People becoming apprehensive after some cases of adverse events following immunisation (AEFI) being reported on day one of the COVID-19 vaccination drive and technical problems encountered initially could be among the factors behind further slump in the turnout on the second day of the exercise, say experts.

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Nearly 3,600 healthcare workers received the shots in Delhi on January 18, the second day of the drive in the national capital, with sources saying just eight medical staff got the jabs at AIIMS. According to data shared by officials later, the target of the day in Delhi was 8,136, thus only 44 per cent of that could be reached.

Cases of AEFI was reported in 26 persons, including two severe ones, and one person was hospitalised, officials said on January 18.
On day one, 4,319 healthcare workers -- 53.3 per cent of those registered, had got the shots in Delhi, while one "severe" and 51 "minor" cases of AEFI (adverse events following immunisation) were reported.

Various reasons are being attributed to the low turnout, including some technical issues and fears related to adverse events. However, the government has maintained that no case of serious or severe AEFI is attributable to vaccination till date. Experts feel people becoming apprehensive after several cases of AEFI reported on day one could be a major factor.

Besides, many adopting a "wait and watch" approach, lack of communication and glitches in Co-Win app are among other reasons for low turnout on day one and even further low on day two. "Yes, the AEFI cases reported must have played on minds of people and the apprehension may have resulted in lower turnout. But there are other factors too. And, after all it's a voluntary exercise, so people make their own choice. But, we at our hospital are trying to reach out to healthcare workers through heads of all departments to boost their confidence level," said B L Sherwal, medical director of Rajiv Gandhi Super Speciality Hospital.

At the Delhi government-run LNJP Hospital, only 12 healthcare workers got vaccination on January 18, compared to 32 on day one, as per data shared by officials. No one showed AEFI at this site, a senior official said. At the Rajiv Gandhi Super Speciality Hospital, the number of people who got vaccinated on January 18 stood at 20 with no AEFI cases. It was nearly half of the figures on day one -- 45, officials said.

The Delhi Health Minister, interacting with reporters on January 19, reiterated that this is a voluntary exercise and people are making their own decisions, as it is the initial phase. Asked if statements made by a few political leaders raising doubts over its efficacy and safety, could be a factor, he said, "No. Going for vaccination is a personal decision, and has nothing to do with what political statements have been made about it."

When asked if AEFI was a factor in low turnout on the second day, the city health minister said, turnout of nearly 50 per cent is "not very low" and coronavirus situation is also under control in Delhi. "It's initial days of the drive, and it will take time, but people's confidence will be increased and it will pick up. As a government, we are also taking all the steps to push up their confidence level," he said.

Asked if technical issues with CoWIN app, was also a factor, he said, the app is "creating hurdles" at times. "Sometimes, it is not working, and it has not stabilised yet," Jain said, adding, no plan to do the job manually. Co-Win is an online platform for monitoring COVID-19 vaccine delivery. "There were some glitches in the app at our hospital. We expect the number to increase during the course of the drive," said Suresh Kumar, medical director of LNJP Hospital.

N K Ganguly, former director-general of Indian Council of Medical Research, said the numbers will increase gradually as people become "well-informed" about the vaccines. On January 16, the Resident Doctors' Association of the Ram Manohar Lohia Hospital had requested the hospital to vaccinate them with Serum Institute's Covishield instead of Covaxin. The association wrote a letter and said the doctors were a bit apprehensive about Covaxin due to the lack of a complete trial. Those taking Covaxin are asked to sign a separate consent form, acknowledging that the jab is being administered without the phase-3 trial.