish to receive vaccines from government providers.

Additionally, some reports have implied that persons previously infected with COVID-19 may not receive vaccination, the Chief Minister noted, adding that the basis of such recommendations was unclear, given the conflicting advice from the World Health Organisation. Since the policy appears to differentially categorise people who may already have been infected, Captain Amarinder Singh said that it would be helpful to have the recommendations backed by international scientific consensus before development and implementation of such a policy, even if it may result in more doses being available for others.

Noting that beyond individuals defined by occupation and role, it may be important for epidemiological purposes to immunize defined areas, such as densely populated urban areas known to be hot spots or potential hot-spots, the Chief Minister said the state will be better positioned if there is flexibility in implementation of immunization. This is particularly important in providing the state with vaccines as a tool to suppress emerging outbreaks, as has been done for several outbreaks, including influenza and Ebola, he added.

Thanking Government of India for supporting the State Government in the Covid-19 pandemic and congratulating Modi for taking all special steps to make Covid-19 vaccine available to all the citizens of the country, Captain Amarinder Singh said that Punjab has already undertaken preparatory activities for an effective vaccination programme as per the guidelines received from the Union Ministry of Health & Family Welfare.

Outlining the action plan for Covid-19 vaccination, the Chief Minister said that the data of healthcare workers, both in Government and Private sectors, had been compiled and shared on the digital platform, Committees for monitoring the vaccination programme at the State and at the district/ block levels had also been formed and started functioning besides the audit of cold-chain availability for storage & transportation of the vaccine has been conducted and the shortfall in the equipment shared with the Central Government.

Referring to certain issues with regard to Covid-19 control and vaccination especially its procurement, supply and storage, the Chief Minister pointed out that the total requirement of cold chain capacity at different temperatures cannot be clearly defined until the vaccine product is identified and the dosage availability intimated through central procurement as advised. He further said that real time record of what capacity is available in medical and agricultural sectors would be maintained by the his government, which would be only possible if the state had potential excess capacity.

On the issue of engagement of private sector for vaccination, Captain Amarinder Singh said that at present, there are no adult immunization programmes that target adults, even in campaigns, so there will be challenges in implementation. Given that private practitioners and facilities provide a significant proportion of healthcare services in cities, Captain Amarinder Singh said that it would be helpful to understand how the services of private group are to be best utilized to lessen the burden on the public system. Even if a decision is made that the private sector is not to be used for the delivery of publicly procured vaccines, the Chief Minister emphasized the need to clarify in what will be available to the private sector in terms of vaccines. For example, will the private sector be able to get and provide vaccines that are different from what is available in the public sector, questioned Captain Amarinder Singh, adding that this will create a two-tier system which will need to be carefully handled.

The Chief Minister, in his letter, also highlighted the need for clarity on using testing for informed action for vaccines by strategically changing the current approach to testing for both, the virus and the antibodies. This is significant to understand where vaccines are needed most, as well as the potential impact of vaccines, specially to inform future vaccination approaches, he said, adding that it would be helpful to have national and state-specific approaches to the strategy for testing, which could be based on the advice of infectious disease experts and epidemiologists, added Captain Amarinder Singh.

Given that vaccinations and vaccines for the pandemic are being closely watched, the Chief Minister also underscored the need to have a coordinated regularly updated communications plan, as well as a crisis management plan, which could be tailored by states while being aligned with the Centre, to make it far more beneficial.

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