Booking a vaccination slot in India
Since January 2021, the Indian government has faced a rather daunting task: the need to immunize 1.3 billion people, or about one sixth of the world’s population. Technology has been both a catalyst and an obstacle in this process.
At 4 p.m. on April 28, 2021, the Indian government opened vaccine registration for people between the ages of 18 and 45. Over 10 million people signed up in 8 hours, causing CoWIN, which is the Indian government’s vaccine reservation portal, to Plant.
The CoWIN portal was part of a mobile application called Aarogya Setu, which was designed for contact tracing of people with COVID-19 from March 2020. It was supposed to help people book a vaccination center, help people record their vaccination data, and remind them of their next one dose.
However, there were some glitches.
When Indian vaccines were rolled out to the elderly and people with co-morbidities, issues ranged from not receiving text alerts after receiving a vaccine to issues with slot reservations. There were also concerns that it was not scalable, especially when vaccinations opened up to a larger segment of the population.
Dr Ram Sewak Sharma, Director General of the Indian National Authority, said in an interview with the Economic times that the platform existed because the government was focused on using technology to boost healthcare.
“The CoWIN platform is enabled with real-time monitoring of vaccine data. From vaccine registration to issuance of vaccination certificates, our system is fully prepared and activated with the right technologies. The system is highly scalable, ”he said.
However, for many Indians, planning their vaccines has been a very frustrating experience.
For security reasons, the CoWIN website automatically logs users out 15 minutes after logging in. A person needs to register with photo ID and reserve their slot fairly quickly.
“Although the website user interface is correct, (navigation) is difficult because you have to constantly refresh the page to see the updated information (vaccine availability)”, Ranjini Rao, professor of marketing communications at Commits College from Bengaluru, India, Told Medical News Today.
In early May, the Indian government declared that walk-in vaccinations would not be allowed for people between the ages of 18 and 44, making registration on CoWIN mandatory. This was to ensure that people maintain an appropriate physical distance in vaccination centers, authorities said.
However, the reality was quite different. When Rao was able to book a slot for her and her husband at Bowring Hospital in Bangalore, the slot was scheduled from 3 p.m. to 6 p.m. “When we arrived after an hour’s drive, we were shocked. The line snaked from the first floor to the sixth! It was a super-spreading event, this vaccination campaign. Fearing that they would be exposed to the virus, the couple left.
For many people, the registration process was fairly straightforward. However, many did not go as far as Rao, as booking a time slot for the vaccination proved impossible.
“I started calling it the Grand Bet,” said Rumela Basu, a Kolkata-based freelance writer.
She visited the CoWIN website throughout the day, but slots were always full in centers around her home. After a week, she decided she needed expert help.
Tech startups and anonymous technicians fill the gap at CoWIN
After India rolled out the CoWIN platform for the over-18s, techs and tech startups across the country jumped into action, trying to help people book slots faster.
Many of them, like Chandra (who prefers to have a name), have worked anonymously and for free. Chandra is studying computer science at college, but has been home for several months on an extended break due to COVID-19 quarantines. So, to help people, he created a bot on Twitter called the Vaccine update in Bangalore.
“What we are doing is perfectly legal,” he said. MNT. “Vaccination windows in hospitals do not open all at once. So the bot I built continues to crawl the CoWIN website and Aarogya Setu app every 1.35 seconds, checking for these new openings and sending alerts to people who have signed up.
With slots disappearing seconds after opening, these notifications can give people an edge when trying to book vaccines.
Basu also registered on Less than 45.in and getjab.in. These are popular vaccination services that also track time slots and alert users to availability by sending messages through Telegram and email. However, even that didn’t seem to help.
Whenever she received an alert, she would immediately log into CoWIN and enter her state and district information to check available slots. She did it all in under a minute, she said, but the slots were already full. Soon, finding a niche became an obsession.
“I connected to CoWIN in the shower, during breakfast, leaving behind a half-eaten lunch. There were times when I gave a little cry in the middle of a conversation with my family at tea time or just when we were seated, surprising everyone because there was an alert.
– Rumela Basu
Others who have used the CoWIN website have also complained about the disappearance of the slots, which some attributed to high demand for vaccines and a shortage of supplies.
However, it is not possible to rule out technical difficulties, said Basu. “Sometimes you would see a number in yellow indicating that there is a slot, but within 5 seconds of putting in the captcha / code to reserve it, it looks like the vaccination center is full.”
Once, a new vaccination center in the Basu neighborhood reported that it had over 100 vaccines available, and yet, when it went online, there were no slots. When she refreshed the page and returned to it, the number of available vaccines remained unchanged, showing that the slots were still not full. She found it confusing, she said.
Even as urban and educated populations struggle with the CoWIN platform, many expect the situation to deepen the country’s already asymmetric digital divide, making immediate access to a vaccine even more difficult for the multitude of rural poor. from India.
“While there is a need for a technological backbone like CoWIN that can help us record and track immunization data, there are also some challenges that need to be overcome,” said Dr. Anant Bhan, bioethics researcher and global health and visiting professor at Yenepoya University in Mangaluru, India.
Lack of flexibility has been one of the main obstacles in the third phase of India’s vaccination campaign. “If people can access the vaccine only through such a digital platform, then this approach would exclude or make it very difficult for a significant part of the population. There is also a gender divide. Poorer women are less likely to access technological devices, ”he said. MNT.
However, some changes have recently taken place to help improve access. Since mid-May, CoWIN has been available in 14 Indian languages. Previously he only used English.
On June 15, 2021, the Ministry of Health announced that registration without appointment would become authorized, waiving the need for reservations. Now people over 18 can get vaccinated by going to vaccination centers, just as older adults did in the previous campaign.
According to data released by the Ministry of Health, nearly 55% of the 211.8 million doses administered until May 29, 2021, took place during walk-in visits. Authorities have now asked more than 250,000 community service centers, which are India’s primary health care centers, to help rural citizens register.
On June 21, 2021, India recorded its highest daily vaccination rate: 8.1 million doses, or 2.5 times the daily average. However, these figures are not consistent. They dropped to just over half, or about 5 million doses, the next day.
Technological limitations risk becoming “an obstacle to life-saving vaccines”
Basu finally got the vaccine during a private drive organized at her boyfriend’s housing company on June 3, 2021, about a month after trying to book his slot. There was an appropriate physical distance with a few doctors overseeing the process, and she paid for the vaccine.
The vaccine would have been free if she had managed to reserve it at a vaccination center. Still, it was a relief to finally receive vaccination certificates, she said.
As the delta variant tears communities apart in India and around the world, there is no more time to tackle slow vaccination efforts, public health experts say.
“A lack of access to technology should not become a barrier to life-saving vaccines, especially when the intention [is] to improve coverage and immunize as many people as possible now, ”said Dr Bhan.
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