Phase 3 vaccination: 70% of Punjab’s Covishield doses in May reserved for those with co-morbidities

With Punjab being allocated only 3.30 lakh doses Covishield for the 18+ category from the Serum Institute of India (SII) for the month of May, Chief Minister Captain Amarinder Singh on Monday ordered that 70 per cent of the doses to be reserved for individuals with co-morbidities, and the remaining 30 per cent for the high-risk category of employees and workers in this age group.

Chairing a high-level virtual review meeting, Amarinder announced that within these groups, a district-wise allocation has been prioritised based on population index, mortality and density. Given the severe supply constraints, it has been decided to limit the vaccination for the 18-44 age group in this phase to major urban centres, he said, while expressing concern over the fact that even for the 45+ age group, the state was in short supply of the vaccine from the Centre.

In the 18-44 age group, for the month of May, the maximum allocation of 50% has been prioritised for Group A of the most affected districts of SAS Nagar, Jalandhar, Ludhiana, Amritsar, Bathinda and Patiala. Another 30% has been reserved for the Group B districts of Hoshiarpur, Pathankot, SBS Nagar, Faridkot, Kapurthala and Gurdaspur, while 20% will be utilised in the other districts that have the least cases at present.

These decisions have been taken in accordance with the vaccine strategy recommended by the state’s Vaccine Expert Committee for May, an official spokesperson said after the meeting. The committee recommended that when further doses are available or as the epidemiologic situation changes, the prioritisation framework may be modified. The committee comprises Dr Gagandeep Kang, Dr Jacob John and Dr Rajesh Kumar.

Accepting the recommendations of the committee, CM approved expansion of the list of comorbidities to include obesity (BMI>30), disabilities (e.g. spinal cord injury) and multiple co-morbidities determined to increase risk by a treating physician, in addition to those specified by the central government. He pointed out that since individuals with co-morbidities are at highest risk of severe disease and deaths, it was imperative to vaccinate them on priority.

For the remaining 30% (high-risk category), CM said that while the strategic roadmap contains a list of professions at risk, given the limitation of vaccine availability, for the month of May, the top three categories have been chosen. These are: i) government employees, ii) construction workers, iii) teachers and other staff at government and private educational establishments, all of whom have greater interactions with other individuals and are at higher risk of infection and transmission.

It may be noted that the Punjab government has placed an immediate order of 30 lakh doses with Serum Institute of India Ltd. for the 18-44 category, but has been informed that the allocation will be 3.30 lakh doses only for the month of May.

To boost supplies, the Vaccine Expert Committee has recommended that increased doses be sought in partnership with the private sector and other sources. It has also suggested that the state government initiate a consultation with national and international vaccine experts to recommend the dosing strategy for Covishield and possibly other vaccines, given the international experience with expanding population coverage and its impact.

Further, the committee has recommended development of a plan for evaluation of vaccine effectiveness for prioritized groups, those with co-morbidities, and the general populations. This will be valuable in designing further control efforts and may be done in conjunction with infectious disease modelling for the state, the committee stressed.